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Pavlović M, Ogrinc N, Šarabon N. Body asymmetries as risk factors for musculoskeletal injuries in dancesport, hip-hop and ballet dancers? Eur J Transl Myol 2022; 32:11020. [PMID: 36445245 PMCID: PMC9830391 DOI: 10.4081/ejtm.2022.11020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The study aimed to determine the incidence and expression of body asymmetries in dancers of three different dance styles: dancesport (n = 14), hip-hop (n = 21) and ballet (n = 20) and to examine how body asymmetries (muscle strength and power, stability and range of motion) are associated with musculoskeletal injuries occurring over the past 12 months. DESIGN Cross-sectional and retrospective study. METHODS Maximal isometric voluntary contraction was measured for trunk, hip, knee and ankle movements. Participants performed a single leg stance, unilateral landing, weight bearing symmetry, squat and countermovement jump on force platforms. Passive range of motion was measured for hip, knee and ankle with two-arm goniometer or digital inclinometer (hip flexion, extension and rotations). A retrospective questionnaire was used to collect data on musculoskeletal injuries occurring in the last 12 months. RESULTS Different dance styles were associated with different body asymmetries, including strength asymmetries (hip flexion and external rotation), agonist/antagonist asymmetries (trunk flexion/extension, hip abduction/adduction, ankle dorsi/plantar flexion) and hip adduction and internal rotation range of motion asymmetries. Moreover, strength asymmetries of hip flexion, adduction and abduction/adduction as well as stability asymmetries were associated with the total number of musculoskeletal injuries. CONCLUSIONS The incidence of body asymmetries (> 10%) in dancesport, hip-hop and ballet dancers was confirmed, as well as the association of some asymmetries with self-reported injuries occurring over the last 12 months. The cause-effect relationship should be clarified by further studies.
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Affiliation(s)
- Monika Pavlović
- University of Ljubljana, Faculty of Health Sciences, Ljubljana, Slovenia, , University of Primorska, Faculty of Health Sciences, Izola, Slovenia
| | - Nina Ogrinc
- Conservatory of Music and Ballet Ljubljana, Ballet College, Ljubljana, Slovenia,
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia, Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria, InnoRenew CoE, Human Health Department, Izola, Slovenia, S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia,University of Primorska, Faculty of Health Sciences, Polje 42, SI-6310 Izola, Slovenia. ORCID ID: 0000-0003-0747-3735
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2
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Nogier A, Tourabaly I, Barreau X, Ramos-Pascual S, van Rooij F, Saffarini M, Courtin C. Little or No Differences in Hip Morphology Between Professional Dancers and Controls: A Systematic Review. Clin J Sport Med 2022; 32:e527-e542. [PMID: 34759183 DOI: 10.1097/jsm.0000000000000985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/01/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To systematically evaluate and synthesize the literature on bony hip morphology of professional dancers, as measured by 2D or 3D imaging techniques. DATA SOURCES A literature search was performed on November 20, 2020, using MEDLINE, Embase, and Cochrane. Clinical studies were eligible if they reported on hip morphology of professional dancers. Two independent reviewers screened titles, abstracts, and full-texts to determine eligibility; performed data extraction; and assessed the quality of eligible studies according to the Joanna Briggs Institute (JBI) checklist. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. MAIN RESULTS The search returned 1384 records; 449 were duplicates, 923 were excluded after title/abstract/full-text screening, and 12 were eligible, reporting on 447 individuals (352 professional dancers and 95 controls). The JBI checklist indicated that 11 studies scored ≥4 points. For professional dancers, lateral center edge angle was 22.4 to 30.8 degrees, acetabular version was 6.7 to 13.5 degrees, neck-shaft angle was 132.5 to 139.5 degrees, and femoral version was 4.7 to 14.4 degrees. Statistically significant differences between dancers and controls were found in some of the studies for acetabular version, neck-shaft angle, and femoral version, although only femoral version showed clinically relevant differences. CONCLUSIONS The bony hip morphology of professional dancers is similar to that of other athletes and age-matched controls, which is in contrast to the authors' clinical experience. We presume that the abnormal morphology we have seen at the clinic is only present in symptomatic dancers who require total hip arthroplasty (THA) and is not a general characteristic of all dancers. Further studies should compare the hip morphology of dancers undergoing THA with matched nondancers.
