Older adults' perspectives on process variables in a dance movement therapy and physical exercise fall prevention intervention: A qualitative study within a randomized controlled trial

Although addressing both physical and psychological dimensions in fall prevention is essential for older adults, the experiential processes underlying integrative interventions remain insufficiently understood. This study examined how older adults perceived meaningful session components, instructional styles, and group dynamics in two interventions: physical exercise integrated with Dance Movement Therapy (PE+DMT) and physical exercise alone (PE). Sixty-one community-dwelling older adults (mean age 75.9 ± 6.2 years) were randomly assigned to either PE+DMT (n = 31) or PE-only (n = 30). Both groups received the Otago Exercise Program, with the PE+DMT group receiving additional DMT elements targeting emotional expression, bodily awareness, and group interaction. Short semi-structured interviews were conducted after sessions 4, 8, 12, and one-month post-intervention. Data were analyzed using interpretative phenomenological analysis, followed by descriptive frequency analysis to examine variations across groups and time. Four themes emerged: physical exercise experience, quality of instruction, socio-emotional group dynamics, and connections between interpersonal relationships and bodily security. Frequency analysis showed that PE+DMT participants consistently described emotionally meaningful experiences, whereas PE-only participants emphasized functional aspects, during the intervention and at follow-up. Analysis over time indicated evolving engagement, with emotional content becoming more salient in later PE+DMT sessions. Supportive relationships were remembered as significant in both groups. Integrating DMT into PE-based fall prevention fosters a holistic experience, appreciated by older adults for its functional benefits, personalized and professional instruction, and supportive group environment. These findings highlight the value of mind–body approaches in geriatric care and support incorporating emotional and social engagement into exercise programs.