The Effectiveness of Classical Ballet Training on Health-Related Outcomes: A Systematic Review

in Journal of Physical Activity and Health
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Background: Regular physical activity is of paramount importance to reduce chronic disease risk. Classical ballet training requires balance, strength, and range of motion. Participation in social ballet classes is increasing. Ballet training interventions may be an alternative method of regular, enjoyable activity. This review aimed to determine the effectiveness of classical ballet training interventions on physical and psychological health. Methods: Ten databases were searched until April 2019. The included studies investigated classical ballet training interventions of a ≥4-week duration, on any population (no restrictions on experience and clinical condition), measuring physical health or psychological outcomes. Results: Twenty-three studies (25 intervention groups) were included, comprising experienced (19 groups) and novice dancers (6 groups). In experienced populations, muscular strength was the most commonly reported outcome. However, only 25% of these studies reported improvements. With novice dancers, including clinical populations, balance showed the most positive change, improving in 75% of studies that reported this measure. Conclusions: Classical ballet training may improve balance in novices and maintain physical activity across the life span. Experienced dancers showed no further improvement, perhaps due to an already greater ability. There was large heterogeneity between the included studies. A greater focus on classical ballet interventions for inexperienced populations is required.

The authors are with the Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.

Ward (rachel.ward@unsw.edu.au) is corresponding author.
  • 1.

    Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):13021310. PubMed ID: 27475271 doi:10.1016/S0140-6736(16)30370-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ. 2019;366:l4570. PubMed ID: 31434697 doi:10.1136/bmj.l4570

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    World Health Organization. Physical activity factsheet. 2018. https://www.who.int/news-room/fact-sheets/detail/physical-activity. Accessed December 1 2019.

    • Export Citation
  • 4.

    Fong Yan A, Cobley S, Chan C, et al. The effectiveness of dance interventions on physical health outcomes compared to other forms of physical activity: a systematic review and meta-analysis. Sports Med. 2018;48(4):933951. PubMed ID: 29270864 doi:10.1007/s40279-017-0853-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Hwang PW, Braun KL. The effectiveness of dance interventions to improve older adults’ health: a systematic literature review. Altern Ther Health Med. 2015;21(5):6470. PubMed ID: 26393993

    • Search Google Scholar
    • Export Citation
  • 6.

    Rodrigues-Krause JK, Reischak-Oliveira A. Dancing for healthy aging: functional and metabolic perspectives. Altern Ther Health Med. 2019;25(1):4463. PubMed ID: 29428927

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    The Sydney Morning Herald. Ballet for adult beginners. 2011. https://www.smh.com.au/lifestyle/health-and-wellness/ballet-for-adult-beginners-20110404-1cw0i.html. Accessed May 3, 2019.

    • Export Citation
  • 8.

    The Sydney Morning Herald. Never too old to be called to the barre. 2016. https://www.smh.com.au/lifestyle/health-and-wellness/never-too-old-to-be-called-to-the-barre-20160822-gqxzel.html. Accessed May 3, 2019.

    • Export Citation
  • 9.

    The Royal Academy of Dance. Welcome to silver swans. 2019. https://www.royalacademyofdance.org/silverswans/. Accessed May 3, 2019.

    • Export Citation
  • 10.

    Queensland Ballet. Dance for Parkinson’s. 2019. https://www.queenslandballet.com.au/classes/dance-for-parkinsons. Accessed May 3, 2019.

    • Export Citation
  • 11.

    Malone T, Hardaker WT. Rehabilitation of foot and ankle injuries in ballet dancers. J Orthop Sports Phys Ther. 1990;11(8):355361. PubMed ID: 18796895 doi:10.2519/jospt.1990.11.8.355

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Ward RE. Biomechanical Perspectives on Classical Ballet Technique and Implications for Teaching Practice. [PhD thesis]. Sydney, Australia: The University of New South Wales; 2012.

    • Search Google Scholar
    • Export Citation
  • 13.

    Kadel NJ, Donaldson-Fletcher EA, Gerberg LF, Micheli LJ. Anthropometric measurements of young ballet dancers examining body composition, puberty, flexibility, and joint range of motion in comparison with non-dancer controls. J Dance Med Sci. 2005;9(3-4):8490.

    • Search Google Scholar
    • Export Citation
  • 14.

    Khan K, Roberts P, Nattrass C, et al. Hip and ankle range of motion in elite classical ballet dancers and controls. Clin J Sport Med. 1997;7(3):174179. PubMed ID: 9262883 doi:10.1097/00042752-199707000-00004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Sawers A, Allen JL, Ting LH. Long-term training modifies the modular structure and organization of walking balance control. J Neurophysiol. 2015;114(6):33593373. PubMed ID: 26467521 doi:10.1152/jn.00758.2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surgery. 2003;73(9):712716. doi:10.1046/j.1445-2197.2003.02748.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Annino G, Padua E, Castagna C, et al. Effect of whole body vibration training on lower limb performance in selected high-level ballet students. J Strength Cond Res. 2007;21(4):10721076. PubMed ID: 18076222

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Candelario-Gorbea C, Ortiz A, Ramirez-Marrero F, Martinez LR. Effectiveness of a PNF intervention on active and passive range of motion during “développé á la sécond” in ballet dancers. Orthop Phys Ther Prac. 2014;26(3):198202.

    • Search Google Scholar
    • Export Citation
  • 19.

    da Silva C, Goldberg T, Soares-Caldeira L, Oliveira R, de Paula Ramos S, Nakamura F. The effects of 17 weeks of ballet training on the autonomic modulation, hormonal and general biochemical profile of female adolescents. J Hum Kinet. 2015;47(1):6171. doi:10.1515/hukin-2015-0062

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Hedgepeth SL. The Effects of Ballet Training on Isokinetic Strength, Power, and Muscular Endurance. [MSc thesis]. Virginia, VA: Virginia Polytechnic Institute and State University; 1987.