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Affiliation(s)
- Alexis Nogier
- Service de Chirurgie Orthopédique, Clinique Trenel, Sainte-Colombe, France
- Service de Chirurgie Orthopédique, Clinique Maussins-Nollet, Paris, France
- Clinique Nollet, Paris, France
| | - Idriss Tourabaly
- Service de Chirurgie Orthopédique, Clinique Maussins-Nollet, Paris, France
- Clinique Nollet, Paris, France
| | | | | | | | | | - Cyril Courtin
- Service de Chirurgie Orthopédique, Clinique Trenel, Sainte-Colombe, France
- Service de Chirurgie Orthopédique, Clinique Maussins-Nollet, Paris, France
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3
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Gorwa J, Kabaciński J, Murawa M, Fryzowicz A. On the track of the ideal turnout: Electromyographic and kinematic analysis of the five classical ballet positions. PLoS One 2020; 15:e0230654. [PMID: 32210478 PMCID: PMC7094876 DOI: 10.1371/journal.pone.0230654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/05/2020] [Indexed: 11/18/2022] Open
Abstract
The turnout of the lower extremities is the major component of the classical ballet positions (CPs) and correctly is initiated in the hips. The aim of this research was to determine the differences in the electromyographic and kinematic variables in the five CPs in ballet students with greater and lesser amount of passive hip external rotation (HER). A group of 14 female pre-professional ballet dancers 11–16 years of age participated in the study. Based on the amount of passive HER, participants with higher values made up greater rotation group (n = 7) whereas those with lesser values formed lesser rotation group (n = 7). Electromyographic activity of 14 muscles from right side of the trunk and right lower extremity was recorded with the surface electrodes while subjects were standing in all five CPs (CP1-CP5). The external rotation of the hips, knees and feet were recorded with the motion capture system. The kinematic differences between the groups were revealed in asymmetric positions CP4 and CP5 where foot progression angle was significantly lesser in forward than backward setting only in lesser rotation group. In lesser rotation group the ankle and back muscles were more engaged in CPs while abdominal and hip muscles less when compared with greater rotation group. This finding suggests that in the group with lesser passive HER the mechanism of forced turnout was employed. The most remarkable finding in our work was that various electromyographic patterns can be observed between groups in all CPs, while kinematic differences may be marked only in asymmetric positions.
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Affiliation(s)
- Joanna Gorwa
- Department of Biomechanics, Poznan University of Physical Education, Poznan, Poland
- * E-mail:
| | - Jarosław Kabaciński
- Department of Biomechanics, Poznan University of Physical Education, Poznan, Poland
| | - Michał Murawa
- Department of Biomechanics, Poznan University of Physical Education, Poznan, Poland
| | - Anna Fryzowicz
- Department of Biomechanics, Poznan University of Physical Education, Poznan, Poland
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4
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Lin CW, Su FC, Lin CF. Kinematic Analysis of Postural Stability During Ballet Turns ( pirouettes) in Experienced and Novice Dancers. Front Bioeng Biotechnol 2019; 7:290. [PMID: 31709249 PMCID: PMC6823550 DOI: 10.3389/fbioe.2019.00290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/09/2019] [Indexed: 11/13/2022] Open
Abstract
Turning is an important but difficult movement, often performed in ballet choreography. Understanding the postural sway during ballet turns is beneficial to both dancers and dance teachers alike. Accordingly, this study evaluated the postural sway angle during ballet turns in female novice and experienced ballet dancers by means of the inclination angle, determined from the center of mass (COM) and center of pressure (COP). Thirteen experienced dancers and 13 novice dancers performed ballet turns (pirouettes). The COM-COP inclination angle was measured during the preparatory, double-leg support, and single-leg support phases of the turn. The novice dancers exhibited significantly greater ranges of the COM-COP inclination angle in the anterior-posterior (AP) and medial-lateral (ML) directions during the preparatory (AP direction, p < 0.001; ML direction p = 0.035), double-leg support (AP direction p < 0.038; ML direction p = 0.011), and ending phases (AP direction p < 0.001; ML direction p = 0.024). Moreover, during the preparatory phase, the novice dancers failed to adjust their posture in a timely manner, and therefore showed overshooting errors. Finally, during the ending phase, the novice dancers showed a greater standard deviation of the COM-COP inclination angles and performed continual postural adjustments, leading to a less smooth movement than the experienced dancers. In conclusion, the novice dancers were suggested to focus on the COM-COP adjustment during both preparatory and ending phases.
