McCormack, Moira; (2022) The Development of a Musculoskeletal Profiling Tool to Guide Entry into Classical Ballet. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The classical ballet profession requires both athleticism and artistry in a professional dancer with a physique that satisfies the aesthetic demands of the artform. Intensive training starts very young in vocational schools, but injury rates and attrition are high. Based on the consensus of a modified Delphi Survey sent out internationally to enquire about the most frequently selected attributes in the professional dancer, a battery of musculoskeletal assessment tests, some already in use, was selected. A focus group of experts was consulted to advise on suitability for inclusion in the audition profile prior to entry into vocational training. Fourteen range of movement (ROM) and functional movement control (FMC) tests were trialled on eighteen preprofessional ballet students (16 – 17 years) who had newly entered training. Three experienced physiotherapists conducted a repeated assessment, and reliability studies were carried out. Intra- and inter-rater reliability was calculated. The intraclass correlation coefficient (Model 3,1), standard error of measurement and minimal detectable change were used to calculate the intra-rater reliability. The continuous measures were also divided into categories and the alpha coefficient was used. The filmed FMC tests were scored, and the Kappa coefficient was calculated. Intra-rater reliability was moderate to excellent for ROM (ICC = .614 - .970) and substantial to excellent for the FMC (Cohen’s kappa = .670 – 1.000). The inter-rater reliability for hip rotation reached moderate acceptability only on the right (ICC = .515 - .622) and spinal extension in the second round (ICC = .584). When continuous measurements were categorised and the Alpha Coefficient was used, hip rotation was acceptable on both sides and both rounds (.616 - .856). For spinal extension the Alpha Coefficient was acceptable at .748. The inter-rater reliability of the three FMC tests was acceptable (.449 - .820) but the ballet technique-based tests resulted in low agreement with Raters 1 and 3 only, reaching moderate agreement (.410 - .654). The modified plank test was fair to moderate (.347 - .471) in spite of excellent intra-rater reliability (.838 – 1.000). The use of categories when measuring ROM is recommended to improve agreement between raters. Scoring functional movement requires practise by therapists to improve reliability, and familiarity with technical movements in ballet requires physiotherapists to develop specialist skills. Standardised, reliable tests are recommended to capture each physique and its particular combination of attributes, including spine, hip and plantarflexion. Decision making at audition can be supported and facilitated.

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