Occupational Health and the Performing Arts: An Introduction

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.

Translation, cross-cultural adaptation, reliability and validity of the Brazilian Portuguese version of the 'Fit to Dance?' survey

BACKGROUND

The 'Fit to Dance?' survey has been used in a number of studies to understand the health and wellbeing of dancers. These data have not been collected in Brazil as there is no validated questionnaire available in Brazilian Portuguese, culturally validated in Brazil with a scope as broad and comprehensive as that of 'Fit to Dance?'.

OBJECTIVE

Translate into Brazilian Portuguese and culturally validate the questionnaire 'Fit to Dance?' in Brazil.

METHODS

This was a validity and reliability study of the Brazilian Portuguese version of the 'Fit to Dance?'

SURVEY

The stages of the research were: translation into the target language (Brazilian Portuguese), translation synthesis, translation validation and cross-cultural adaptation by a committee of experts in Dance Medicine and Science (DMS), reverse translation into English, pilot study (test/retest), and final version of the questionnaire.

RESULTS

The questionnaire was applied to 21 dancers of different dance genres, with an age average of 25 ± 7.0 years. Cronbach's alpha (0.705), ICC (0.984) and Kappa (0.794) results reached adequate values.

CONCLUSION

The Brazilian Portuguese version of the questionnaire 'Fit to Dance?' is effective, has adequate levels of validity and reliability, and can be used to report injuries and aspects of health and well-being of Brazilian dancers.

Step type is associated with loading and ankle motion in tap dance

Tap dance generates forces and joint motions that can lead to injury; however, little is known about the magnitude of load across different tap steps. The purpose of this study was to calculate peak vertical forces, average vertical foot velocities, and maximum/minimum ankle angles produced by tap dancers with different levels of experience performing the toe cannon, heel cannon, flap, and cramp roll. This prospective cross-sectional study included 14 female tap dancers aged ≥18 years with varying tap experience. Participants were recorded by three cameras while performing a choreographed tap combination containing four steps of interest on a force platform. Adjusting for experience and dancer-level clustering, we identified the steps-cramp roll and toe cannon-that had the highest peak vertical ground reaction force, angles, and velocities compared to flap and heel cannon. There was no effect of experience. The results supported our hypothesis and provide new insights into step production. Over time, the larger forces associated with these steps could pose an increased risk of injury to bones and joints when compared to smaller forces, which may suggest the importance of adjusting routines to reduce or avoid injury.

Part 1: The Pediatric Hazards of Art Materials

Hazardous substances can be found in art materials that children encounter at school, at home, and in other settings, and adult behaviors can contribute to children's risks from these hazardous art materials. Some art materials contain severe irritants, allergens, chronic health hazards, and carcinogens. Most of the hazardous substances found in art materials are known from adult exposures in occupational or environmental settings, and few have been specifically studied in children. For many of these hazards, only limited treatments are available, so prevention is imperative. Despite laws focusing on art material labeling and designation as safe for children, there are some concerns about the accuracy of these labels. Children are at special risks from hazardous material exposures because of their developing physiologies and intellects. A wide range of art activities are taught in schools and some can include hazardous materials. Art activities and precautions that are appropriate for children in 6th grade and below and others for 7th grade and older are outlined. Excellent resources are available for further information on hazardous art materials, prevention recommendations, and health and safety programs for schools. [Pediatr Ann. 2023;52(6):e213-e218.].

The Actor's Voice: Vocal Performance Assessment by Different Professionals

INTRODUCTION

The voice production of actors is complex and can be assessed by different professionals. The objective of this study was to measure actor's global vocal performance (GVP) based on overall voice quality (OVQ) and overall severity (OS), by consensus auditory-perceptual evaluation of voice (CAPE-V), and to investigate the possible correlation between these two analyses in actors without self-reported vocal complaints.

METHODS

A total of 39 actors participated in this study, including 20 men and 19 women. Their ages ranged from 18 to 53 years (mean of 33.3 years), with a mean duration of eight years of professional experience. The referred actors were asked to perform predefined CAPE-V tasks and provide one voice sample in which they read a poem at normal loudness; all tasks were recorded. A professional speech-language therapist evaluated the OS based on CAPE-V vocal tasks; scores up to 35.5 mm represented normal parameters, while those from 35.6 to 50.5 mm represented mild deviation, 50.6 to 90.5 mm indicated moderate deviation, and 90.6 to 100 mm indicated severe deviation. A theater director and another speech-language therapist classified the voice samples using the OVQ scale. The OVQ was measured using a 200-mm visual analogue scale. The calculation of terciles allowed the division into three groups regarding the GVP: lowest score group; intermediate score group; and highest score group. The scores of both analyses were compared by sex and groups. Lastly, a correlation analysis was performed between the two analyses for the total sample.

RESULTS

There was a significant difference among the three groups and a mild vocal deviation in the lowest score group. In addition, an inversely proportional correlation was observed between GVP and OS. No sex-related differences were observed in the scores for either analyses.

CONCLUSION

The actors without self-reported voice complaints presented differences on GVP scores and their distribution was independent of sex and length of professional experience. Vocal deviation, although mild, on average was greater in actors who had the lowest scores in GVP, with an inversely proportional correlation between these two parameters.