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Affiliation(s)
- Chai-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan.,Department of Physical Therapy, Shu Zen Junior College of Medicine and Management Kaohsiung, Kaohsiung, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan.,Musculoskeletal Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Feng Lin
- Musculoskeletal Research Center, National Cheng Kung University, Tainan, Taiwan.,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Mayes S, Smith P, Cook J. Impingement-type bony morphology was related to cartilage defects, but not pain in professional ballet dancers' hips. J Sci Med Sport 2018. [PMID: 29526410 DOI: 10.1016/j.jsams.2018.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Professional ballet dancers may have hip bony morphology that predisposes them to cartilage or labral injury. However, the relationship between bony morphology and pathology has not been investigated in ballet. This study investigates associations between bony morphology, chondrolabral defects and hip pain in ballet dancers. DESIGN Cross-sectional study. METHODS 33 male and female professional ballet dancers, (mean age 27 years (range 19-39)), completed questionnaires with hip pain measured on a visual analogue scale; and underwent 3.0-T magnetic resonance imaging (3T MRI) to measure lateral centre edge angles (LCEA), alpha angles in the anterior and superior position, femoral neck-shaft angles (NSA) and acetabular version angles; and to detect acetabular labral tear and articular cartilage defects. RESULTS Seventeen dancers (51.5%) had impingement-type (alpha angle>50.5° or acetabular version <10° or >20°) and 19 (58%) had instability-type (LCEA<25° or NSA>135°) bony morphology. Cartilage defect prevalence was higher in dancers with impingement-type bony morphology (n=14) compared to those without impingement-type morphology (n=4, p=0.001). There was no relationship between instability-type bony morphology and cartilage defects (p>0.05). There was no relationship between labral tears and bony morphology (p>0.05). Neither chondrolabral pathology nor any morphological feature were associated with hip pain (p>0.05 for all). CONCLUSIONS Impingement-type bony morphology was related to cartilage defects, but not labral tear. Hip pain was not associated with pathology or bony morphology. Longitudinal studies are warranted to determine if bony features, such as cam morphology, acetabular retroversion or anteversion, are precursors to symptomatic hip joint injury or osteoarthritis.
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Affiliation(s)
- Susan Mayes
- The Australian Ballet, Australia; School of Allied Health, La Trobe University, Australia.
| | | | - Jill Cook
- School of Allied Health, La Trobe University, Australia.
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Gontijo KNS, Amaral MAD, Santos GCD, Candotti CT. Métodos usados para avaliar o en dehors ou turnout de dançarinos e bailarinos clássicos: revisão da literatura. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/17100124042017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO A técnica do ballet clássico exige a realização máxima do en dehors ou turnout, caracterizado pela rotação externa de membros inferiores. Considerando a sua importância, diversos protocolos para a sua avaliação e mensuração têm sido propostos. O objetivo desta revisão foi investigar sistematicamente quais os métodos utilizados para avaliar o turnout de bailarinos clássicos e/ou praticantes de ballet clássico existentes atualmente. A busca foi feita nas bases de dados Scopus, Science Direct e PubMed, no mês de fevereiro de 2016, e os artigos encontrados deveriam: estar redigidos na língua inglesa, avaliar bailarinos clássicos ou dançarinos que praticassem ballet clássico e mensurar o en dehors ou turnout. Foram encontrados 593 artigos, dos quais 25 foram pré-selecionados para esta revisão, apresentando quinze diferentes métodos e instrumentos de mensuração do turnout: cinemetria; inclinômetro; turnout protactor ou transferidor para medir o turnout; goniômetro; Dupuis Tropometer; transferidor original; fotos dos sujeitos; discos rotacionais; teste de flexibilidade de Nicholas; flexímetro; desenho clínico dos pés; sujeito sobre um pedaço de papel ou solo ou quadro branco; ressonância magnética; filmagem do sujeito executando sequência de passos; Dasco Pro Angle Finder. Esta revisão apresenta forte evidência para afirmar que não há, até o presente momento, um método ou instrumento padrão-ouro para mensuração do turnout de bailarinos, de modo que esta costuma ser adaptada e escolhida de acordo com o objetivo de cada estudo.
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Fraser JL, Sugimoto D, Yeng YM, d'Hemecourt PA, Stracciolini A. Bony Morphology of Femoroacetabular Impingement in Young Female Dancers and Single-Sport Athletes. Orthop J Sports Med 2017; 5:2325967117723108. [PMID: 28840149 PMCID: PMC5555507 DOI: 10.1177/2325967117723108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Femoroacetabular impingement (FAI) is a painful and limiting condition of the hip that is often seen in young athletes. Previous studies have reported a higher prevalence of this disorder in male athletes, but data on the structural morphology of adolescent and young adult female athletes, specifically those involved in dance, are lacking. PURPOSE (1) To investigate the radiographic morphology of FAI deformities in adolescent and young adult female single-sport dance and nondance athletes and (2) to examine the differences in the radiographic findings between these 2 groups. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A retrospective chart review of 56 female single-sport athletes 10 to 21 years of age with a diagnosis of FAI within a single-sports medicine division of a pediatric academic medical center was performed. Acetabular index (AI), lateral center-edge angle (LCEA), crossover sign, and ischial spine sign were measured bilaterally on anteroposterior radiographs; alpha angle (AA) was measured on lateral films, and anterior center-edge angle (ACEA) was measured on false-profile films. Independent t tests and Mann-Whitney U tests were used to compare mean angle measurements between dance and nondance athletes. Dichotomized categorical variables and crossover and ischial spine signs were analyzed between dance and nondance athletes by applying a chi-square test. Statistical significance was set as P < .05 a priori. RESULTS Significant differences in angle measurements were noted. AA was significantly lower in the dancers compared with the nondance athlete group (49.5° ± 6.0° vs 53.9° ± 7.3°, P = .001). The LCEA and ACEA of dance athletes were significantly greater compared with nondance athletes (33.8° ± 6.7° vs 30.9° ± 5.8° [P = .016] and 36.0° ± 8.1° vs 32.3° ± 7.0° [P = .035], respectively). No significant difference in AI was seen between the 2 cohorts (5.0° ± 4.0° for dancers vs 5.9° ± 3.4° for nondancers, P = .195). CONCLUSION Significant differences existed in the radiographic bony morphology of young female single-sport dance athletes compared with nondance athletes with FAI. In dance athletes, symptoms were seen in the setting of normal bony morphology.