    • Search Google Scholar
    • Export Citation
  • 21.

    Houston S, McGill A. A mixed-methods study into ballet for people living with Parkinson’s. Arts Health. 2013;5(2):103119. PubMed ID: 23805165 doi:10.1080/17533015.2012.745580

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Khan K, Bennell K, Ng S, et al. Can 16-18-year-old elite ballet dancers improve their hip and ankle range of motion over a 12-month period? Clin J Sport Med. 2000;10(2):98103. PubMed ID: 10798790 doi:10.1097/00042752-200004000-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Kirkendall DT, Bergfeld JA, Calabrese L, Lomabrdo JA, Street GM, Weiker GG. Isokinetic characteristics of ballet dancers and the response to a season of ballet training. J Orthop Sports Phys Ther. 1984;5(4):207211. PubMed ID: 18806416 doi:10.2519/jospt.1984.5.4.207

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Koutedakis Y, Cross V, Sharp NCC. Strength training in male ballet dancers. Int J Dance Sci Med Educ. 1996;4(3):210219.

  • 25.

    Koutedakis Y, Sharp NCC. Thigh-muscles strength training, dance exercise, dynamometry, and anthropometry in professional ballerinas. J Strength Cond Res. 2004;18(4):714718. PubMed ID: 15574072

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Kujala UM, Oksanen A, Taimela S, Salminen JJ. Training does not increase maximal lumbar extension in healthy adolescents. Clin Biomech. 1997;12(3):181184. doi:10.1016/S0268-0033(97)00078-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Liederbach M, Gleim GW, Nicholas JA. Monitoring training status in professional ballet dancers. J Sports Med Phys Fitness. 1992;32(2):187195. PubMed ID: 1434589

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    López-Ortiz C, Egan T, Gaebler-Spira DJ. Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy. SAGE Open Med. 2016;4:15.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    López-Ortiz C, Gladden K, Deon L, Schmidt J, Girolami G, Gaebler-Spira D. Dance program for physical rehabilitation and participation in children with cerebral palsy. Arts Health. 2012;4(1):3954. PubMed ID: 25431617 doi:10.1080/17533015.2011.564193

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    McGill A, Houston S, Lee RYW. Effects of a ballet-based dance intervention on gait variability and balance confidence of people with Parkinson’s. Arts Health. 2019;11(2):133146.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    McMillan A, Proteau L, Lebe RM. The effect of pilates-based training on dancers’ dynamic posture. J Dance Med Sci. 1998;2(3):101107.

    • Search Google Scholar
    • Export Citation
  • 32.

    Micheli LJ, Cassella M, Faigenbaum AD, Southwick H, Ho V. Preseason to postseason changes in body composition of professional ballet dancers. J Dance Med Sci. 2005;9(2):5659.

    • Search Google Scholar
    • Export Citation
  • 33.

    Moller A, Masharawi Y. The effect of first ballet classes in the community on various postural parameters in young girls. Phys Ther Sport. 2011;12(4):188193. PubMed ID: 22085713 doi:10.1016/j.ptsp.2011.04.001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Notarnicola A, Maccagnano G, Pesce V, Pierro S, Tafuri S, Moretti B. Effect of teaching with or without mirror on balance in young female ballet students. BMC Res Notes. 2014;7:426. PubMed ID: 24996519 doi:10.1186/1756-0500-7-426

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Özdinc SA, Turan FN. Effects of ballet training of children in turkey on foot anthropometric measurements and medial longitudinal arc development. J Pak Med Assoc. 2016;66(7):869874. PubMed ID: 27427138

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Pigeon P, Oliver I, Charlet JP, Rochiccioli P. Intensive dance practice. Am J Sports Med. 1997;25(2):243247. PubMed ID: 9079182 doi:10.1177/036354659702500219

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Scheidler AM, Kinnett-Hopkins D, Learmonth YC, Motl R, López-Ortiz C. Targeted ballet program mitigates ataxia and improves balance in females with mild-to-moderate multiple sclerosis. PLoS One. 2018;13(10):e0205382. PubMed ID: 30335774 doi:10.1371/journal.pone.0205382

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Stalder MA, Noble BJ, Wilkinson JG. The effects of supplemental weight training for ballet dancers. J Appl Sport Sci Res. 1990;4(3):95102.

    • Search Google Scholar
    • Export Citation
  • 39.

    Tsanaka A, Manou V, Kellis S. Effects of a modified ballet class on strength and jumping ability in college ballet dancers. J Dance Med Sci. 2017;21(3):97101. PubMed ID: 28871900 doi:10.12678/1089-313X.21.3.97

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Mangine GT, Gonzalez AM, Townsend JR, et al. Influence of baseline muscle strength and size measures on training adaptations in resistance-trained men. Int J Exerc Sci. 2018;11(4):198213. PubMed ID: 29795731

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Keogh JWL, Kilding A, Pidgeon P, Ashley L, Gillis D. Physical benefits of dancing for healthy older adults: a review. J Aging Phys Act. 2009;17:479500. PubMed ID: 19940326 doi:10.1123/japa.17.4.479

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Kiepe M-S, Stöckigt B, Keil T. Effects of dance therapy and ballroom dances on physical and mental illnesses: a systematic review. Arts Psychother. 2012;39(5):404411. doi:10.1016/j.aip.2012.06.001

    • Crossref
    • Search Google Scholar
    • Export Citation
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