Classical Ballet Dancers Research Articles

Effects of mulligan concept in classical ballet dancers with pain in the lower limbs

Introduction: The Mulligan concept is a manual therapy technique that addresses the restoration of arthrocinematic processes and inadequate osteocinematic movements, resulting in reduced muscle tension, postural failure and pain relief. Objectives: To analyze the effectiveness of the Mulligan concept in reducing lower limb pain processes in classical dancers. Methods: Longitudinal study, approved by the Ethics and Research Committee of the Universidade Estadual do Piauí, according to the decision of No. 2064503, composed by 4 classical dancers. An evaluation of the pain level was performed using a digital algometer (Wagner Instruments) with a ten-kilogram-force (Kgf) capacity in dancers who presented painful symptoms in the knee. The level pain before and after the intervention with the Mulligan concept was verified in the following points: patellar ligament (PL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). The Mulligan concept was performed actively, painlessly, with adjustments by the therapist and was maintained at the end of the knee amplitude for 10 seconds. This protocol was repeated 3 times in the first attendance, in the second 10 times, in the third there were 2 repetitions of 10 slides and in the subsequent attendances there were 3 repetitions of 10 slides. Results: An increase in the average of the pain threshold in patellar, medial collateral and lateral collateral ligaments was observed in all participants of the study, when comparing the initial values of the 1st care and the final values of the 12th Mulligan session. The lateral collateral ligament presented the most significant result, with p = 0.02. Statistical analysis was performed through the BioEstat 5.0 program. The Shapiro-Wilk tests were applied to assess the normality of variables, and the t-student test was considered statistically significant p<0.05. Conclusion: statistically the lateral collateral ligament showed an immediate and lasting significant improvement in the pain threshold of the dancers with the therapeutic intervention of the Mulligan concept.

Kettlebell Training for Female Ballet Dancers: Effects on Lower Limb Power and Body Balance.

The aim of the present study was to evaluate the effects of 5 month kettlebell-based training on jumping performance, balance, blood pressure and heart rate in female classical ballet dancers. It was a clinical trial study with 23 female dancers (age = 21.74 ± 3.1 years; body height = 168.22 ± 5.12 cm; body mass = 53.69 ± 5.91 kg) took part in the study. Participants were divided into two groups: a kettlebell group (n = 13), that followed a commercial kettlebell training protocol named the “Simple & Sinister protocol”, and a traditional dance training control group (n = 10). In the kettlebell group, kettlebell training completely replaced the jump and balance section of dance classes. Both groups performed balance and jumping tests before and after the training period. Blood pressure and the heart rate were also measured. The kettlebell group showed significant improvements in the balance tests (antero-posterior and medio-lateral oscillation) with both legs and eyes open as well as in all types of jump exercises (unrotated: +39.13%, p < 0.005; with a turnout: +53.15%, p < 0.005), while maximum and minimum blood pressure and the heart rate decreased significantly (max: -7.90%, p < 0.05; min: -9.86%, p < 0.05; Heart rate: -17.07%, p < 0.01). The results for the control group were non-significant for any variable. Comparison between groups showed significant differences for all variables analyzed, with greater improvements for the kettlebell group. Our results suggest that specific kettlebell training could be effective in improving jump performance and balance in classical dancers to a significantly greater degree compared to classical dance training.

The Validity of the Session Rating of Perceived Exertion Method for Measuring Internal Training Load in Professional Classical Ballet Dancers.

The aim of this study was to investigate the convergent validity of session rating of perceived exertion (s-RPE) with objective measures of internal training load (TL) in professional classical ballet dancers. Heart rate and s-RPE data were collected in 22 professional classical ballet dancers across a total of 218 ballet class or rehearsal sessions. Eleven participants completed at least 9 sessions, and were therefore included in analyses of individual relationships between s-RPE and objective measures. To calculate s-RPE, the session duration was multiplied by the RPE, measured using the modified Borg CR-10 scale. The Edwards summated heart rate zones (Edwards TRIMP) and Banister training impulse (Banister TRIMP) methods were used as criterion measures of internal TL. Pearson product-moment correlation coefficients were used to determine intra-individual relationships between s-RPE and objective measures. Repeated measures correlations were used to identify intra-individual relationships common across the cohort. Positive linear relationships were seen between s-RPE and objective measures across all session types [Edwards TRIMP: rrm (195) = 0.81, p < 0.001; Banister TRIMP: rrm (195) = 0.79, p < 0.001], in ballet class [Edwards TRIMP: rrm (58) = 0.64, p < 0.001; Banister TRIMP: rrm (58) = 0.59, p < 0.001], and in rehearsals [Edwards TRIMP: rrm (119) = 0.82, p < 0.001; Banister TRIMP: rrm (119) = 0.80, p < 0.001], as well as across both males [Edwards TRIMP: rrm (136) = 0.82, p < 0.001; Banister TRIMP: rrm (136) = 0.80, p < 0.001], and females [Edwards TRIMP: rrm (57) = 0.80, p < 0.001; Banister TRIMP: rrm (57) = 0.78, p < 0.001]. Intra-individual correlation coefficients ranged from 0.46–0.96 [Edwards TRIMP: mean r = 0.81 ± 0.11, p = 0.051 – < 0.001; Banister TRIMP: mean r = 0.78 ± 0.14, p = 0.13– < 0.001]. These results demonstrate that s-RPE is a valid and practical method for measuring internal TL in professional classical ballet dancers.

