This study aimed to assess factors associated with altered thoraco-lumbo-pelvic alignment among adolescents who attend classical ballet class. 57 adolescents were distributed into a case group formed by student ballet dancers with altered thoraco-lumbo-pelvic alignment and a control group formed by student ballet dancers with neutral alignment. The adolescents were subjected to an anthropometric and postural evaluation (photographic record of posture in the lateral view analysed using the vector graphics editor software Corel Draw 3), abdominal muscle strength test and questionnaire. The practice of ballet through Royal Academy of Dancing (RAD) method was 10.47 times more likely to be associated with altered thoraco-lumbo-pelvic alignment than the practice through Vaganova method in adolescents, and muscle strengthening was 6.23 times more likely to be associated with altered alignment when controlling for the other study variables. RAD method combined with muscle strengthening was associated with altered thoraco-lumbo-pelvic alignments among adolescents who showed weak or normal abdominal muscle strength, performed another physical activity, danced ballet for five years or less, had a weekly training load over three hours and usually slept in the prone position. The practice of ballet by the RAD method, in addition to the practice of muscle strengthening, was a factor associated with altered thoraco-lumbar-pelvic alignment.
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