Abstract
BACKGROUND: Dance is a novel recreational activity that may improve psychosocial outcomes in inpatient neurological rehabilitation; however, adapted dance programs in neurological rehabilitation settings are still emerging. OBJECTIVE: This paper describes the co-design process undertaken to develop an adapted dance program for use in neurological rehabilitation. It also presents a study protocol aimed at evaluating the program's feasibility, acceptability, and preliminary efficacy in a subacute hospital setting. METHODS: A 3-phase co-design approach was used to develop the Dance as an Adjunct Therapy for Neurological Rehabilitation - Creative Enrichment for Recovery (DAN-CER) program and protocol, including knowledge seeking, seeking expert input, and refining. Information sources included a literature review, stakeholder meetings, workshops, and focus groups with clinicians and patients. This study has approval from two ethics committees (HREC/2023/QGC/99631 and GU 2023/813). RESULTS: We undertook 4 workshops with Queensland Ballet, and 2 focus groups were undertaken with staff and neuroscience ward patients. The resultant program was mapped to the Template for Intervention Description and Replication (TIDieR) checklist. A mixed methods design was selected to evaluate the program. Primary outcomes are the feasibility and acceptability of the adapted dance program with data on accrual and attendance collected weekly. Semistructured interviews with patients and staff were conducted postintervention. The secondary outcome is the efficacy of DAN-CER for improving well-being and affect, with impact on fatigue monitored. Adapted dance classes and data collection assessments began in late October 2024, and data collection was completed in late February 2025. At the time of manuscript submission, 14 participants had been recruited. Interviews have been transcribed, and preliminary coding is underway; findings are expected to be submitted for publication in December 2025. CONCLUSIONS: The rigor of the multiphase co-design process enabled the development of an adapted dance intervention capable of accommodating the physical, cognitive, and communication challenges of neurorehabilitation ward patients. The proposed mixed methods protocol will enable multidimensional evaluation of the adapted dance program. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69452.