Tele-Dance Interventions for Health Outcomes: A Scoping Review

Abstract

Introduction:

The rapid expansion of telehealth, particularly during the COVID-19 pandemic, accelerated the development of technology-mediated movement interventions to support physical and psychological health. Among these, tele-dance interventions (TDI) emerged as accessible and scalable models of care; however, a comprehensive synthesis of the evidence supporting these interventions remains limited. This scoping review maps existing literature on the feasibility, acceptability, and health-related outcomes of TDI across diverse populations.

Methods:

Guided by Arksey and O’Malley’s framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines, we conducted a systematic search of 6 electronic databases and identified 26 eligible studies employing quantitative, qualitative, or mixed-methods designs. Methodological quality was appraised using the Mixed Methods Appraisal Tool. All interventions were delivered synchronously via videoconferencing platforms and were primarily adapted from established in-person dance programs, typically incorporating warm-up activities, structured or improvisational movement, and cool-down phases.

Results:

Across studies, TDI were consistently feasible and well accepted among older adults, individuals with neurological conditions, and people living with chronic illness. Psychosocial benefits, including enhanced social connection, improved mood, and reduced loneliness, were commonly reported. Physical outcomes such as improvements in balance, gait, and strength were also observed, suggesting potential functional benefits relevant to rehabilitation and health promotion.

Conclusion:

TDI offer important advantages, including increased accessibility, flexible delivery formats, and scalability beyond in-person care. However, limitations include methodological heterogeneity, small sample sizes, underrepresentation of diverse populations, and limited long-term follow-up. Overall, TDI represent a promising telehealth modality, warranting future research emphasizing methodological rigor, inclusive design, hybrid delivery models, and implementation-focused evaluations.

Keywords

tele-dance interventions telehealth dance-based intervention physical and psychosocial health

Introduction

Dance has long been recognized as a powerful, multifaceted modality that advances physical and psychological well-being across the lifespan. As both artistic expression and purposeful physical activity, it blends aerobic and anaerobic exertion, rhythm and musicality, creativity and improvisation, and inherently social interaction, offering a distinctive route to health promotion.^1,2 Within this broad umbrella, therapeutic dance refers to structured or improvisational movement practices drawn from varied dance styles to support physical wellness and emotional expression, whereas dance/movement therapy (DMT) is a psychotherapeutic modality that intentionally harnesses movement, creative process, and the therapist–client relationship to meet clinical goals.³

Accumulating evidence shows that dance can enhance psychomotor functioning,^4,5 elevate mood, and reduce distress,⁶ support cognitive processes such as attention and executive function,⁷ and improve overall quality of life.⁸ These benefits have been reported across clinical and nonclinical groups, including people living with Parkinson’s Disease (PD), cancer, and age-related decline,^9,10 as well as children and adolescents, for whom dance has been associated with gains in physical health (e.g., cardiovascular fitness, bone health) and psychosocial well-being (e.g., reduced anxiety and improved body image).^11–13 Meta-analytic work further indicates that dance is at least as effective as, and sometimes superior to, structured exercise programs on a range of health outcomes,¹⁴ underscoring its promise as a whole-person intervention.

Historically, most dance programs have been delivered in person, either individually or in groups. Yet the rapid expansion of digital technologies—accelerated by the COVID-19 pandemic—has pushed many health-promoting and arts-based interventions online.^15–18 For dance specifically, synchronous (live, interactive) delivery is especially salient: the art form relies on moment-to-moment attunement, shared rhythm, mirroring, and immediate feedback, elements that asynchronous or purely self-guided formats may only partially capture. At the same time, tele-delivery can mitigate longstanding barriers to participation, such as transportation challenges, geographic isolation, scheduling constraints, or mobility limitations—factors that disproportionately affect older adults and those with chronic conditions. Prior telehealth research suggests that real-time, supported digital interventions can achieve high adherence and outcomes comparable with face-to-face care.^19–22

Despite this momentum, most reviews of telehealth-supported physical activity still center on generalized exercise or fitness programs,^23,24 leaving a gap in our understanding of how dance—an embodied, relational, and expressive modality—translates to live digital environments. Furthermore, the effectiveness of synchronously delivered telehealth dance interventions remains largely unexamined. Given the inherently embodied and relational nature of dance—an art form that is moment-to-moment, ephemeral, and deeply rooted in shared presence and interpersonal connection—real-time interaction may be particularly critical to preserving the therapeutic and expressive qualities of dance in virtual formats. Moreover, the field lacks an integrated picture of who is being served by tele-dance interventions (TDI), how interventions are being delivered (e.g., platforms, formats, facilitator types), what outcomes are being measured (e.g., physical, psychosocial, feasibility), and with what quality the studies are conducted. Questions about feasibility (e.g., technology barriers, adherence), acceptability (e.g., satisfaction, preference for online vs. in-person), safety, and long-term sustainability also remain underexplored—particularly outside the exceptional context of pandemic-related restrictions. To address these gaps, this scoping review synthesizes emerging literature on TDI aimed at promoting physical and/or psychosocial health.

Guided by Arksey and O’Malley’s framework¹⁵ and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR),²⁵ we mapped the characteristics of interventions (populations, settings, delivery methods, components), summarized feasibility and acceptability findings (including adherence, safety, and technology issues), and described reported physical and psychosocial outcomes. We included quantitative, qualitative, and mixed-methods studies to capture the breadth of evidence and illuminate how different methodological traditions have approached tele-dance. Finally, we identified methodological limitations, conceptual and practical gaps, and directions for future research, such as hybrid delivery models that integrate the accessibility of telehealth with the embodied richness of in-person dance.

Methods

DEFINITION

For this review, we defined TDI as any dance program, encompassing a variety of styles, delivered remotely in a synchronous manner. This delivery occurs between a patient or client and a dance intervention provider through a digital technology platform that facilitates live streaming or interactive communication.

SEARCH STRATEGY

The research team conducted a multi-stage systematic literature search following PRISMA-ScR guidelines. The initial search strategy was developed in consultation with a research librarian (SP) and conducted in March 2022 across six databases: PubMed, Scopus, Web of Science, IEEE Xplore, ACM Digital Library, and SPORTDiscus. Searches were limited to English-language publications. Search terms combined concepts related to dance and movement-based practices with technology-mediated or remote delivery, including: (dance OR ballet OR zumba OR flamenco OR tango OR “creative movement” OR “dance movement therapy” OR “dance therapy” OR five rhythms OR hip-hop OR breakdancing)* AND (technology OR virtual OR “remote delivery” OR computer OR digital OR “video conference*” OR video OR online OR telehealth OR synchronous OR telemedicine OR “internet-based” OR tele* OR Zoom OR Skype)*. The search strategy was translated and adapted for each database to accommodate differences in controlled vocabulary and syntax. Reference lists of key articles were also manually screened.

The initial search identified nine eligible studies, which were considered limited given the rapid expansion of telehealth research during and following the COVID-19 pandemic. Therefore, the identical search strategy was repeated in July 2024, with updated syntax where applicable and date limits applied from April 2022 to July 2024. This updated search yielded 16 additional eligible studies. To ensure the currency of the evidence, a final supplementary search was conducted in December 2024, identifying one additional eligible study.

