Assessing Readiness for En Pointe in Young Ballet Dancers

Pointe Readiness in Youth Ballet Dancers: A Pilot Study on Dance Instructor Decision Making

Introduction: Transiting to dancing en pointe is an important milestone for young dancers who wish to progress in ballet training. Various criteria exist regarding pointe readiness, including age, range-of-motion, endurance, strength, balance, and technique. However, awareness and use of these criteria by dance instructors is currently unknown. The purpose of this pilot study was to assess the awareness and use of pointe readiness criteria by youth ballet instructors. Methods: A cross-sectional web-based survey study design was used, which included questions regarding dance instruction experience, dance studio characteristics, and criteria used to assess pointe readiness. Ballet instructors were recruited for participation. Data are presented as percentages and frequencies. Results: Thirty-one ballet instructors completed the survey from 15 states (1 international). Years of pointe ballet instruction ranged from 2 to 30+ years, with 35% indicating more than 30 years of experience. Instructors reported students begin pointe at age 11.8 years (range 9-15 years). A majority of instructors require 5 years of ballet experience prior to dancing en pointe (range 2-8 years). Reported pointe readiness criteria included strength (100%), dance technique (94%), age (87%), and years of ballet experience (71%). While all instructors reported evaluating a dancer's strength, assessments of flexibility and movement quality were not evaluated by 42% and 45% of instructors, respectively. Strength, dance technique, and age were rated as the greatest indicators of a dancer's readiness to begin pointe. Finally, instructors reported low knowledge of existing pointe readiness criteria. Conclusion: Ballet instructors initiated pointe work at age 12 and required 5 years of ballet experience before beginning to dance en pointe. While strength, dance technique, and age were the top considerations for evaluating readiness, approximately 40% of instructors did not evaluate flexibility or movement quality prior to progressing to pointe, and overall, knowledge of existing criteria was low.

Differences in the Rotation Axis Between Professional and Experienced Amateur Ballet Dancers During pirouette en dehour in Classical Ballet With Wearing Pointe Shoes: A Pilot Study

Introduction: En pointe, in which weight is placed on the tiptoes, is a fundamental practice for female ballet dancers with pointe shoes. The center of mass (COM) is maintained over the base of support and the relative position of COM to the center of pressure (COP) is especially important when conducting a pirouette in ballet. A pirouette is a fundamental turn in classical ballet with flat shoes and pointe shoes. The investigation of the turn with pointe shoes would be favorable for understanding the movement with limited base of support. Herein, we aimed to determine the differences in the ability to perform pirouettes with pointe shoes between professional and amateur ballet dancers. Methods: This study included 8 professional and 9 amateur ballet dancers. The dancers performed a single pirouette, and the movement was captured and analyzed in 3 phases: turning with double-leg support (TDS), turning with single-leg support in pre-swing (TSSp), and turning with single-leg support in mid-swing (TSSm). The analysis focused on the inclination between the vertical angle and the COP-COM line, the vertical maximum reaction force, and the jump-up time in each phase. Results: The results showed no significant differences between the TDS and TSSp. However, professional ballet dancers exhibited significantly lesser posterior inclinations (professional; 2.05° ± 0.90°, amateur; 3.88° ± 1.67°) and jump-up time (professional; 0%, amateur; 1.4% ± 1.3%) than amateur dancers during TSSm. Conclusion: Overall, the findings suggest that professional dancers exhibit superior control skills regarding the COP-COM line than amateur dancers during TSSm. These results may be attributed to the fact that professional dancers can maintain the COM as close to the upright as on the COP without jumping during TSSm. This enables professional dancers to conduct the movements esthetically and continue on to the other movements in the dance phase.

Effect of dance movement therapy on balance in adults with Down Syndrome. A pilot study

Systematic participation in dance therapy may improve balance and reduce risk of falls. The aim of this study was to assess the effect of dance therapy on balance and risk of falls in adults with Down syndrome. Study participants comprised 23 persons with Down syndrome aged 26- 49 years who underwent dance therapy. Before and after the therapy, all participants were measured on a BioSway balance platform using three tests: postural stability, limits of stability, and M-CTSIB fall risk. Mean result was lower following intervention (2.40 ± 1.81 vs. 1.65 ± 1.32; p = .006) in the postural stability test. The limits of stability test found a statistically significant difference (26.30 ± 8.99 vs. 37.90 ± 12.54; p < .001). The results of this study only partially supported the hypothesis that dance therapy improves balancing skills in adults with Down Syndrome.

Effects of the infrared laser on classical ballerinas' feet: Analysis of plantar foot and static balance

BACKGROUND AND PURPOSE

Overuse injuries and painful symptoms in athletes and dancers (especially classical ballerinas) may lead to reduced functional performance. However, laser application may reduce pain and increase physical conditioning. The aim of the current study was to evaluate the immediate and long-term effects of infrared laser on classical ballerinas' feet.