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Affiliation(s)
- Joana L Fraser
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Dai Sugimoto
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
| | - Yi-Men Yeng
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Pierre A d'Hemecourt
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
| | - Andrea Stracciolini
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
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8
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Carter SL, Bryant AR, Hopper LS. Lower-Leg and Foot Contributions to Turnout in University-Level Female Ballet Dancers A Preliminary Investigation. J Am Podiatr Med Assoc 2017; 107:292-298. [PMID: 28880595 DOI: 10.7547/15-142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Turnout in ballet is produced through summation of the joint structure characteristics and ranges of motion at the hip, knee, ankle, and foot. Contributions of the hip joint to functional turnout in dancers have received extensive examination, whereas little is known about contributions from the knee, ankle, and foot. The aim of this study was to explore the nonhip components of turnout to dancers' functional turnout in first position by assessing passive external tibiofemoral rotation and active measures of foot pronation, ie, navicular drop and Foot Posture Index. METHODS Nineteen female university-level dance students aged 16 to 19 years participated in this descriptive correlational study. External tibiofemoral rotation, navicular drop, Foot Posture Index, and functional turnout were measured for the participants' right and left legs. RESULTS Regression analyses revealed a weak relationship between passive external tibiofemoral rotation and functional turnout. Correlation analysis revealed a moderate negative relationship between passive tibiofemoral external rotation and the Foot Posture Index in functional turnout. CONCLUSIONS These findings suggest that the lower leg does contribute to dancers' overall position of functional turnout. However, current methods are not useful in predicting a dancer's lower-leg contribution and alignment in functional turnout in first position.
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Affiliation(s)
- Sarah L. Carter
- Podiatric Medicine and Surgery Division, School of Allied Health, The University of Western Australia, Perth, Australia
| | - Alan R. Bryant
- Podiatric Medicine and Surgery Division, School of Allied Health, The University of Western Australia, Perth, Australia
| | - Luke S. Hopper
- Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia
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9
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Bony morphology of the hip in professional ballet dancers compared to athletes. Eur Radiol 2016; 27:3042-3049. [DOI: 10.1007/s00330-016-4667-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 11/01/2016] [Accepted: 11/17/2016] [Indexed: 01/01/2023]
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10
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Hopper LS, Sato N, Weidemann AL. Single-leg squats can predict leg alignment in dancers performing ballet movements in "turnout". Open Access J Sports Med 2016; 7:161-166. [PMID: 27895518 PMCID: PMC5118020 DOI: 10.2147/oajsm.s119388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The physical assessments used in dance injury surveillance programs are often adapted from the sports and exercise domain. Bespoke physical assessments may be required for dance, particularly when ballet movements involve “turning out” or external rotation of the legs beyond that typically used in sports. This study evaluated the ability of the traditional single-leg squat to predict the leg alignment of dancers performing ballet movements with turnout. Three-dimensional kinematic data of dancers performing the single-leg squat and five ballet movements were recorded and analyzed. Reduction of the three-dimensional data into a one-dimensional variable incorporating the ankle, knee, and hip joint center positions provided the strongest predictive model between the single-leg squat and the ballet movements. The single-leg squat can predict leg alignment in dancers performing ballet movements, even in “turned out” postures. Clinicians should pay careful attention to observational positioning and rating criteria when assessing dancers performing the single-leg squat.
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Affiliation(s)
- Luke S Hopper
- Western Australian Academy of Performing Arts, Edith Cowan University, Mt Lawley, WA, Australia
| | - Nahoko Sato
- Department of Physical Therapy, Nagoya Gakuin University, Seto, Japan
| | - Andries L Weidemann
- Western Australian Academy of Performing Arts, Edith Cowan University, Mt Lawley, WA, Australia
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Quanbeck AE, Russell JA, Handley SC, Quanbeck DS. Kinematic analysis of hip and knee rotation and other contributors to ballet turnout. J Sports Sci 2016; 35:331-338. [DOI: 10.1080/02640414.2016.1164335] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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