Records from all search stages were pooled and deduplicated prior to screening. Titles and abstracts were screened for relevance, followed by full-text review using consistent eligibility criteria across all search waves. Screening, full-text review, data extraction, and methodological appraisal for newly identified records were conducted using the same procedures established in 2022. In total, 26 studies met the inclusion criteria and were included in the final scoping review.

SELECTION OF ARTICLES

Articles were eligible if they met the following criteria: written in English; reported primary research using quantitative, qualitative, or mixed-methods designs; and described a telehealth-based dance intervention aimed at promoting physical and/or psychosocial health outcomes. No restrictions were placed on the dance genre. To ensure a minimum evidentiary standard, only primary studies published in peer-reviewed journals were included.

We excluded articles that: (a) examined dance interventions delivered exclusively through asynchronous methods (e.g., prerecorded videos such as YouTube classes); (b) focused solely on online or video game–based movement without human facilitation (e.g., Dance Dance Revolution, Wii Fit); (c) described technical or professional dance training rather than health-related interventions; or (d) provided only anecdotal descriptions without empirical analysis of outcomes. After removing duplicates, two reviewers independently screened titles and abstracts for relevance. Full texts of potentially eligible studies were then assessed against the predefined criteria to determine final inclusion.

DATA EXTRACTION

All data were reviewed and extracted by two reviewers in a standardized manner using a purposefully designed template. The following data were extracted from the studies: first author, year of publication, country, study design, study population (sample size, age, gender), intervention characteristics (duration, frequency, intervention components, dance style, delivery platform, and control/comparison group), all outcomes measured, and key findings. Extracted data were checked by the first author, and any disagreements were resolved by discussion and consensus. Data were descriptively analyzed and presented narratively in relation to the review questions.

ASSESSMENT OF METHODOLOGICAL QUALITY

The methodological quality of the included studies was assessed using criteria adapted from the Mixed Methods Appraisal Tool (MMAT),²⁶ which is designed for use in systematic reviews incorporating qualitative (QUAL), quantitative (QUAN), and mixed-methods (MM) studies. The MMAT includes design-specific criteria for QUAL, QUAN randomized controlled trials (RCTs), QUAN nonrandomized studies, and MM designs, enabling appraisal of methodological features relevant to each study type.

Each criterion was independently rated by two reviewers as “yes,” “no,” or “unclear.” Consistent with common practice, one point was assigned only when both reviewers rated a criterion as “yes.” Although the MMAT developers advise caution in generating overall numeric scores, summary ratings were used in this review to facilitate comparison across studies. Given the absence of a definitive cutoff, we classified quality into three levels for descriptive purposes: low (1–2), medium (3–4), and high (5).

ANALYSIS AND SYNTHESIS OF THE RESULTS

The included studies were classified as QUAL, QUAN, or MM by three reviewers, based on the study design identified by the study authors and on the nature of the findings.²⁷

Results

STUDY SELECTION AND CHARACTERISTICS

The first two searches via databases identified 6,548 studies. After duplicates were removed, the resulting 2,821 citations were screened by reviewing their titles and abstracts. A total of 2,708 citations were excluded, resulting in 113 citations potentially meeting eligibility criteria. A total of three reports were sought for retrieval. Of these, 112 full texts were obtained and reviewed, while one could not be retrieved. After reviewing the full-text articles, 87 studies were further excluded. Articles were reviewed but excluded for reasons such as: being in-person rather than tele-based; not involving a dance intervention; utilizing video game or VR platforms; focusing on general fitness programs; targeting dance technique improvement rather than health outcomes; being review articles; employing asynchronous delivery formats; or primarily reporting process evaluations. The third search, conducted in December 2024, identified one additional study. Across all searches, 26 articles published between 2016 and 2024 were included in the final analysis, representing a total sample size of 942 participants. The overall study selection process is depicted in the PRISMA flow diagram ( Fig. 1 ).

Fig. 1.

PRISMA flowchart. PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses.

OVERVIEW OF INCLUDED STUDIES

Table 1 summarizes the characteristics of the 26 TDI studies included in this review. Fourteen employed QUAN designs (54%), five were QUAL (19%), and seven used MM approaches (27%). Among QUAN studies, four were RCTs, six were nonrandomized, and four were descriptive. Most QUAL studies utilized thematic analysis,^32,34,36,52 with the exception of Shim et al.,⁴⁸ which adopted a framework analysis approach. MM studies primarily used single-group pre–post designs, except for Seidler et al.,⁴⁷ which employed a two-arm quasi-experimental design comparing in-person and telehealth delivery formats. Humphries et al.³⁷ and Rugh et al.⁴⁶ shared a common study protocol but investigated distinct research questions. Studies were primarily conducted in the United States (n = 9), followed by the United Kingdom (n = 4), Australia (n = 3), Canada (n = 3), Brazil (n = 2), and one study each from Germany, Denmark, India, Japan, and Sweden.

Table 1.

