The Effect of an Eyes-closed Dance-specific

Training Program on Dynamic Balance in Elite

Pre-professional Ballet Dancers
A Randomized Controlled Pilot Study
Kimberley Hutt, M.Sc., and Emma Redding, Ph.D.

Abstract tests, and distances reached significantly rectional and rotational activities that
Visual conditions for a dancer vary improved in one of the two “reach” bal- challenge balance control, and dancers
greatly between theatrical performance ance tests. No significant improvements continually strive to improve balance
environments and dance studios, and this were observed in the control group for any in order to enhance their stability dur-
variability may be detrimental to their dy- variation of the tests. These results indi- ing the execution of a step or piece of
namic balance performance, particularly cate that dancers can be trained to adopt
proprioceptive strategies to maintain
choreography.
under stage lighting. In order to maintain
balance control, dancers reportedly rely dynamic balance, which consequently Yim-Chiplis and Talbot3 stated
heavily on visual input, yet those who rely improves their balance performance. that balance provides the foundation
more on proprioceptive strategies for bal- Such findings could encourage use of for human mobility and functional
ancing have been found to be more stable. eyes-closed training in daily dance classes independence, highlighting the fun-
The purpose of this study was to assess due to its potential to improve dancers’ damental importance of balance to
the capability of an eyes-closed, dance- balance control. normal human locomotion. Research
specific training program to nurture in has shown that dance practice itself

C
dancers proprioceptive mechanisms that lassical ballet has attracted can autonomously provide effective
may facilitate their dynamic balance con- audiences worldwide since balance training. 4 While the pre-
trol. Eighteen elite pre-professional ballet the 17th Century.1 It is an art cise neurophysiological mechanism
dancers were randomly assigned to either form that becomes more accessible behind this effect is yet to be fully
a control (eyes open) or experimental
when its performers have mastered established, dancers have been shown
(eyes closed) group for the intervention.
The balance abilities of all subjects were the fundamental skills required to to be exceptionally sensitive to varia-
tested using five dance-specific variations execute complex movement patterns. tions in their gravitational axis.5 Con-
of the Star Excursion Balance Test before One such skill is balance. Balance is sequently, research has used dance as a
and after a 4 week balance intervention. not only essential for successful bal- method to improve the balance ability
Reach distance and time to complete the let performance,2 but many classical of non-dancers6; however, dancers’
tests were recorded separately as indirect choreographies showcase a dancer’s balance abilities need to be superior
measurements of dynamic balance. The balance ability to excite an audi- to those of the general population for
intervention consisted of dance-specific, ence—for example, Princess Aurora successful and efficient dance perfor-
eyes-closed exercises integrated into the in Sleeping Beauty. mance.
dancers’ daily ballet class and designed Classical ballet dancers must have Balance refers to the ability to
progressively to challenge the dancers’ bal-
sophisticated balance mechanisms in maintain the body’s center of grav-
ance. During the intervention period, the
control group undertook the same exercise order to position themselves effective- ity over its base of support.7 During
program with their eyes open. Results ly during the complex choreographed dance, when the center of gravity is
revealed significant improvements in time sequences of dance practice and displaced beyond the vertical projec-
to complete the three “timed” balance performance. Dance involves multidi- tion of the base of support, the dancer
will become unstable and begin to
Kimberley Hutt, M.Sc., and Emma Redding, Ph.D., are at the Trinity Laban fall.8 This explains why dynamic bal-
Conservatoire of Music and Dance, London, United Kingdom. ance becomes more difficult as the
base of support is reduced in size,
Correspondence: Kimberley Hutt, M.Sc., 42 Laurel Avenue, Potters Bar, for example, from fifth position to
Hertfordshire EN6 2AB, United Kingdom; kimhutt1@me.com.
arabesque, from a flat foot to demi
Copyright © 2014 J. Michael Ryan Publishing, Inc.
http://dx.doi.org/10.12678/1089-313X.18.1.3
3
4 Volume 18, Number 1, 2014 • Journal of Dance Medicine & Science