Correlation between degreeof hallux valgus and kinematics in classical ballet: A pilot study.

Hallux valgus is a serious medical concern for classical ballet dancers. Although it is well-known that progression of hallux valgus is related to inappropriate movement techniques in classical ballet, the kinematic relationship between the degree of hallux valgus and ballet techniques has not been substantiated. To develop proper training methods that prevent progression of hallux valgus, this study aimed to investigate the relationship between the degree of hallux valgus and movement techniques in classical ballet. Seventeen female classical ballet dancers at the advanced college-level participated in this study. Kinematic analysis of standing and plié in the first position was conducted via video capture technique. The Pearson product-moment correlation analysis was performed to examine the degree of hallux valgus and the following three kinematic variables: (1) the extent to which turnout is forced by other joints in the lower extremity than the hip joint, (2) the direction difference between the knee and toe in the transverse plane, and (3) the pelvis obliquity angle. Among these kinematic variables, we found a significant correlation between the hallux valgus angle and the pelvis obliquity angle during plié (P = .045). The greater the hallux valgus angle, the greater the retroversion of the pelvis, a result which was contrary to our prediction. We present the first evidence that the degree of hallux valgus correlates with kinematics in a very basic technique of classical ballet.

Ultrasound imaging features of the Achilles tendon in dancers. Is there a correlation between the imaging and clinical findings? A cross-sectional study

ObjectivesTo analyze the prevalence of tendon pathology and performance associated in pre-professional classic dancers with no history of Achilles tendon (AT) pain. Design: A cross-sectional study was conducted. ParticipantsTwenty-nine classic ballet dancers without AT pain (58 tendons) were recruited. The tendons were classified (normal, abnormal) using ultrasound imaging (USI). Cross-sectional area (CSA) and thickness of flexor hallucis longus (FHL) muscle were measured using USI. Range of movement (ROM) of the first metatarsophalangeal join, balance test, endurance test and vertical jump were measured (bilaterally) as performance variables. ResultsMore than a half (62%) of the participants had at least one abnormal tendon, with 45% of the dancers in the abnormal group having bilateral abnormalities. Dancers with AT pathology had significantly more years of dancing and number of weekly pointe hours than those with no pathology on US imaging. No significant differences between the groups were identified for the rest of the variables. Dancing years were moderately correlated with AT thickness. ConclusionsAsymptomatic classic dancers had a high incidence of tendon pathology. Increased dancing years was associated with pathology in the AT. Nevertheless, these abnormalities may not affect dance performance.

Studies of Classical Ballet Dancers' Equilibrium at Different Levels of Development and Versus Non-Dancers: A Systematic Review.

In classical ballet, the execution of extreme movements on small bases of support causes the dancers constantly to seek balance. The objective of this systematic literature review was to evaluate the effects of classical ballet training on static and dynamic balance in order to emphasize the differences between dancers and non-dancers and between dancers with different levels of experience. Searches for scientific papers were conducted by two independent researchers in the PubMed, Science Direct, and LILACS databases. A secondary search was carried out by "snowballing" references in the selected studies. A modified Downs and Black checklist and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale were used to evaluate the methodological quality and evidence strength of the included studies, respectively. From 364 initial studies, nine were found to be eligible (five did analyses in static situations, two in dyna- mic situations, and two in both). With a maximum potential of 10 points, the methodological quality ranged from 6 to 8 on the Downs and Black checklist. It was found that the level of experience in ballet makes for better balance. However, there are indications that classical ballet dancers become more dependent on vision to control balance compared to non-dancers.