General Characteristics and the Intervention Components of the Included Studies

STUDY ID AND COUNTRY	AIM	STUDY DESIGN	POPULATION (MEAN AGE, % FEMALE)	PLATFORM AND CAMERA ENGAGEMENT	DOSE AND DURATION	SPECIFIC PROGRAM NAME, INTERVENTION DEVELOPMENT CONTEXT, AND COMPONENT	DANCE STYLE
Anderson et al., 2024²⁸ USA	Feasibility of online dance program for children and adolescents with developmental disability	QUAN–RCT (expressive movement initiative vs. WLC)	Children and adolescents with neurodevelopmental disabilities N = 43 (8.63, 39)	- Zoom -Required	10 weekly 60-min sessions	- Expressive movement initiative -PA -Warm-up, movement games, synchronous play -Group and one-on-one sessions alternated weekly	Ballet, choreography-based dance movement
Bek et al., 2021²⁹ Australia	Feasibility of home-based dance program for PwPD	QUAN–descriptive (cross-sectional)	Older adults with PD N = 276 (NR) -Current users: 178 (69.5, 75.8) -Nonusers: 98 (67.8, 73.5)	- NR -Optional	Varied (weekly ∼2 ≥ weekly for a few weeks to several years)	- Dance for PD®, Silver Swans -PA -Streamed live classes + prerecorded videos and DVDs	Jazz, ballet, tango, dance theater, freestyle, and choreography
Bryl et al., 2024³⁰ USA	Patient-reported benefits and satisfaction with virtual DMT	MMR–explanatory sequential design (program evaluation)	Adults postcancer N = 39 (64.7, 89.7)	- IM@Home, Zoom -Optional	6 weekly 60-min sessions	- PA -Check-in, warm-up, structured and freestyle expressive movement, cool-down, closure, and social connection	Structured and unstructured dance movement within DMT context
Chen et al., 2024³¹ Canada	Effect of online dance classes for fall prevention in older women	QUAN–quasi-experimental (single-arm pre-, mid-, posttest)	Women 65+ years N = 16 (74.38, 100)	- Zoom -Required	12 weeks, 2×/week, 75-min each	- PA -Warm-up, ballet and modern exercises, and stretch recovery	Ballet, modern
Delabary et al.,, 2024³² Brazil	Impact of Brazilian dance on the quality of life of PwPD before and during COVID-19	QUAL–description	PwPD 50+ years N = 14 (71.1, 64)	- WhatsApp, Zoom -NR	2 weekly 60-min sessions (exact duration NR)	- PA -Warm-up, improvisation and gestures, cool-down	Brazilian dance, improvisation, choreography
Ghanai et al., 2021³³ Canada	Effect of single online dance session on mood in PwPD	QUAN–quasi-experimental (single-arm pre- to posttest)	PwPD N = 22 (68, 77.3)	- Zoom -Optional	1 session (length NR)	- Dance for PD® -PA -Introduction, warm-up, step sequences, paired dance, improvisatory movement, closing	Jazz, ballet, Argentinian tango, dance theater, improvisation, choreography
Hansen et al., 2024³⁴ Denmark	Benefits of online dance intervention on mental and physical health outcomes for older women	MMR–convergent parallel design (single-arm pre- to posttest)	Older women N = 45 (74, 100)	- Zoom -NR	12 weeks of 2 sessions/week, at 75-min	- Breathing, improvisation/contemporary dance, salsa, cool-down	Improvisation, salsa
Harrison et al., 2024³⁵ USA	Effects of virtual ballet on gait, fall risk, mood, and life satisfaction in older adults	QUAN–RCT (ballet vs. wellness group)	Women 55+ years Ballet: N = 21 (67.81, 100) Wellness: N = 23 (69.96, 100)	- Zoom -Required	12 weeks of 2 sessions/week, at 45-min	- PA -Ballet group: greeting, stretching, and mobility exercises, ballet barre, walking exercises, reverence -Wellness group: greetings, presentation on health, discussion, closing remarks	Ballet
Horne et al., 2024³⁶ UK	Feasibility of an online dance-based PA intervention for caregivers	QUAL–description	Adult caregivers N = 6 (54, 100)	- Zoom -NR	6 weekly 60-min sessions	- PS -Live or recorded session -Seated upper- and lower-body movements, seven songs/dances from different regions and eras, freestyle dance, cool-down	Conditioning and somatic movement
Hubner et al., 2023 Germany	Feasibility of digital ballroom dancing course	QUAN–descriptive	Adults w/ cancer + caregivers N = 65 (NR, 56.9)	- NR -NR	12 weekly 60- to 70-min sessions	- PA -Introduction, ballroom dance training, goodbyes	Ballroom dance: standard and Latin American dances
Humphries et al., 2023³⁷ USA	Effects of a single online dance class on mental health and social connectivity during COVID-19	QUAN–quasi-experimental (single-arm pre- to posttest)	Healthy adults N = 47 (32.47, 91)	- Zoom -Required	Single 60-min session	- PS -Choreography, performance, and observation	Modern, ballet, jazz
Hyodo et al., 2023³⁸ Japan	Feasibility and acceptability of a web-based aerobic dance exercise program for older adults	QUAN–descriptive	Older adults N = 16 (77.6, 75)	- Zoom -NR	20-min/day × 5 days for 8 weeks (37 sessions)	- Slow aerobic dance exercise -PS -Warm-up, upper-body dynamic movements, cool-down	Light-intensity aerobic dance
Kosurko et al., 2022²² Canada	Effect of multimodal dance program on social inclusion	QUAL–description	Older adults; dementia dyads; LTC staff; community facilitators; volunteers N = 289 (NR)	- NR -NR	8 weekly sessions (session length NR)	- Sharing dance older adults -PA -Activities targeting physical awareness, mobility, coordination, strength, and expression	NR
Krampe et al., 2016³⁹ USA	Feasibility of engaging older adults in healthy-steps via Fuze videoconferencing	QUAN–descriptive	Older adults (residents of an assisted living facility) N = 28 (NR) Older adults: 14 (77, 60); nursing students: 14 (NR)	- Fuze -Required	Single 45-min session	- Lebed method/healthy-steps -Warm-up, movements for strengthening, flexibility, ROM, improving balance, cool-down, and group sharing	Guided creative movement
Macdonald et al., 2022⁴⁰ Australia	Feasibility/acceptability of a 16-week classical ballet intervention for breast cancer survivors, delivered face-to-face and/or online	QUAN–non-RCT	Breast cancer survivors N = 29 (53, 100)	- Zoom -NR	16 weeks of 2 sessions/week, at 60-min	- PA -Warm-up, ballet-based barre exercises, standing, jumping, balancing, traveling and turning combinations, cool-down	Ballet
Millman et al., 2023⁴¹ UK	Effect of BA vs. dance exercise for DDD symptom reduction and interoception/mindfulness, and examination of related symptom associations	QUAN–RCT BA vs. DE DDD group vs. healthy control	Individuals with DDD N = 60 (NR) DDD: 31 (32.97, 68); Control: 29 (31.8, 72)	- Zoom -NR	6 days BA (20-min) or DE (15-min) + check-in +6 days; 4- to 6-week washout; crossover	- PA -BA: warm-up and structured dance movement using guided imagery for bodily awareness; DE: warm-up, learning a short and simple dance phrase	Dance/movement tasks designed within the framework of DMT
Moo et al., 2023⁴² UK	Benefits and challenges of tele-DMT with children with ASD	MM intervention design–quasi-experimental (single-arm pre- to posttest)	Children with ASD N = 10 (24.3, 60)	- Zoom -Required	6 weekly sessions at 45 to 60-min	- PA -Warm-up, mirroring, instructive segment of relationship plays, parent–child dyads	Mirroring, improvisation, and developmental movement, or relationship play in the context of DMT
Morris et al., 2021⁴³ UK	Feasibility and impact of online therapeutic dancing classes for PwPD	MM intervention design–quasi-experimental (single-arm pre- to posttest)	Adults with PD N = 12 (58, 75)	- Zoom -Unclear	8 biweekly sessions at 60-min	- ParkinDANCE -PA -Warm-up, active dance and personalized exercise, cool-down	Tango, Irish, tap, salsa, waltz
Pandya et al., 2024⁴⁴ India	Impact of online dance sessions on body image, body (dis)satisfaction, and well-being of women with disabilities	QUAN–quasi-experimental (dance vs. WLC, pre- and posttest)	Women with physical disabilities N = 98 (IG1: 29.34, 100; CG1: 28.96, 100; IG2: 30.06, 100; CG2: 29.15, 100)	- Zoom -NR	30-min live + async homework, 2×/week for 20 weeks	- NPP -Warm-up and choreography -Biweekly asynchronous homework	Choreographed dances illustrating five narratives of body appreciation and self-image
Pinto et al., 2023⁴⁵ Brazil	Feasibility and effects of an online dance program for older adults with and without PD	QUAN–quasi-experimental (older adults with vs. without PD)	Adults 45+ years with and without PD N = 26 PwPD N = 12 (69, 83.3) Pw/oPD N = 14 (69, 92.9)	- Zoom -NR	8 weeks of 2 sessions/week, at 60-min	- Dance for PD® -Greetings, seated full-body movements, standing with support, cool-down/farewell	Ballet, modern dance, jazz, tap, samba, salsa, tango
Rugh et al., 2022⁴⁶ USA	Impact of online dance on mental health and social connection across varied dance backgrounds and learning styles	Mixed-methods intervention design–quasi-experimental (single-arm pre- to posttest)	Healthy adults N = 47 (32.47, 91)	- Zoom -Required	Single 60-min session	- Dance for PD® -Warm-up, technique, choreography, and improvisation	Jazz, ballet, and contemporary
Seidler et al., 2017⁴⁷ USA	Feasibility of virtual group tango for PwPD and comparison with in-person classes	QUAN–quasi-experimental: non-RCT (tele-rehab vs. in-person)	PwPD N = 20 (NR, 55) Tele-rehab = 10 (68.1, 60) In-person: 10 (68.9, 50)	- Zoom -Required	12 weeks of 2 sessions/week, at 60-min	- NPP -Warm-up, rhythm and partner work, practice of new step plus integration with previously learned patterns, and cool-down	Modified Argentine tango
Shim et al., 2024a⁴⁸ USA	Explore participants’ lived experiences and perceived psychological and social effects of M-DMT among older adults with MCI	Qualitative intrinsic case study	Older adults with MCI N = 2 (70.5, 50)	- Zoom -Mandatory	12 weekly 60-min sessions	- Mindful movement -PS -Check-in and warm-up, movement-based interactions related to main theme, group discussion, and closure -Live session + asynchronous daily practice	Mindfulness-based DMT (semi-structured and self-guided movements through mindfulness and DMT techniques)
Shim et al., 2024b⁴⁹ USA	Feasibility, acceptability, and preliminary effects of M-DMT on loneliness and psychological well-being in older adults with MCI	Mixed-methods intervention design (single-arm pre- to posttest)	Older adults with MCI N = 16 (70.88, 68.8)	- Zoom -Mandatory	12 weekly 60-min sessions	- Mindful movement -PS -Check-in and warm-up, movement-based interactions related to main theme, group discussion, and closure -Live session + asynchronous daily practice	Mindfulness-based DMT (semi-structured and self-guided movements through mindfulness and DMT techniques)
Tunçgenç et al., 2024⁵⁰ UK	Impact of an online hip-hop dance program on adolescents’ social bonding, well-being, and future orientation	QUAN–RCT (online dance vs. WLC)	Adolescents from the general population N = 58 (13, 89.7)	- Zoom -Cameras encouraged (optional)	5 weekly 60-min sessions	- PS -Warm-up, hip-hop choreography, creative pose tasks in breakout rooms, peer sharing, discussion	Hip-hop/street-style choreography
Walton et al., 2022⁵¹ Sweden	Feasibility/safety, psychosocial effects, and participant experiences of digital home-based dance for PD	Mixed-methods intervention design–quasi-experimental (single-arm pre- to posttest)	Adults with PD N = 58 (13, 89.7)	- Zoom -Mandatory	10 weekly 60-min sessions + optional social time before/after	- Dance for PD®-PA -Warm-up, seated upper- and lower-body dance movements, improvisation and choreography, cool-down exercises	Ballet, flamenco, contemporary dance, theatrical interpretation, improvisation, and choreography