METHODS

Eight female adults who perform classical ballet training and feel pain in their foot, but report no injuries in the last 6 months participated in the study. Infrared laser (808 nm) was applied on ballerina's feet twice a week during three months. The laser parameters utilized were 100 mW average optical power and spot size of 0.04 cm² applied during 1 min, leading to 6 J and 125 J/cm² per point. Thermography, algometry and unipodal static standing balance test were performed.

RESULTS

There was a significant increase in plantar arch temperature (1.6 °C for center and 2.3 °C for border, p < 0.05) immediately after laser treatment for all ballerinas. The pressure pain thresholds (PPT) were significantly increased for 5 of 7 analyzed sites (p < 0.05). Regarding to the static standing balance, the time on one-foot showed a significant increases (from 23 ± 12 s to 34 ± 13 s, p < 0.05) only when the test was performed on the left foot (support foot).

CONCLUSION

Then, there were pain relief and improvement of functional performance in ballerinas. The possible mechanism of laser action in reducing pain and thus enhancing performance, like higher blood flow of foot due to an increase of cutaneous temperature, will be discussed.

Surgical Outcomes of Os Trigonum Syndrome in Dancers: A Case Series

Background

Management of ankle pain in dancers can be challenging because of the repetitive stress and complex demands placed on this region. Despite the prevalence of ankle injuries in this population, literature on surgical outcomes and return to dance is limited.

Purpose

To retrospectively evaluate the efficacy and functional outcomes after surgical excision of a symptomatic os trigonum in dancers.

Study Design

Case series; Level of evidence, 4.

Methods

Between June 2006 and June 2016, a total of 44 dancers underwent surgical excision of a symptomatic os trigonum at a single institution and by a single surgeon. All patients presented with symptoms of posterior ankle impingement syndrome and subsequently failed nonsurgical treatment. Clinical analysis was conducted using various pre- and postoperative patient-reported outcome questionnaires, including the Veterans RAND 12-Item Health Survey (VR-12), Foot Function Index-Revised (FFI-R), and visual analog scale (VAS) for pain, as well as subjective patient satisfaction.

Results

A total of 44 patients (54 ankles; mean age, 18.2 years) were retrospectively evaluated at a mean follow-up of 33.4 months. The VR-12 Physical Health score improved from a mean score of 37.8 ± 11.9 to 51.2 ± 10.5 (P < .001). The cumulative FFI-R score improved from 46.45 ± 13.8 to 31.2 ± 9.7 (P = .044), with the subcategory of "activity limitation" representing the highest-scoring FFI-R subcategory at 65.28 ± 13.4 preoperatively and improving to 34.47 ± 12.4 at follow-up (P < .001). The mean VAS score for subjective pain improved significantly from 5.39 ± 2.84 to 1.73 ± 2.10 (P < .00044).

Conclusion

Overall, the findings of the present study demonstrate that dancers of varying style and level improved significantly according to various clinical measures. Patients included in this study reported that they returned to their previous level of dance upon completion of physical therapy and maintained thriving postoperative careers, which for several meant dancing at the professional level.

Effect of different forms of physical activity on balance in older women

The aim of this study was to analyze the effect of two types of physical activity, dance, and general exercises, on balance in older women. Study participants comprised two groups of women. The participants attended 45-min DMT (n = 20) or GRE sessions (n = 19) three times per week for 12 weeks. Before and after the training, the participants underwent the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test. Improvement of the balance was confirmed for only one test both for the dance group and the general exercises group.

Effect of expertise in ballet dance on static and functional balance

RESEARCH QUESTION

The purpose of this study was to examine the postural sway characteristics of the ballet dance experts in quiet standing and at their limits of stability with an approach not used before in dancers.

METHODS

The study was conducted on thirteen female ballet dancers and thirteen non-training females. The data were collected with a use of a force plate. To gain a better insight into the postural control processes, we used the rambling-trembling and sample entropy analyses in the COP data processing.

RESULTS

The main findings of the study showed professional dancers to have higher values of postural sway characteristics in comparison to the non-trainees while performing simple motor tasks. Also, higher values of the trembling component in the group of dancers during quiet standing and the inclined positions were observed. This might be a sign of higher capacity of the postural system to deal with postural instability in dancers.

IMPORTANCE

Our results confirmed that the visual information is important in the process of postural control of dancers', which is proven by increased dislocations of the COP without visual feedback. The sample entropy results indicated more irregular characteristics of postural sway in ballet dancers representing more automated postural control. The data analysis methods showed high sensitivity to the subtle changes in postural control due to the dance training.