Person-job fit across the work lifespan – The case of classical ballet dancers

This study examines how employees assess demands-abilities and needs-supplies across their work lifespan, and how they better adjust to their work. Based on person-environment fit theory, the job design and the lifespan literatures, and using interviews with a sample of 40 professional ballet dancers, our research shows how the interplay between demands, abilities, needs, organizational resources, and regulation strategies contributes to a process of adjustment, and consequently enhances psychological well-being across the work lifespan. Additionally, we contribute to literature on well-being by presenting evidence of how organizational resources are perceived differently across the work lifespan and why. We also extend theory on job crafting by showing that crafting is partly a function of the phases of one's lifetime and by presenting evidence of forms of crafting among older workers. With increased longevity, individuals will need to remain working or recraft a career after reaching retirement age. Addressing age-related changes and considering the importance of organizational resources to well-being can help promote active aging.

Trigger toe caused by tenosynovitis of the flexor hallucis longus in a classical ballet dancer: a case report

Trigger toe caused by tenosynovitis of the flexor hallucis longus in a classical ballet dancer: a case report

QUALITATIVE ASSESSMENT OF A SEQUENCE OF “ALLEGRO” IN CLASSICAL BALLET DANCERS WITH DIFFERENT TECHNICAL LEVEL

Since training of professional classical ballet dancers is primarily focused on the aesthetic component of performance there is a necessity to assess its qualitative aspects. This study aimed to investigate whether the Performance Competence Evaluation Measure (PCEM) adapted version for classical ballet can be a valid and useful tool: 1) to assess the performance of an “Allegro” sequence; 2) to discriminate between different levels of dancers’ experience. Twenty-four female classical ballet dancers divided in two subgroups [Ballet students (n = 12) and Pre-professional dancers (n = 12)] were recruited to perform a 70 seconds sequence of “Allegro” specifically choreographed. Each performance was assessed by three very experienced judges, which scores were based on a Likert scale (ranging from 1 to 5) to evaluate the following four parameters: 1) Full Body Involvement (FBI); 2) Body Integration and Connectedness (BIC); 3) Articulation of Body Segments (ABS); 4) Movement Skills (MS). The inter-rater reliability values were ranging from good (between 0.6 and 0.8) and very good (over 0.8) for all parameters, while the test-retest reliability showed a very good agreement for all parameters. The Allegro is a dance sequence with greater dynamism that better highlights differences of execution between dancers with different technical levels and the Mann-Whitney test showed significant differences for all parameters (P=0.001) with lower values for the ballet students. In conclusion, the PCEM adapted version for classical ballet showed to be a valid tool: 1) to assess the performance of Allegro; 2) to discriminate between different dancers’ level of experience.

Coaches, gender non-conforming youth and athletics: examining male identity and masculine expression

Participation in athletics by gender non-conforming (GNC) and lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) is lower in comparison to their participation in other school activities; LGBT students avoid athletic fields, locker rooms, and coaches. We examine the ways DeVita, a GNC student athlete in high school negotiated his identity, expression, and sexual orientation as an accomplished classical ballet dancer and all-conference soccer player. Using Butler’s work on gender and discourse, we analyze DeVita's gender identity, gender expression, sexual orientation, and the performances of masculinity he maintained to ensure his emotional safety, position on his teams, and access to playing time. We underscore the ways two coaches affirmed his identity and expression and represent their everyday speech acts as account of the ways educators can disrupt the discourse of dominant binary gender norms.

Countermovement Jump and Drop Jump Performances Are Related to Grand Jeté Leap Performance in Dancers With Different Skill Levels.

Blanco, P, Nimphius, S, Seitz, LB, Spiteri, T, and Haff, GG. Countermovement jump and drop jump performances are related to grand jeté leap performance in dancers with different skill levels. J Strength Cond Res 35(12): 3386-3393, 2021-Thirty-five classical ballet dancers were chosen to investigate relationships between the grand jeté leap, countermovement jump (CMJ), and drop jump (DJ) and establish whether the magnitude of the relationship between these tests differed across 3 skill levels. Subjects (male: n = 11 and female: n = 24) were divided into 3 groups: novice (n = 12; age: 16.6 ± 1.5 years; height: 1.7 ± 0.1 m; body mass: 58.0 ± 13.0 kg), semiprofessional (n = 13; age: 20.0 ± 1.6 years; height: 1.7 ± 0.1 m; body mass: 64.1 ± 10.5 kg), and professional (n = 10; age: 23.8 ± 3.5 years; height: 1.8 ± 1.2 m; body mass: 63.3 ± 14.7 kg). Grand jeté leap height, followed by CMJ and DJ vertical displacement, was assessed. Significant relationships were found between the grand jeté, CMJ (r = 0.77, p = 0.001) and DJ (r = 0.76, p = 0.001). After a Fisher's r-z transformation, professional dancers and novice dancers showed greater r-value differences in CMJ (r2 - r1 = 0.27) compared with novice (r2 - r1 = 0.17) and semiprofessional dancers (r2 - r1 = 0.11), indicating larger strength of CMJ to grand jeté relationship in professionals. The grand jeté leap showed large to very large correlations with CMJ and DJ within groups. These common performance tests were determined to be practical and efficient methods for assessing the jumping ability of dancers. As dance skill increased, larger correlations were observed, suggesting that dancers with superior ballet skills may be more likely to use their underpinning physical capacities to jump higher within the context of ballet-specific jumping.