ASD, autism spectrum disorder; BA, body awareness; BPM, beats per minute; CM, creative movement; DDD, depersonalization–derealization disorder; DE, dance exercise; DMT, dance/movement therapy; MCE, mutual camera engagement; MCI, mild cognitive impairment; M-DMT, mindfulness-based dance/movement therapy; MMR, mixed-methods research; NPP, nonpandemic protocol; NR, not reported; PA, pandemic adapted; PD, Parkinson’s disease; PS, pandemic specific; QUAL, qualitative; QUAN, quantitative; RCT, randomized controlled trial; TH, telehealth; WLC, wait list control.

Publication trends indicate a gradual increase in TDI studies before 2020, followed by a sharp rise during and after the COVID-19 pandemic, culminating in peak publication activity in 2024 ( Fig. 2 ).

Fig. 2.

Number of Studies by Year.

STUDY POPULATIONS

Studies represented diverse populations across the lifespan ( Fig. 3 ): 14 studies (54%) included individuals with neurological or age-related cognitive conditions, 7 of which focused specifically on Parkinson’s disease. Five studies (19%) involved healthy older adults, three (12%) targeted individuals affected by cancer, and four (15%) focused on healthy adults. Three studies (12%) examined children or adolescents, including those with autism or developmental disabilities, and adolescents participating in an online group dance program. The remaining studies addressed women with physical disabilities, adult caregivers, and adults with depersonalization–derealization disorder.

Fig. 3.

Participant Populations.

Participant ages spanned from early childhood to older adulthood (mean ages 8.6–77.6 years), although most studies (approximately 85%) focused on adult or older adult populations. Among the 24 studies reporting gender, participants were predominantly female (median 73%). Sample sizes ranged from 2 participants to 289. Ten studies (38%) did not report participants’ race or ethnicity. Nearly three-quarters of the studies (73%) were conducted during the COVID-19 pandemic, contextualizing the prominence of remote delivery approaches.

INTERVENTION SETTINGS AND DELIVERY FORMATS

Most interventions (92%) were delivered in group-based formats, often emphasizing collective movement, social engagement, and shared expressive experience. Only a small number of studies incorporated individual or dyadic components to accommodate specific populations (e.g., children with autism or developmental disabilities). Across studies, group delivery remained the predominant format regardless of age group, clinical condition, or dance genre. Four studies (15%) offered single-session interventions, whereas the remainder implemented multiweek programs lasting between 6 and 20 weeks. Interventions were primarily led by dance instructors or multidisciplinary teams, and five studies (19%) explicitly identified credentialed dance/movement therapists as facilitators or framed the program as DMT-based.

DANCE PROGRAM CHARACTERISTICS BY POPULATION

Dance program structures varied based on the target population and intervention goals. Programs for older adults incorporated ballet, modern dance, aerobic movement, improvisational tasks, and mindfulness-based DMT. Session lengths ranged from brief 20-minute daily practices to biweekly 75-min classes delivered over 12 weeks, reflecting wide flexibility in dosing and structure. Programs for individuals with PD frequently adapted the Dance for PD® curriculum, integrating warm-ups, choreographed sequences, improvisation, and expressive movement. Session durations varied from single 20-min introductory classes to twice-weekly 60-minute sessions delivered over extended periods ranging from 6 weeks to 12 months.

Cancer-focused programs employed either ballet or DMT-based frameworks, emphasizing gentle movement, expression, and embodied coping. These programs typically involved 45- to 75-min sessions delivered once or twice weekly across 6–16 weeks. Interventions for individuals with other clinical conditions, such as neurological or psychological disorders, similarly integrated expressive movement, structured choreography, and mindfulness-informed practices. Programs involving children, adolescents, and individuals with developmental disabilities emphasized attunement, mirroring, playful movement exploration, and structured or semi-structured choreography to support social engagement and communication. These interventions were generally offered once weekly for 6–10 weeks, with session lengths of 45–60 min and occasional use of individual or dyadic formats to accommodate participant needs.

