effect of rhythmic gymnastics on the rhythm perception ...

Journal of Strength and Conditioning Research, 2006, 20(2), 298–303 q 2006 National Strength & Conditioning Association

EFFECT OF RHYTHMIC GYMNASTICS ON THE RHYTHM PERCEPTION OF CHILDREN WITH DEAFNESS ELENI G. FOTIADOU, VASILIOS K. TSIMARAS, PARASKEVI F. GIAGAZOGLOU, MARIA P. SIDIROPOULOU, ANNA M. KARAMOUZI, AND NICKOLETTA A. ANGELOPOULOU Laboratory of Developmental Medicine and Special Education, Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Greece.

ABSTRACT. Fotiadou, E.G., V.K. Tsimaras, P.F. Giagazoglou, M.P. Sidiropoulou, A.M. Karamouzi, and N.A. Angelopoulou. Effect of rhythmic gymnastics on the rhythm perception of children with deafness. J. Strength Cond. Res. 20(2):298–303. 2006.—This study was designed to examine the effect of a rhythmic gymnastics program on the rhythm perception of children with deafness. Two groups—control and experiment—of 12 and 17 children, respectively, coming from the same school for the deaf participated in this study. The duration of the program for the individuals in the experiment group was 16 weeks (at a frequency of 3 lessons per week, for 40 minutes each lesson), while children of both groups adhered to their regular school schedules. Five rhythmic patterns in 3 speeds (tempi) were reproduced both by a metronome and each child’s performance and were recorded on a digital disk before and after the application of the program. The rate of time deviation (in seconds) between the 2 beats represented the score for each child. The average rate of the 5 rhythmic patterns in each tempo was calculated separately, giving 3 scores (one for every tempo) for each child. Significance was set at p # 0.05. The data revealed significant postexercise differences in favor of the experiment group, an improvement of the experiment group in all pre-post values, as well as an improved medium tempo with relation to the control group. The findings show the effectiveness of the specific program in terms of improving rhythm ability, thus indicating its use in educating children with deafness on rhythm instead of preferring the routine of the adapted school program. KEY WORDS. rhythm, rhythm ability, hearing loss

INTRODUCTION earing, a strong line of communication that enables individuals to learn about the world around them, is a major factor contributing to the psychomotor development of every individual (1, 30). Although hearing loss is not universally considered to be a developmental disability, deafness affects speech, language, communication, intelligence, social and emotional development, behavior, attention, academic achievement, and motor performance (1, 6, 18, 27). Furthermore, hearing loss affects the conception and perception of sounds and rhythm (1, 2, 8, 18, 27). Rhythm is an integral part of motor coordination, which provides improvement and completion of ocular and auditory perception, balance ability, kinesthetic awareness, and speech development (29). Individuals with hearing impairment who fail to develop rhythm have subsequent difficulties in improving basic dance elements such as balance ability, equilibrium, and kinesthetic awareness (2). Lack of rhythm sense results in various difficulties relat-

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ed to motor and dancing activities, social adjustment, and expression of feelings. One of the major difficulties in educating children with hearing impairment involves their inability to perceive time intervals and, thus, rhythm patterns (2, 4, 7, 8, 14, 22, 23). Musical instruments and materials are rich resources of sensory and motor involvement. To develop rhythmic perception, emphasis should be given to the introduction of special rhythmic elements, such as visual and auditory metronome, triangles, cymbals, bells, tambourines, hand drums, bass drums, timpani, bongos, and maracas (1, 2, 16, 25). Dance is an ideal activity for the improvement of motor performance and self-concept of youth with hearing impairment (24), an indispensable tool that facilitates self-actualization, especially the awareness of the body with regard to appreciating its own ability for movement (19, 31). Research has been conducted with regard to the psychological and cognitive aspects of individuals with hearing loss through the implementation of a dance program (2), and many schools have integrated dance into their curriculum as a means of enhancing body rhythm (2, 5). Rhythmic gymnastics provide kinesthetic stimulation, a form of exercise that allows realization of physical and mental capability, leading to improved socialization, creativity, and behavior (3, 20). The simultaneous use of techniques involving body movements, apparatus elements, and rhythm increase the perception of rhythmic visual and kinesthetic stimuli. Therefore, rhythmic gymnastics provides an effective means to increase the rhythmic ability of children with deafness. Studies concerning sense of rhythm, perception, and maintenance of rhythmic patterns along with the reproduction of a musical phrase show that the performance of children who are deaf or hard of hearing is less than that of children without hearing impairment (7, 8, 14, 22, 23). It is relatively easy for the educator to evaluate the perception of rhythm in the hearing as well as in the hearing-impaired children, while it is much more difficult in children with deafness as a result of their inability to perceive combinations of different rhythmic patterns. Visual stimuli can partially substitute for the inability to perceive rhythm through the auditory mode. Although children with deafness can efficiently comprehend the rhythm by kinesthetic stimuli coming from beats on percussion instruments and wooden surfaces, they seem to have difficulties in understanding the nature and feature of the pauses (silent time intervals) that