Cross-validation of prediction equations for estimating body composition in ballet dancers

IntroductionIn sports related to low body weight, such as classical ballet, the assessment of body composition is important for monitoring performance and health status. This study aimed to cross-validate anthropometry and bioelectrical impedance (BIA) predictive equations for estimating body composition of non-professional classical ballet dancers, using dual-energy-X-ray absorptiometry (DXA) as a reference method.Materials and methodsThirty-seven female non-professional classical dancers (median age of 19 years), at intermediate/advanced level, were evaluated in a cross-sectional study. Body composition was evaluated by DXA, anthropometry and tetrapolar BIA. Twenty different predictive equations of anthropometry (n = 8) and BIA (n = 12) were used to estimate Body Fat (BF) and Fat-Free Mass (FFM), testing their validity against DXA using the Bland-Altman statistics.ResultsFor BF estimated by anthropometry equations, just one equation showed agreement with DXA (r = 0.852, p < 0.0005; p = 0.600 for one sample T-test). According to the Bland-Altman analysis, this equation also showed validity, with the absence of proportional bias. Regarding the predictive BIA equations tested, none were valid for our study group.ConclusionOnly one of the anthropometric equations, the one proposed by Durnin and Womerley (1974), but none of the BIA equations analyzed, was valid for the evaluation of body composition of the studied classical dancers. Our results emphasize the importance of previous cross-validation of existing equations or the development of specific equations for body composition assessment in specific populations.

Eating disorders and associated factors in professional classical ballet dancers in Brazil

Eating disorders and associated factors in professional classical ballet dancers in Brazil

Assessment of musculoskeletal pain in dance focusing on dance-style related differences

ABSTRACTObjectives: Pain in dance may be related to the high specific load on the musculoskeletal system caused by dance techniques. Up to the present, data on pain-relevant aspects considering the dance style as a contributing factor to pain occurrence in dance are still pending. The aim of this study was to analyze and compare dance-style specific pain with regard to prevalence, localization, subjective pain perception, duration, frequency, temporary dynamics and pain evaluation in dancers of the two popular dance styles (ballet and contemporary dance).Methods: The quantitative cross-sectional observation study with descriptive focus was carried out in n = 64 classical (ballet) dancers (B) and n = 81 jazz/modern/contemporary dancers (JMC). All participants were non-professional dancers. The data were collected by using an online questionnaire consisting of existing pain assessments adapted for dance.Results: Above all, differences were found in the comparison of the dancers’ body regions. While the lower extremity was particularly affected in ballet dancers (B) (right calf, p = 0.04; forefoot and toes, p < 0.01), dancers of the JMC were more frequently affected by pain in the head and trunk (neck, p < 0.01; upper back, p < 0.01) and the upper extremity (shoulders, p < 0.01; wrists, p < 0.01; left elbow, p = 0.03). More than 65% of the dancers (B and JMC) reported pain in the context of dancing within the recent 3 and 12 months. Further parallels in the two dance styles could be observed in the subjective sensation of pain, the temporal course and the evaluation of pain.Conclusion: In the overall view of pain aspects, the parallels between the investigated dance styles prevail, which dominate in the aspects of pain prevalence, subjective perception, temporal progression, and pain evaluation. This allows the careful conclusion that the dance style performed is of limited importance for the pain aspects mentioned. The differences must be taken into account in future prevention measures.

Quality of life is associated with fatigue among Brazilian professional dancers

This cross-sectional study aimed to analyze the relationship between quality of life and levels of fatigue among Brazilian professional dancers. A total of 127 professional classical ballet and contemporary dancers, both male and female, from professional dance companies of the Brazilian South-Southeast region, participated in the study. Data were collected using online self-administered questionnaires, the World Health Organization Quality of Life – Biomedical Research and Education Foundation (WHOQOL – BREF) and the Fatigue Symptom Checklist (FSC), to characterize the participants. Multiple linear regressions were used for data analysis. The results showed that worsened psychological health, social relationships, environment, and total quality of life domains were associated with the drowsiness and dullness scale. Worsened physical health, psychological, and total quality of life domains were also associated with the inability to concentrate scale. However, improvement in social relationships and total quality of life domains were associated with the awareness of physical discomfort scale. These results indicate that fatigue affects the quality of life of professional dancers differently based on the scales used to measure fatigue, which highlights the importance of studies empirically testing specific fatigue-modifying factors in professional dance contexts.