Finally, programs for women with physical disabilities employed choreographic narratives and expressive movement themes within 60-min, twice-weekly sessions delivered over 20 weeks. Across all populations, session content commonly combined structured dance elements (e.g., warm-ups, choreography, technique-based sequences) with improvisation, creative tasks, and group reflection.

DELIVERY PLATFORMS AND SETTING

Zoom was the dominant delivery platform (88%), with Fuze and Acrobat Connect each used once, while three studies (12%) did not specify the platform. Six studies (23%) employed multimodal delivery, combining live-streamed and prerecorded content with in-person interactive components. Intervention settings included at-home participation, residential facilities with remote instruction, and hybrid arrangements in which participants gathered in shared physical spaces with remote facilitation. Camera-use policies varied: 11 studies (42%) required cameras to remain on, 2 studies (8%) explicitly permitted optional camera use, and the remaining studies (50%) did not specify their expectations.

DATA COLLECTION METHODS

Across the included studies, quantitative data were obtained using standardized self-report instruments (n = 8), study-specific questionnaires (n = 5), and structured logs (n = 12). Physical performance data were collected in six studies^{31,34,35,40,47,51} through objective assessments such as gait velocity, sit-to-stand tests, 6-minute walk tests, and upper-limb mobility measures. Twelve studies administered validated mental health and psychosocial questionnaires. Qualitative data were collected through interviews, focus groups, and open-ended survey responses, allowing for exploration of participants’ subjective experiences.

STUDY OUTCOMES AND FINDINGS

The studies evaluated a diverse array of outcomes, including feasibility and acceptability of TDI, physical and cognitive functioning, and psychosocial benefits ( Table 2 ). Below are summarized results organized by specific outcome categories.

Table 2.

Summary of Feasibility, Outcomes, and Delivery Experience

STUDY	FEASIBILITY/ACCEPTABILITY	PHYSICAL OUTCOMES	PSYCHOSOCIAL OUTCOMES	TECHNOLOGY ISSUES	SAFETY	FORMAT PREFERENCE
Anderson et al., 2024²⁸	High feasibility; good attendance (82.6%); strong engagement	↑ Dynamic motor skills (p = 0.05, d = −1.50); positive trend overall	No significant group differences: both showed positive trends in social communication and motivation	No major tech issues beyond routine Zoom adjustments	No adverse events	—
Bek et al., 2021²⁹	High acceptability: 95% reported benefits; adherence not quantified	Self-reported ↑ in balance, posture, mobility, energy, movement confidence, sleep	↑ Mood, ↑ confidence; ↓ anxiety; ↓ social connection vs. in-person classes	Intermittent AV/connection issues; generally manageable	No adverse events	Preferred live classes; strong interest in hybrid models
Bryl et al., 2024³⁰	High acceptability (100% satisfaction); moderate adherence (∼49% attended ≥ 3/6 sessions)	↑ Physica activity (NS, p = 0.06, d = 0.39); qualitative ↑ strength, flexibility, balance, energy	↓ Anxiety (p = 0.009, d = −0.56); distress (p = 0.04, d = −0.43); ↑ joy (p = 0.004, d = 0.61); strong creative expression and social connection	Minimal tech issues: optional camera use valued	No adverse events	—
Chen et al., 2024³¹	High feasibility (87.5% attendance; 62.5% completed ≥ 80% of classes)	↑ Dynamic balance (p = 0.008–0.009); ↑ plantarflexor strength (p = 0.015–0.020); no change in postural stability or sit-to-stand	No significant changes in SF-36 general health	No tech issues reported	No adverse events	—
Delabary et al., 2024³²	High acceptability; sustained participation pre- and mid-pandemic	Self-reported ↑ balance, gait, agility, energy, ↓ stiffness; 71% ↑ physical well-being	57% ↑ emotional well-being; 64% ↑ friendship/social connection; ↑ motivation and confidence	Connectivity issues, audio/video lag, intermittent setup difficulties	No adverse events	Preference for in-person; online acceptable during COVID
Ghanai et al., 2021³³	Moderate–high feasibility; ∼64% of pre-COVID participation maintained	—	↓ Negative affect (p = 0.010, d = 1.27); ↑ positive affect (p = 0.006, d = 1.32); ↑ combined affect (p = 0.006, d = −0.04); ↑ overall mood (p < 0.001)	Internet instability for some; occasional video interruptions	No adverse events	∼62% preferred in-person; minority preferred online for convenience
Hansen et al., 2024³⁴	Moderate–high feasibility; 71% completion; strong enjoyment	↑ Arm curls (p = 0.005, d = 0.54); ↑ 2-min steps (p = 0.016, d = 0.45); ↑ sit-and-reach (p < 0.001, d = 1.05); other mobility outcomes NS	QUAN: NS for loneliness (p = 0.054) and HRQOL-mental (p = 0.118); QUAL: ↑ well-being, confidence, social connection	Audio/lag issues; reduced interaction for prerecorded sessions	No adverse events	Preferred in-person/group formats
Harrison et al., 2024³⁵	Moderate–high feasibility; acceptability good among completers; 32% attrition	↑ Velocity (p < 0.001), ↑ stride length (p = 0.002) for both groups; ballet ↓ (p = 0.029) vs. control ↑ (p = 0.008); ↑ gait variability metrics (p’s < 0.03). ↑ Balance (p < 0.001); ↑ balance confidence (p = 0.002); ↑ single-leg-stance duration (p < 0.001); ↓ sway (p = 0.029); ↓ dual-task cost (p = 0.035) Falls: Ballet 19%→0% vs. control 9%→13% (p = 0.024)	↑ QOL (p = 0.008); mood NS (p = 0.07).=	Minor Wi-Fi/audio issues	No adverse events	—
Horne et al., 2024³⁶	High acceptability; strong engagement	↑ Self-reported strength, flexibility, energy, conditioning	↑ Mood, relaxation, emotional well-being; ↑ caregiver respite (“me time”)	Minor issues for one participant; recordings helpful	No adverse events	Online format acceptable; interest in hybrid options
Hübner et al., 2023⁵³	High acceptability (87.7% enjoyed classes); initial access difficult (60%) but improved	—	↑ Well-being immediately and for 3–4 days postsession (d = 0.65–1.58)	60% initial access problems; 26% ongoing issues; visual limitations	No adverse events	Strong in-person preference; only 12.3% would consider online after pandemic
Humphries et al., 2023³⁷	High feasibility (80% completion)	—	↑ Positive affect (p = 0.044); ↓ negative affect (p < 0.001); ↓ depression (p < 0.001); ↑ self-esteem (p < 0.0001); ↑ social connectedness (p = 0.004); anxiety and loneliness NS	No tech issues reported	No adverse events	—
Hyodo et al., 2023³⁸	Very high feasibility (94% retention; median adherence 97.4%); ↑ enjoyment (6.7→8.5)	—	Enjoyment only (↑)	73% early tech challenges; 27% no issues	No adverse events; one safety withdrawal (high blood pressure)	—
Krampe et al., 2016³⁹	High feasibility/acceptability; strong enthusiasm; 100% satisfaction (front/second rows)	—	↑ Enjoyment, alertness, engagement with student partners	Some video blurriness; reduced engagement in back rows	No adverse events	—
Kosurko et al., 2022²²	High acceptability; strong engagement; valued local access; facilitators essential; program expanded across rural sites	Not primary; qualitative ↑ physical engagement	↑ Social connection, inclusion, enjoyment, confidence; ↓ isolation	Connectivity problems; facilitator strain; prerecorded content increased reliability	Safety not discussed	Participants preferred live-stream; facilitators preferred prerecorded; blended delivery well received
Macdonald et al., 2022⁴⁰	High feasibility (77.6% attendance); high satisfaction (≥87% enjoyed)	↑ Shoulder range of motion (flexion, p = 0.001; extension, p < 0.001; abduction, p = 0.007); ↓ sedentary time (p = 0.007); ↑aerobic capacity NS	No significant QoL change; qualitative ↑ mood, confidence, stress reduction, body awareness, pain management	Occasional lag/audio issues	One mild adverse event (light-headedness)	Preferred hybrid/in-person; online valued for convenience
Millman et al., 2023⁴¹	Moderate–high feasibility; BA rated harder than DE; no dropout	—	↓ DD symptoms (p < 0.001); ↓ anomalous bodily experience; ↑ mindfulness; ↑ interoception (controls)	No tech issues	No adverse events	—
Moo et al., 2023⁴²	Low feasibility; 60% dyads dropped out; meaningful engagement for completers	—	↑ Bonding; ↑ child engagement; ↑ parent insight; ↑ attunement	Screen aversion; difficulty staying on camera; parent burden	No adverse events	Strong preference for in-person delivery
Morris et al., 2021⁴³	Very high feasibility (100% attendance)	—	↑ Confidence, ↑ mastery, ↑ motivation, ↑ enjoyment; perceived daily functioning	Minimal issues (short internet outages)	No adverse events	Valued 1:1 format; some interest in group/in-person continuation
Pandya et al., 2024⁴⁴	High feasibility (82% retention); homework completion predicted greater gains	—	↓ Body dissatisfaction (g = −0.56), ↑ well-being (g = 0.88)	No tech challenges noted	No adverse events	—
Pinto et al., 2023⁴⁵	High feasibility (100% adherence)	PD group: ↑ Five times sit-to-stand test (p = 0.016); others NS	PD: ↓ anxiety/depression (p = 0.047) Non-PD: ↑ vitality (p = 0.037) Both groups reported increased mood and energy	Moderate videoconferencing difficulty in PD (∼10% sessions needed support)	No adverse events	—
Rugh et al., 2022⁴⁶	High feasibility; 100% session completion; high enjoyment (8.4/10)	—	↓Negative affect (p = 0.028); ↑ social connectedness (p = 0.007); ↑ positive affect tied to enjoyment (p = 0.015); ↑ anxiety with higher difficulty (p = 0.037)	Minor issues: difficulty seeing instructor, pinning video, sound/music	No adverse events	Preference not directly assessed; mixed feelings about online vs. in-person
Seidler et al., 2017⁴⁷	High feasibility (85% retention; 87% online attendance vs. 84% in-person attendance)	↑ Balance (p < 0.001); ↓ motor severity (p < 0.001); no gait changes	—	Minor tech management needs	No adverse events	—
Shim et al., 2024a⁴⁸	High feasibility: both participants completed all 12 sessions; strong engagement	—	↑ Mindfulness, ↑ emotional expression, ↑ interpersonal connectedness, ↑self-awareness, and ↓ loneliness	Zoom easy to navigate; minor initial support needed	No adverse events	—
Shim et al., 2024 b⁵²	High feasibility (75% attended ≥ 75% sessions); high satisfaction; 93% would continue/recommend	↑ Physical activity (NS p = 0.054, d = 0.21)	↓ Loneliness (p = 0.006, d = 0.79), ↓ depression (p = 0.005, d = 0.68), ↑ positive affect (p = 0.01, d = 0.81), ↑ psychological well-being (p = 0.015, d = 0.50)	Minor survey related tech issues	One minor event (arm soreness)	—
Tunçgenç, 2024⁵⁰	Mixed feasibility: high enjoyment; high attrition (43%)	—	↑ Social bonding intervention > control (p < 0.0001); ↑ well-being intervention ↑ (p < 0.0001) while control ↓; ↑ hope (future orientation) intervention > control (p < 0.0001); bonding predicted ↑ well-being and future outlook	No formal tech data; implied camera-use challenges; online format contributed to attrition	No adverse events	—
Walton et al., 2022⁵¹	High feasibility (86% attendance; 83% high motivation)	↑ Mobility (p = 0.016, d = = .557); qualitative ↑ balance, rigidity, stride	↓ Depression (p = 0.003, d = −0.680); ↑ QoL (p < 0.001); cognition (p = 0.005, d = −0.624); ↑ mood, alertness, cognitive engagement	Minor audio/video lag; small screen; 96% rated tech satisfactory	No adverse events	Preferred digital as supplement; mixed in-person connection