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are used in several rhythmic patterns. Thus, the comprehension of rhythm should be executed by different rhythmic patterns, including both beats and pauses in different tempi. Reliable objective measurement of rhythm has been achieved by using computerized assessment that includes synchronization with an external beat and the tapping of rhythm patterns (12, 13). In reviewing the literature, however, it seems that no other studies have made any similar evaluation concerning children with deafness. Based on the information provided above, the questions we sought to answer are the following: (a) Can children with deafness comprehend rhythmic patterns? (b) Will they correspond successfully to an interventional rhythmic gymnastics program? and (c) Will they improve their rhythmic ability? Thus, this study was designed to examine whether an adapted rhythmic gymnastics program can be effective in improving the rhythm perception of children with deafness by measuring their ability to execute rhythmic patterns prior to and after participation in the program. The rhythmic ability is expressed by the succeeded mean time frequency (in seconds) of 5 rhythmic patterns in each of 3 defined tempi.

METHODS Experimental Approach to the Problem

In this study, the sample consisted of 29 children coming from a residential school for children with deafness. The subjects were assigned to 2 groups—a control group and an experimental group—of 12 and 17 subjects, respectively. The experiment group received a 16-week training program designed to improve the rhythm perception ability of its participants. The methods of data collection included pre and post measurements of the rhythm perception ability for all participants of both groups. Subjects

Twelve children (6 boys and 6 girls) with deafness (mean age, 7.9 6 0.9 years; mean height, 128.0 6 8.7 cm; mean weight, 27.2 6 5.6 kg) constituted the control group. Seventeen children (9 boys and 8 girls) with deafness (mean age, 8.0 6 0.8 years; mean height, 128.3 6 7.9 cm; mean weight, 28.5 6 4.9 kg) constituted the experiment group. The subjects fulfilled the same criteria so as to achieve group homogeneity: (a) Socio-economic status (middleclass families); (b) School placement (residential school for children with deafness); (c) Etiology (all of the 29 children were diagnosed with bilateral sensorineural hearing loss. Nine participants from the experiment group and 6 from the control group were deaf as a result of congenital factors, and 8 from the experiment and 6 from the control group were deaf as a result of meningitis during infancy); (d) Hearing level (hearing loss greater than 70 dB); and (e) IQ (normal intelligence). The participants had no cochlear implants or any other physical or vision-related impairments. A larger number of subjects were assigned to the experiment group to allow a sufficient sample size for this study. Finally, all subjects successfully completed the rhythmic gymnastics program. The initial measurements of rhythm perception were performed after assignment to the groups. All participants and their parents or legal guardians

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provided written informed consent prior to participation, as approved by the ethics committee of our university. Procedures

Rhythmic Gymnastics Program. The duration of the rhythmic gymnastics program for each participant in the experiment group was 16 weeks, at a frequency of 3 evening classes per week, each class lasting 40 minutes. None of the students in the experiment group was absent for more than 2 training days or for 2 consecutive training days. Instructional procedures were based on demonstration and a total communication approach. The participants of both groups adhered to their regular school schedule, which included participation in physical education activity at a frequency of 3 times per week, for 40 minutes each session. However, no instruction in rhythmic gymnastics or related activities was given to the children in the control group during the entire period of the research project. Prior to the application of the rhythmic gymnastics program, some exercises were introduced to familiarize the children with the awareness of rhythm, such as tapping of a finger, clapping of hands, or stamping of feet at a variety of tempo and speed changes. The activities were repeated using musical instruments (drums) in different tempi. The children followed the tempo of the beat as given by the teacher. Since deep breathing is important for the development of the rhythmic movements as well as the inner rhythm, fast running, repeated jumps, and similar exercises that increase the cardiovascular pulse and breathing rate were used (2). Adaptations of the usual rhythmic gymnastics program should be performed in order to render the program suitable for children with deafness. The rhythmic gymnastics program was designed according to certain basic movements (1, 3, 20, 25) drawn from classical ballet technique, rhythmic gymnastics apparatus technique, and rhythm and dance elements and was enriched with a variety of activities to eliminate monotony and maintain the same training effect (Table 1). All rhythmic gymnastics apparatuses were used except clubs to avoid injuries and extra difficulty (2 pieces of apparatus). Each activity consisted of a variety of activities developed from the basic principles of rhythmic gymnastics. Sharp movements of competitive rhythmic gymnastics that could generate side effects such as dizziness or vertigo were not included. A slow, safe, rhythm-inhibiting, nonthreatening approach was used during the whole program (1), so no side effects could be observed. Each exercise was demonstrated and executed before starting the main program in order to familiarize each child in the experiment group with its elements. Instructions were repeated until the student knew what was to be expected (26). Various movements in different tempi (unequal duration, strong or elegant movements, very slow to very fast) were used to achieve rhythm awareness (3, 20, 25). All activities were performed individually, in pairs or in teams of 3 children, either in an isolated manner or using combinations of 2 or more activities. To promote creativity and team collaboration activities, children were successfully encouraged to initiate the improvisation of simple choreographies added to the program. Measurements. A Wittner Taktell piccolo metronome (Wittner, Isny, Germany), a wooden surface, and a Sony

