Lack of alignment between the lowerlimb structures, such as the hips, knees, and longitudinal arches of the feet, has been described as an important predisposing factor in musculoskeletal injury among classical ballet dancers. However, no studies were found that analyzed basic ballet movements with quantification of objective criteria of the movements. The purposes of this study were: 1. to establish a methodology to quantify, using kinematic evaluation, the technical criteria that guide the correct execution of all phases of the plié (simultaneous flexion of the hips, knees, and ankle joints); and 2. to explore whether experienced ballet dancers respect those criteria when performing the plié. The technical criteria considered were the following: 1. midfoot stability; 2. pelvic positioning in a neutral alignment; 3. pelvic stability, represented by pelvic angle variation; and 4. vertical alignment of the knee joint with the second toe of the ipsilateral foot. Twenty dancers from Porto Alegre, Brazil, with 18 years of uninterrupted ballet training, were filmed while performing plié using four synchronized cameras. The descriptive statistical analysis involved calculating the median, minimum, and maximum of each of the technical criteria. Results showed that for criterion 1, the 20 dancers showed great stabilization of the midfoot; for criteria 2 and 3, 18 dancers displayed pelvic instability tending toward retroversion throughout execution of the plié; and for criterion 4, 13 dancers presented with medial misalignment of the knees at all phases of the plié. Using these criteria, it was possible to characterize the plié from a kinematic point of view.
The purpose of this study was to evaluate the midfoot longitudinal arch height and correlate it with active hip external rotation (ER) in dancers during static postures and technical steps of classical ballet (i.e., first position, demi-plié, battement fondu à la seconde, pas jeté à la seconde, and grand jeté à la seconde). A 3D motion analysis system was used for kinematic analysis. The arch height was significantly reduced during the battement fondu à la seconde, pas jeté à la seconde, and grand jeté à la seconde when compared to standing (p = 0.000 for all comparisons), first position (p = 0.000, p = 0.000, and p = 0.001, respectively) and demi-plié (p = 0.015, p = 0.003, and p = 0.006, respectively). No significant correlation was found between arch height and active hip external rotation (p > 0.05). Hence, active hip external rotation does not seem to be related to midfoot pronation in this sample. Other factors, such as intrinsic and extrinsic foot muscle strength, may be related to the midfoot arch height. These findings contribute to a better understanding of ballet steps, but future studies are required to clarify this topic completely.
Este estudo teve como objetivos: (i) desenvolver o Método de Avaliação da Aprendizagem dos Princípios do Pilates (MAAPPilates) com base nos estágios da aprendizagem motora (cognitivo, associativo e autônomo); (ii) verificar a validade de conteúdo do método; e (iii) avaliar a reprodutibilidade intra e inter-avaliador do método. Para a validação de conteúdo quatro experts receberam a planilha de avaliação de dois exercícios de Pilates (The Hundred e Roll Up) juntamente com um vídeo mostrando a execução dos exercícios. Para a avaliação de reprodutibilidade três avaliadoras analisaram, de forma independente e em dois momentos distintos com intervalo de sete dias entre eles, vídeos de 30 participantes executando os dois exercícios. Para avaliar a reprodutibilidade intra-avaliador foram utilizados os resultados da 1ª análise comparativamente a 2ª análise da mesma avaliadora, e para avaliar a reprodutibilidade inter-avaliador foram utilizados os resultados da 1ª análise das três avaliadoras. A análise estatística foi baseada no ICC (< 0,05). Depois de efetuadas as alterações solicitadas pelos experts, a versão final do instrumento foi considerada muito adequada quanto ao objetivo de avaliar a aprendizagem dos princípios do Pilates por meio dos estágios da aprendizagem motora, confirmando a validação de conteúdo. Os valores de ICC foram em média 0,792 e 0,664, confirmando a reprodutibilidade intra e inter-avaliador, respectivamente. Com base nos resultados obtidos, pode-se afirmar que o MAAPPilates é válido e reprodutível, podendo ser utilizado por diferentes avaliadores ou pelo mesmo avaliador em diferentes momentos, fornecendo informação confiável sobre qual o estágio da aprendizagem motora em que se encontra o praticante de Pilates, podendo auxiliar no processo de avaliação e no desenvolvimento e acompanhamento de um treinamento de Pilates.
The MADAAMI (Método de Avaliação Dinâmica do Alinhamento Articular dos Membros Inferiores-Dynamic Evaluation Method of Lower Limb Joint Alignment) is an instrument that has been developed and validated with the aim of providing direct, simple, and practical support for the identification of compensations and misalignments of joints. The first version of the instrument had some limitations. The goals of the present study are to update the instrument (MADAAMI-II), evaluate its content validity, and verify inter-rater and intra-rater reproducibility during the execution of demi-plié, grand plié, and fondu in two turnout positions of classical ballet (120° and self-reported) and in parallel foot position. The study was approved by the local university's Ethics Committee, and 20 ballet dancers from different levels of the Bolshoi Theater School in Brazil participated. Each dancer was digitally recorded executing the three steps in the different foot positions. To verify inter-rater reproducibility, three independent raters used the MADAAMI-II's score sheet. To verify intra-rater reproducibility, a single rater repeated the evaluation after a 7-day interval. Cohen's Kappa Coefficient (α = 0.05) was used. The results showed kappa values ranging from 0.062 to 0.357 in the inter-rater reproducibility analysis and from 0.431 to 0.806 in the intra-rater reproducibility analysis. We concluded that MADAAMI-II is, due to its practicality, valid, reproducible, and suitable for use by the same rater engaged in the classical ballet teaching-training process.
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