BA, body awareness; DE, dance exercise; DD, depersonalization–derealization; NS, no significant; QOL, quality of life; –, not assessed.

FEASIBILITY AND ACCEPTABILITY

Overall, TDI were consistently described as feasible and acceptable. Positive feedback predominated across studies, with participants frequently describing interventions as beneficial and recommendable.

ADHERENCE AND ENGAGEMENT

Adherence and engagement were reported in 18 studies (69%). High adherence was documented in several interventions, including 100% attendance in ParkinDANCE⁴⁰ and a median adherence of 97.4%. Reported completion thresholds were met by most participants in Walton et al.,⁵¹ where 91% attended ≥70% of sessions. Attendance rates of 77.6% and 75% were noted for ballet⁴⁰ and mindfulness-based DMT⁴¹ programs, respectively. Seidler et al.⁴⁷ reported comparable attendance across online (87%) and in-person (84%) formats. Lower adherence was observed in Moo and Ho,⁴² in which three of five dyads discontinued early. Tunçgenç et al.⁵⁰ reported high session engagement but noted attrition between baseline (n = 58) and postintervention (n = 33); attrition analyses showed no baseline differences between completers and noncompleters across most psychosocial measures.

TECHNOLOGICAL ACCEPTANCE AND ISSUES

Ten studies (38%) addressed technological acceptance. Participants generally adapted quickly to online platforms, though challenges included unstable internet connections, small screen sizes, audio–video lag, and limited digital literacy. Most issues were resolved after initial sessions. One study⁴² reported participant withdrawal due to technology-related motivational fatigue.

ADVERSE EVENTS AND SAFETY

Seven studies explicitly reported safety outcomes, all indicating no significant adverse events. Minor anticipated effects (e.g., muscle soreness) were noted. Seventy-three percent of studies did not report on safety monitoring, limiting interpretation.