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TABLE 1. Rhythmic gymnastic program. Body movement elements 1. Walking patterns in different tempos (2/4, 3/4, 4/4) along with the rhythmic clapping of hands or stamping the feet alternately in all directions. 2. Marching in all directions at varying speeds using intermediate pauses, on the toes, or flat foot, with combination of steps, knee raising (less than 458), 1/2 turns, change step, hop, slide walk and leap, skipping step, gallop step, spring step, or any combination of the above. 3. Body waving or performing circular movements or figure-8 (spirals) with hands in all directions. Apparatus elements Rope movements 1. Simple spinning, wrapping, and circling of the rope 2. Cross-turning of the rope forward or backward 3. Skipping or hopping while passing through the rope 4. Figure-8s and swaying with the rope folded in 2 and swinging with the rope vertically and horizontally with one or both hands Hoop movements 1. Simple throws with the hoop spinning and wrapping 2. Hoop rotations and circles 3. Swinging the hoop around the wrist in all planes 4. Passing the hoop from one hand to the other, around the feet, around the waist, and around the head 5. Rolling the hoop on the floor over short or longer distances Ball 1. 2. 3.

movements Ball rolling over the floor and over parts of the body Simple wrapping and spinning on the floor with the ball Swinging the ball with one or both hands vertically and horizontally, freely and rhythmically, with springing movements of the legs 4. Making simple circles with 2 arms as well as passing the ball from one arm to the other 5. Walking combined with passing the ball from one hand to the other, around the feet, around the waist, and around the head in all directions 6. Walking combined with bouncing the ball on the floor

Ribbon movements 1. Walking combined with making circles, spirals, or snakes with a ribbon 2. Small tosses and catches with a ribbon 3. Figure-8s of the ribbon in front vertical and horizontal 4. Vertical spirals in front and to the side of the floor, with the ribbon 5. Horizontal spirals with the ribbon, around the children 6. Large swings with the ribbon vertically and horizontally

Portable Minidisk Recorder MZ-R 90 (Sony Electronics Inc., San Diego, CA) were used as equipment for rhythm perception measurements. The analysis of sound data was carried out using the Sound Forge 4.5 audio editing program on a PC (Sonic Foundry, Madison, WI). The reproduction of 5 demonstrated rhythmic patterns (Figure 1) in 4/4 meter (2) in 3 tempos was requested from the children with deafness. Tempo (-os, -i) is a musical term referring to time frequency of beats within a rhythmic pattern. A rhythmic pattern can be executed in different tempos. The most usual and intelligible tempi are slow (andante), medium (moderato), and fast (allegro) tempi. These patterns had been comprehended and executed by children with deafness in a preliminary study (17). That study aimed to establish those rhythmic pat-

FIGURE 1. study.