The Epidemiology of Low Back Pain and Injury in Dance: A Systematic Review.

Dance is a physical pursuit that involves loading the spine through repetitive dynamic movements and lifting tasks. As such, low back pain (LBP) and low back injury (LBI) have been identified as common health problems in contemporary and classical ballet dancers. However, clarity regarding the experience of LBP and LBI in dance is lacking. To systematically review and synthesize the epidemiology of LBP and LBI in dance populations. A comprehensive search of 6 electronic databases, back catalogs of dance science-specific journals, and reference lists of relevant articles and a forward citation search were performed. Fifty full-text articles were included in the final systematic review. There was considerable methodological heterogeneity among the included studies. The median (range) point, yearly, and lifetime prevalence of LBP was 27% (17%-39%), 73% (41%-82%), and 50% (17%-88%), respectively. The lower back contributed to 11% (4%-22%) of time loss and 11% (5%-23%) of medical-attention injuries. Dancers are vulnerable to LBP and LBI. The use of definitions that are sensitive to the complexity of LBP and LBI would facilitate improved understanding of the problem within dance, inform health care strategies, and allow for monitoring LBP-specific intervention outcomes. J Orthop Sports Phys Ther 2019;49(4):239-252. Epub 18 Jan 2019. doi:10.2519/jospt.2019.8609.

Bone mineral density, body composition, and serum calcium in classical ballet dancers

Bone mineral density, body composition, and serum calcium in classical ballet dancers

Study and development of bioimpedance equations for estimating fat-free mass in classical ballet dancers

Study and development of bioimpedance equations for estimating fat-free mass in classical ballet dancers

An Epidemiological Study of Non-specific Low Back Pain in Non-professional Female Greek Classic Ballet Dancers

Epidemiological study of the incidence of mechanical low back pain (LBP) in non-professional female Greek classic ballet dancers over a year and therapeutic interventions required to address symptoms. Forty-six female classic ballet dancers members of preprofessional schools, aged 16-37 years (mean 28.8 ±5.44 yrs) practicing and training in classic dance for 6-40 hours/week (mean 10.8±6.68) and 2-27 years experience (mean 11.9±4.20 yrs) participated in an epidemiological study concerning the incidence of LBP episodes within the last year, the treatment they received, as well as the period of absence of training and performance due to LBP. A selfadministered questionnaire was employed. Information regarding incidence, duration, and intensity of mechanical low back pain was gathered as well as length of time away from practice or performance. A secondary aim was to investigate the type of conservative treatment that participants in this study received. Thirty-one (67.4%) participants in the study experienced 1-10 (mean 3.26±1.7) episodes of mechanical LBP in the previous 12 months. They had to refrain from dancing activities from 2 to 90 days (mean 16.9±16.22). Twenty one of the participants received some kind of conservative treatment. The incidence of LBP was found to be high among Greek amateur classic ballet dancers resulting in absence from dancing activities for a considerable length of time and raising the need for therapeutic intervention for a considerable percentage of the studied population. Effective prevention strategies of LBP are of vital importance, particularly in younger dancers.

The prevalence and impact of low back pain in pre-professional and professional dancers: A prospective study

ObjectivesTo determine the prevalence of low back pain (LBP) in pre-professional and professional dancers and its impact on dance participation, care-seeking and medication use. DesignProspective cohort study. SettingOne pre-professional ballet school, two pre-professional university dance programs, and a professional ballet company. ParticipantsMale and female classical ballet and contemporary dancers. Main outcome measuresAn initial questionnaire collected demographic and LBP history data. The monthly prevalence of LBP (all episodes, activity limiting episodes and chronic LBP) and impact (activity limitation, care-seeking, and medication use) was collected over a nine-month period. Results119 dancers participated, which represented 54% of those invited. Activity limiting LBP was reported by 52% of dancers, while chronic LBP was reported by 24%. Seventeen percent of all episodes of LBP resulted in some form of dance activity being completely missed. One-third of the sample reported care-seeking and one-fifth of the sample used medication. A history of LBP was associated with activity limiting LBP (p < 0.01; adjusted odds ratio: 3.98; 95% confidence interval: 1.44, 11.00). ConclusionsLBP in dancers was common and had multiple impacts. This study reinforces the need for dancer access to healthcare professionals with expertise in evidence-based LBP prevention and management.