PARTICIPANT PREFERENCES FOR ONLINE VERSUS IN-PERSON DELIVERY

Only a small number of studies directly assessed preferences for online versus in-person delivery. Quantitative data indicated that most adults with Parkinson’s disease preferred in-person sessions (61.9%) over virtual formats.³³ Bek et al.²⁹ similarly reported strong support for in-person classes, with 70.8% of participants favoring a hybrid model that combined in-person programming with home-based digital practice.

Qualitative findings across several studies^29,32,34,42 also indicated a preference for in-person engagement due to perceived benefits such as greater energy, presence, and social connection. Notably, Moo et al.⁴² found that autistic participants expressed a clear preference for in-person sessions, citing relational depth and embodied attunement, while still acknowledging the accessibility benefits of tele-intervention.

PHYSICAL PERFORMANCE AND MOTOR OUTCOMES

Several studies reported improvements in physical health and motor function following participation in interventions. Among individuals with PD, studies have found improvements in balance, gait, posture, flexibility, and mobility.^29,31,47,51 Specifically, interventions such as Dance for PD^® and tango-based programs were associated with reduced motor symptom severity, increased gait velocity, and improved postural control.^31,47,51

Positive changes were also reported in strength and functional mobility outcomes, including sit-to-stand performance, step tests, and upper- and lower-body strength assessments.^31,35,40 For example, older adults and cancer survivors demonstrated improvements in chair stand repetitions, shoulder range of motion, and aerobic capacity following participation.^35,40 Digital dance sessions were additionally associated with reduced sedentary behavior and increased physical activity levels.^40,49 Although some studies did not observe significant between-group differences across all objective measures,^28,31 overall trends indicated enhanced physical functioning in both self-reported and performance-based outcomes.

PSYCHOSOCIAL BENEFITS

Across the studies included, a wide range of psychosocial benefits were frequently reported. Several studies documented increases in mood, positive affect, and emotional well-being,^{30,32,33,37,48,49,51} as well as reductions in anxiety, distress, and depressive symptoms.^30,37,49,51 Other reported outcomes included enhanced self-esteem, motivation, and experiences of joy,^30,37,43,48 and increases in mindfulness, self-awareness, and interoceptive awareness.^41,48,49 Findings from an adolescent sample⁵⁰ extended psychosocial evidence to younger populations, demonstrating significant increases in social bonding, overall well-being, hope, and future outlook. Improvements in social bonding were associated with gains in well-being.

Social connection was reported across multiple studies, with participants noting increased feelings of connection and inclusion, including in remote formats.^{32,45,46,51,52} Several studies described interventions as opportunities for creative expression and shared enjoyment, fostering a sense of community and enhancing overall well-being.^43,48,54

Qualitative reports also indicated improvements in overall wellness, resilience, and emotional support, particularly during periods of isolation and stress during the COVID-19 pandemic.^36,42,51 Although some studies noted challenges, such as reduced opportunities for spontaneous social interaction or initial technology-related difficulties,^51,53 these barriers were generally outweighed by the psychosocial benefits.

ADVANTAGES AND DISADVANTAGES OF DIGITAL DELIVERY

Several studies reported advantages of digital delivery, including increased accessibility for individuals with transportation, mobility, or scheduling barriers.^{29,30,32,43,48,49} Home-based participation allowed for convenience, flexible pacing, and integration into daily routines. In some cases, regular online sessions provided structure during the COVID-19 pandemic and supported consistent engagement.^38,51 Additional benefits included enhanced privacy and opportunities for repeated practice.

Reported disadvantages included technical challenges such as unstable internet connections, limited digital literacy, inadequate devices, and insufficient physical space.^29,33,51 Reduced motivation without in-person structure and fewer opportunities for spontaneous social interaction were also noted. Instructors reported difficulty forming rapport and monitoring movement quality in remote formats.⁵² Some participants perceived reduced physical challenge and expressive range compared with in-person settings.^40,51

STUDY QUALITY

All included studies were appraised using the MMAT. Twelve studies (46%) met all appraisal criteria and were rated as high quality.^{28,31,34,36,38,45,46,48,49,51–53} Thirteen studies (48%) were rated as moderate quality,^{29,30,32,33,35,37,39–42,44,47,50} and one study (4%) was rated as low quality.⁴³

Four QUAL studies^34,36,48,52 were appraised using the qualitative MMAT checklist, and all received the maximum score (5/5). Fourteen QUAN studies were appraised using quantitative MMAT criteria, including four RCTs,^28,35,41,44 six nonrandomized studies,^{31,33,37,40,45,47} and four descriptive quantitative studies.^29,38,39,53 Across QUAN designs, MMAT scores ranged from 3 to 5, with frequently missing information related to confounding variables, treatment fidelity, and participant response rates.

Seven studies used MM designs. Of these, three^46,49,51 were rated as high quality, while four^30,35,42,50 were rated as moderate quality due to limited qualitative completion rates, incomplete reporting of confounders or treatment fidelity, or attrition at follow-up.

Discussion

This scoping review synthesized evidence from 26 studies evaluating TDI across physical, psychosocial, and cognitive outcomes. Collectively, the findings indicate that TDI are generally feasible and well accepted and are associated with improvements in physical functioning, mood, social connectedness, and emotional well-being across populations. At the same time, the literature is characterized by methodological limitations, inconsistent reporting, and limited demographic diversity, underscoring the need for more rigorous and theoretically informed research as tele-dance moves beyond its pandemic-driven expansion.

Most studies focused on older adults, particularly individuals with PD or age-related cognitive decline. This pattern aligns with broader telehealth trends, as these populations frequently face barriers to in-person participation, including mobility limitations, transportation challenges, and caregiver burden.^55–57 Although some studies included cancer survivors, caregivers, individuals with developmental disabilities, children and adolescents, and healthy adults, these populations remain underrepresented. Consistent with telehealth equity concerns,^58,59 most studies did not report race or ethnicity, men were underrepresented, and few interventions explicitly addressed digital literacy or unstable internet access, raising concerns that TDI may inadvertently reinforce existing digital inequities if equity considerations are not intentionally integrated into design and recruitment.

Many TDI were adapted from established in-person programs, such as Dance for PD^®, demonstrating the flexibility of translating embodied, arts-based practices to remote contexts during the COVID-19 pandemic, when rapid implementation was essential.⁶⁰ The majority maintained structural components characteristic of in-person classes, including warm-up sequences, structured or improvisational dance activities across genres, and cool-down phases. Some interventions emphasized formalized styles, including tango and classical ballet, underscoring the breadth of modalities incorporated into tele-dance. This blending of structured and improvisational approaches highlights tele-dance’s inherent flexibility and parallels the successful adaptation of other creative arts therapies to remote contexts.^61,62 However, relatively few interventions were explicitly grounded in DMT theory or telehealth-specific frameworks, and key design features, such as camera-use policies, in-home safety considerations, and strategies for supporting remote embodied attunement, were inconsistently reported. Future TDI development would benefit from integrating DMT theory,⁶³ embodiment and synchrony research,⁶⁴ therapeutic alliance scholarship,⁶⁵ and implementation science to inform interventions intentionally designed for remote delivery rather than adapted from in-person formats.