Rhythmic patterns that have been used in this

terns that could be useful in future studies for the objective measurement of not only the comprehension but also the rhythm of children with deafness. Each rhythmic pattern was demonstrated to each child twice. A metronome was used for ocular (apart from auditory) feedback. The beat was reproduced on a wooden surface, while the pause was given with the combined use of the word and the sign for the pause. A rhythmic gymnastics teacher (the investigator) along with 2 professional music teachers assessed the process of the rhythm performance. The 3 assigned tempos were (a) slow (andante): 60 beats per minute (1 b·s21); (b) medium (moderato): 80 b·min21 (1 b 0.75 s21); and (c) fast (allegro): 116 b·min21 (1 b 0.517 s21) (21). The sound produced by both the metronome and the child was recorded on a portable digital disk. Analysis of sound data included the use of the Sound Forge 4.5 software on the PC to record the exact time (in seconds) of every beat (15). Synchronization as well as deviation (in seconds) between the 2 beats (metronome and child) were recorded continuously. Each child had to execute every rhythmic pattern in 8 repetitions for every tempo. The mean rate of the 8 repetitions for every tempo was excluded, resulting in one rate for every rhythmic pattern. The time range (deviation, in seconds) between the metronome’s (M) steady beat and the child’s one mean for every rhythmic pattern was calculated, resulting in 5 rates for every tempo: ([M-a] for andante [slow], [M-m] for moderato [medium], and [M-al] for allegro [fast] tempo). Next, the means of differences of the 5 rhythmic patterns (named patterns 1, 2, 3, 4, and 5) for each tempo were excluded as achieved scores for the child: [(M-a)1 1 (M-a)2 1 (M-a)3 1 (M-a)4 1 (M-a)5]: 5, and so on for the other tempos. Therefore, 3 scores (one for every tempo) were recorded for each child. The better score was coming from the lesser time difference between the 2 beats (metronome and child beats). Absolute synchronization of the 2 beats meant the best score for the child, indicating his rhythm capability. Measurements of rhythm reproduction were performed prior to and after the application of the rhythmic gymnastics program. Statistical Analyses

Means and standard deviations were calculated for the variable of rhythmic ability in 3 different tempos. Intraclass correlation was included to examine the internal consistency of the pre and post program measures. Multiple analysis of variance (MANOVA) was used to test

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TABLE 2. Pre-post values (seconds) of the rhythm perception in each tempo for the experiment and the control groups. Groups† Experiment (N 5 17)

mean 6 SD (seconds) mean 6 SD (seconds)

Tempo Allegro

Control (N 5 12) p*

Pre Post p

0.057 0.021 ,0.001

0.01 0.01

0.058 0.055

0.01 0.02

,0.001

Moderato Pre Post p

0.082 0.028 ,0.001

0.03 0.02 ,0.01

0.093 0.084

0.03 0.04

,0.001

Andante Pre Post p

0.11 0.03 ,0.001

0.05 0.02

0.109 0.098

0.05 0.05

,0.001

† p 5 In the same group; p* 5 between groups; SD 5 standard deviation.

pre- and postprogram values between the 2 groups (control and experiment) in 3 different tempos. A paired t-test was included, comparing the pre-post measures of rhythm perception within each group. Statistical significance was set at p # 0.05.

RESULTS Comparison of rhythm perception values between boys and girls in each group before the start and after the application of the program revealed no statistical difference. Therefore, the experiment group and the control group consisted of both boys and girls to enhance the validity of results. Intraclass correlation (ICC) revealed low internal consistency of the preprogram measures (ICC 5 .29) and high internal consistency of the postprogram measures (ICC 5 .77). The scores of rhythm perception of each group before and after the application of the rhythmic gymnastics program in each tempo are presented in Table 2. Multiple analysis of variance showed no significant differences between all tempos (allegro, moderato, and andante) with regard to the group factor prior to the application of the rhythmic gymnastics program. Following the 16-week duration of the program, MANOVA revealed a statistically significant difference between the 2 groups (control and experiment) in andante (F 5 28.74, p , 0.001, h2 5 .51, statistical power [P] 5 .99), moderato (F 5 37.15, p , 0.001, h2 5 .58, P 5 1.0), and allegro (F 5 45.45, p , 0.001, h2 5 .62, P 5 1.0) tempos. In particular, data revealed that the experiment group exhibited a superior rhythm ability performance compared to the control group in all 3 tempos. A paired t-test showed that the pre and post rhythm perception values of the experiment group differ significantly in andante (t 5 7.60, df 5 16, p , 0.001) moderato (t 5 6.77, df 5 16, p , 0.001), and allegro (t 5 12.96, df 5 16, p , 0.001) tempos. A statistically significant difference between pre- and postvalues was also found for the control group regarding moderato (t 5 3.46, df 5 10, p , 0.01) tempo.