Across studies, feasibility and acceptability were high, with strong adherence, favorable satisfaction ratings, and minimal adverse events, mirroring findings from tele-exercise and tele-creative arts therapies.^62,66 Nevertheless, adherence varied by population. Notably, substantial dropout in a study involving autistic children and dyads⁴² suggests that synchronous delivery may impose cognitive or sensory demands that are less compatible with some neurodivergent participants. Technological barriers—including audio disruptions, video lag, unstable connections, and limited physical space—were commonly reported and are consistent with broader telehealth literature.⁶⁷ These patterns highlight the importance of proactive engagement strategies, such as structured onboarding, flexible pacing, hybrid delivery formats (e.g., combination of prerecorded and live sessions), individualized participation goals, caregiver involvement, and ongoing technical and relational support.^29,42,51

Preferences regarding delivery format further contextualize these findings. Although participants valued the convenience and accessibility of remote sessions, in-person or hybrid formats were generally preferred when available. Participants consistently described in-person dance as offering heightened embodied presence, shared energy, and relational attunement that were difficult to fully replicate online. These experiences align with DMT scholarship emphasizing nonverbal synchrony and shared movement rhythms as foundational to therapeutic alliance and emotional resonance.^63,64 In line with emerging telehealth models,⁶⁸ TDI may therefore be most effective when conceptualized as part of a flexible continuum that integrates remote, in-person, and hybrid options tailored to individual needs and contexts.

TDI were associated with meaningful physical and motor improvements, particularly balance, gait, strength, and motor symptom severity among individuals with PD and older adults, consistent with tele-exercise literature.^66,69 Psychosocial outcomes were similarly robust, with improvements in mood, anxiety, self-esteem, and motivation reported across studies. Social connectedness emerged as a central mechanism, with participants describing TDI as spaces of shared creativity and mutual support despite physical distance. These findings align with evidence that synchronous, arts-based telehealth interventions can foster social cohesion and emotional resilience.^67,70,71

Despite these benefits, digital delivery introduced distinct challenges. Reduced spontaneity, fewer informal social interactions, and limitations in instructors’ ability to monitor safety and movement quality were commonly noted. Some participants perceived online sessions as less physically engaging or expressive, suggesting that TDI may operate through mechanisms that differ from those of in-person dance. Elucidating these mechanisms, particularly those related to embodiment, sensory engagement, and relational synchrony, represents an important direction for future research.

Finally, although group-based formats predominated and effectively supported social connection, individualized and dyadic tele-dance formats remain underexplored. Evidence from tele-music, tele-art, and tele-drama therapies suggests that individualized approaches may be especially beneficial for participants with sensory sensitivities, mobility limitations, or highly personalized therapeutic goals.^61,72–74 Future research should examine hybrid models that integrate group-based and individualized formats to enhance personalization, accessibility, and therapeutic responsiveness.

The overall methodological quality of included studies was mixed. Although nearly half of the studies met all MMAT criteria and were rated as high quality, a comparable proportion were rated as moderate, and one study was rated as low quality. Common methodological limitations included small sample sizes, lack of control or comparison groups, inconsistent outcome measures, limited reporting of intervention fidelity, unclear handling of confounding variables, and minimal long-term follow-up. These limitations constrain the strength of causal inferences and limit comparability across studies. MM studies, while valuable for capturing participant experiences, frequently demonstrated imbalances between qualitative and quantitative components, such as incomplete qualitative integration or attrition at follow-up. Collectively, these findings underscore the need for more rigorous study designs, including adequately powered RCTs, pragmatic and hybrid effectiveness–implementation studies, standardized outcome reporting, and systematic fidelity assessments to strengthen the evidence base for TDI.

Overall, the evidence suggests that TDI represent a promising and adaptable modality for promoting physical and psychosocial health. However, realizing their full potential requires moving beyond rapid pandemic adaptations toward intentional tele-design grounded in embodiment theory, telehealth research, and implementation science. Priorities for future research include inclusive recruitment, culturally responsive design, theoretically grounded protocols, hybrid delivery models, and rigorous methodological approaches. As digital and hybrid care continue to expand, TDI may play an important role in supporting whole-person health, particularly when offered alongside in-person opportunities that preserve the relational and embodied richness of dance.

Limitations

Several limitations should be considered when interpreting the findings of this scoping review. First, the review intentionally focused on synchronous, live-streamed TDI targeting physical or psychological health outcomes. Consequently, asynchronous formats, self-guided digital programs, and exergame-based dance interventions were excluded, limiting the generalizability of findings to other forms of digitally delivered dance.

Second, consistent with the purpose of scoping reviews, this synthesis was designed to map the scope and characteristics of an emerging field rather than to estimate intervention effects or determine efficacy. Although methodological quality was appraised using the MMAT, studies were not weighted or excluded based on quality, and variability in study rigor and reporting precludes strong causal inferences.

Third, most included studies were conducted during the COVID-19 pandemic, which may limit the transferability of findings to routine, nonpandemic contexts. Participants’ engagement, access, and willingness to participate in tele-dance may have been shaped by public health restrictions, heightened isolation, and limited availability of in-person alternatives.

Additional limitations relate to heterogeneity across studies, including differences in study designs, participant characteristics, intervention duration and structure, instructor training, camera-use policies, and outcome measures. This variability constrained cross-study comparisons and limited the ability to identify optimal intervention components. Moreover, reporting on intervention fidelity, safety procedures, and implementation context, such as staffing, technological support, costs, and physical space considerations, was often limited, restricting assessment of scalability and real-world implementation.

Finally, although this review sought to capture both participant and facilitator perspectives, only one study⁴⁹ explicitly examined interventionists’ experiences. Given the central role of facilitators in ensuring safety, engagement, and therapeutic attunement in tele-dance, future research should more systematically examine facilitator training, support needs, and implementation challenges to inform sustainable and equitable delivery models.

Conclusion

This scoping review shows that TDI are generally feasible, safe, and acceptable, with consistent benefits for mood, social connection, and aspects of physical functioning across diverse populations. To advance the field, future research should employ rigorous and inclusive study designs, ensure consistent use of validated outcome measures, and examine long-term and hybrid delivery models that extend beyond pandemic-era adaptations. Given the complementary strengths of virtual and in-person formats, developing flexible, person-centered models will be essential for meeting varied needs, preferences, and access levels. Continued attention to methodological quality, contextual factors, and equity will be crucial to realizing tele-dance’s promise as an adaptable, accessible, and widely scalable health-promoting intervention.

Footnotes

Acknowledgments

The authors thank Dr. Nalini Prakash for her assistance with the initial literature search and early screening of records, and Ms. Chelsea Faulkner, Ms. Madeline Kling, and Ms. Jaclyn Lo for their assistance with study screening and methodological quality assessment.

Authors’ Contributions

M.S. conceived of and designed the study. S.G.P. developed the search strategy. D.S., C.L., E.U., and M.S. performed the literature search, screening, full-text review, and assessment of the study quality. M.S. and D.S. wrote the draft article. M.S., E.U., and S.G.P. contributed to the revision, editing, and approval of the final article.

Disclosure Statement

The authors declare that they have no competing interests.

Funding Information

No funding was provided for the research.

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