DISCUSSION The results of this study show that the children with deafness understood and executed successfully the 5 rhythmic

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patterns after the application of the rhythmic gymnastics program, corresponded to the program, and significantly improved their rhythmic ability. The assessment of rhythm perception in children with deafness bears specific difficulties. Lack of hearing limits the perception of rhythm, while the visual and kinesthetic stimuli can partially substitute the hearing. Children with deafness could understand rhythm caused by beats better than they did when rhythm was caused by the pauses in the various rhythmic patterns. In this study, the application of the rhythmic gymnastics program exhibited a significant improvement in the rhythm perception of children with deafness in all 3 tempos. The poor intraclass correlation of the preprogram measures (ICC 5 .29) can be attributed to low comprehension and execution of rhythm patterns by the children with deafness, while the high intraclass correlation of the postprogram measures (ICC 5 .77) is the consequence of the interventional program. Additionally, the combination of effect size (h2) and statistical power (P) in all 3 tempos is very good, supporting the effectiveness of the rhythmic gymnastics program. To our knowledge, there are no other similar studies regarding application of rhythmic gymnastics programs in children with deafness. Children with deafness managed to perceive and perform the 5 demonstrated rhythmic patterns, which included beats and pauses in various combinations, in all 3 tempos. As is well known from the literature, significant differences between boys and girls were not observed (8). Rhythm and elements of mature movement can be developed between 5 and 7 years of age (10). A selection of an older age group (7–9 years old) for the present study was considered necessary, since it concerned children with a rhythm perception deficit yet with more biological and psychomotor maturity in terms of the understanding of rhythmic patterns of varied difficulty. An older (above 9 years of age) age group was not selected because the value of the rhythmic measurement and other psychomotor variables lies in introducing intervention programs that should be applied at an earlier age. As the results of this research cannot be compared to those of another relevant study, it appears that the suitable adaptation of rhythmic gymnastics, as it was applied to the children, had better results than did the program of physical education that was applied in the children from the control group from the same school. In order to evaluate the perception of rhythm, professionals commonly use various subjective methods. Yet the application of a specific and objective method is very important for individuals with difficulties in the perception of rhythm, particularly when interventional programs are in process. The use of a specific and objective method, such as the analysis of sound data in the Sound Forge 4.5 software, as applied in children with deafness (15), increases the validity of the influence of the intervention, even in the case of a slight improvement, so that the interventional program can be evaluated. Rhythmic movements help children with deafness to develop abilities relative to different psychomotor areas, such as visual-spatial perception, counting, correct posture, balance ability, and sense of weight of body in the space. The perception of inner rhythm helps in the comprehension and perception of exterior rhythm. The incentive to create an adapted rhythmic gymnastics program for the children with deafness was based on the fact that

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the rhythm of movement correlates with speech rhythm; thus, rhythmical education practices have a positive effect on the speech of children with deafness (19, 24, 31). Sherrill (25) suggested that in order for rhythm programs to be effective, they should be based on changes of various elements of rhythm, such as basic pulse, accentuation, rhythmic patterns, and musical phrase. Rhythmic gymnastics is apparently one of the most appropriate sports for improving the comprehension of rhythm of hearing children. However, without adaptation, the rhythmic gymnastics could not be understood and comprehended by children with deafness. In this study, the program applied and executed was based on the basic principles of rhythmic gymnastics technique adapted, in addition to the needs of children with deafness, paying particular attention to the limitations posed by the features of the disease. Therefore, it appears that the exercises, in the manner they were applied and executed, were safe to all children. During the application of the program, children not only understood and executed the program, but they also showed enthusiasm in using the apparatus and in the variety of rhythmic gymnastics skills. The combination of motion and fine, elegant activities was attractive to the children while simultaneously promoting their creative thinking and imagination skills. As the program developed, they improvised their own program in small groups making simple choreographies. Total communication with demonstration, lip-reading sign language, and optical and ride feedback appeared efficient and in agreement with the techniques of the researchers involved in communication with the deaf (9, 11, 28). Finally, the adaptation of rhythmic gymnastics to the needs of children with deafness, as it is described in the methodology and results summarized above, is the reason for the rhythm improvement. Future studies could further specify the effectiveness of rhythmic gymnastics, by means of intervention programs with younger and older children to determine at what chronological age individuals who are deaf can improve their rhythm ability. Comparisons among different exercise programs could be useful in indicating the most effective ones.

PRACTICAL APPLICATIONS

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A rhythmic gymnastics program can probably improve the rhythm perception and execution of hearing children, with no particular adaptation. The combination of rhythmic gymnastics, with an emphasis on total communication procedure, and kinesthetic stimulation and adaptation of movements and elements reinforces the conduct with rhythm and serves the needs of children with hearing loss. This program can be used for coeducation promoting the integration of hearing-impaired children into classes of hearing children. Also, as a whole, a rhythmic gymnastics program cannot be applicable in daily physical education; some or many parts of such a program should be introduced to reinforce the rhythmic ability of children with deafness.

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Address correspondence to Eleni Fotiadou, fotiadi@phed. auth.gr