pointe, or en pointe as seen in classical mechanism to another. For example, edged. 18 Considering the unique
ballet. dancers may use visual input as the nature of dance and the purported
To maintain balance, there must be dominant mechanism to maintain benefits of specificity, it is no wonder
an efficient and complex integration balance when their eyes are open, yet that in the growing field of dance
of the visual, vestibular, and somato- acutely shift to more proprioceptive science researchers are developing
sensory organs.9 Within these organs, strategies when their eyes are closed. A dance-specific testing protocols and
there are specialized sensory receptors similar shift might be required under training regimens for a number of
which provide information about the stage lighting conditions. physiological, biomechanical, and
external environment (exteroceptors), As previously noted, classical ballet aesthetic components of dance.19,20
maintain physiological homeostasis dancers’ balance abilities are report- Balance and stability testing must
(interoceptors), and report on the edly superior to non-dancers’, yet also be specific to the skills of the
position and movement of muscles when their eyes are closed, their bal- performer. The Star Excursion Bal-
and joints (proprioceptors).10 Proprio- ance abilities are no better,2 suggesting ance Test (SEBT) has been said to
ceptors within muscles and tendons that their ability to shift acutely from stress dynamic balance control21-23
are not only responsible for detecting one balance mechanism to another and is being used among the athletic
body movement and position but also is unsophisticated. This could be ex- population.24 The SEBT is arguably,
contribute to the control of postural plained by Hugel’s hypothesis that therefore, more appropriate for
reflexes to maintain stability while the practice of dance alone does not testing dancers’ balance than other
moving11 and are paramount in the enhance the brain’s afferent signals of validated static balance tests. On the
prevention of injury due to their role vestibular and proprioceptive stimu- other hand, while the SEBT involves
in joint and postural stability. It seems lus.2 This in turn may be explained by reaching a leg in multiple directions
prudent, therefore, to increase the the heavy reliance on visual stimulus that replicate those seen in dance
challenge to these specialized receptors and stable environments seen in dance practice (for example, croisé and
during dance practice with the aim of practice. Perrin and coworkers15 found ouvert), it arguably lacks skill speci-
enhancing dancers’ proprioception that Judokas have superior balance ficity to dance practice. In fact, while
and consequent balance abilities and abilities compared to classical ballet balance tests such as the SEBT are
potentially to reduce the risk of injury dancers when tested with their eyes routinely implemented in screening
associated with loss of stability. closed. The investigators inferred that and rehabilitation programs among
There is general consensus in the Judo relies more heavily on proprio- the athletic and dance population,
literature that ballet dancers use pro- ception than visual references, which until recently no balance test has been
prioceptive and visual stimuli as their may be advantageous to balance designed with specificity to a given
fundamental sensory inputs to main- control. Therefore, research is needed sport or activity, such as dance.
tain balance. Although as yet only an- to investigate the effects of balance The SEBT has now been modified
ecdotal, research has suggested that due training that favors proprioception (mSEBT) to improve its specificity
to the habitual use of mirrors during as the dominant balance mechanism, to dance practice,25 and since the cre-
ballet class and rehearsals dancers rely with the aim of producing a chronic ation and initial testing of the mSEBT,
too heavily on visual cues for dynamic shift in sensory organization from an researchers Glenna Batson and Mar-
balance while dancing.12 This could be- external visual dependency to a more garet Wilson have been working
come problematic to a dancer’s balance proprioceptive “internal awareness” of collaboratively to improve the test.26
when those visual cues change under stability when dancing. Developments to date have included
different dance conditions. Based on In their consideration of balance randomization of the direction to
reports of dancers’ dependence on training for ballet dancers, Huxham, which the working leg extends, in or-
visual input for balance control and Goldie, and Patla16 stated that balance der to challenge the attentional focus
when considering that visual condi- “cannot be separated from the action of the dancer. As with the mSEBT, the
tions in theatrical performance set- of which it is an integral component, “randomized” Star Excursion Balance
tings are not representative of those or from the environment in which it Test (rSEBT) records measurements
in dance studios, the unfamiliar and is performed.” Willardson17 supported of reach distance and timings. While
unaccommodating visual conditions this theory, stating that balance is skill the randomized modifications have
encountered in a theater may prove specific, and that it should be trained yet to be validated and published, the
detrimental to dynamic balance during using the same technical skills that are present investigators consider these
a dancer’s performance.2 required during performance. There- further modifications valuable for
Research has reported an ability for fore, in training dancers it seems ap- their specificity to dance practice, due
ballet dancers to modify the sensory propriate to select a balance-training to the rapid responses to directional
organization that is responsible for program with specificity to dance cues required when performing com-
balance control.13,14 This modification practice. plicated dance sequences.
is known as a “shift,” and it refers to The principle of specificity in sport The objective of the present study
the transition from using one balance is well documented and acknowl- was to improve the dynamic balance
 Journal of Dance Medicine & Science • Volume 18, Number 1, 2014 5

performance of a sample of dancers Table 1.

by increasing the challenge to their Subjects were randomly assigned to
proprioceptive mechanisms of balance one of two groups, control or experi-
control in their daily dance practice. mental, by blindly selecting a piece
It was anticipated that the increased of paper marked with “C” (control)
challenge could be achieved by inte- or “E” (experimental) from a “hat.”
grating an eyes-closed training pro- This resulted in 10 experimental
gram to “switch off” the visual mecha- participants and 9 controls. At the be-
nisms, thus instigating a chronic shift ginning of the study, all subjects met
from visual reliance to proprioceptive the inclusion criteria, which stated
strategies for the maintainance of that they should have no vestibular
dynamic balance. The researchers disorder or recent history of lower Figure 1 The eight spoke grid and direc-
hypothesized that incorporating eyes- limb injury. During the intervention tions used for all variations of the SEBT.
closed practice into daily ballet classes period, one dancer in the control NB: These directions are based on the sub-
would enhance compliance with the group sustained an injury; therefore, ject facing the front spoke and using her
program and reduce the necessity data were collected for 10 dancers in right leg as the dominant “reaching” leg.
for additional training. Significant the experimental group and 8 in the
improvements in dymanic balance control group. SEBT were performed by each par-
abilites would provide sound ratio- ticipant using their non-dominant
nale for dance educators to promote Instrumentation leg as the supporting leg and their
eyes-closed training in dancers’ daily A star-shaped grid, seen in Figure dominant leg as the reaching leg. The
practice. 1, was constructed using Cramer same researcher undertook all expla-
Tape Heavy Zinc Oxide (2.5 cm nations and data collection to enhance
Materials and Methods wide). The portable force plate was intra-test reliability.
Subjects mounted longitudinally in the center
The selection of subjects and protocol of the grid. This was connected to a The Basic SEBT
of the study were ethically approved Kistler® DAQ-system which transmit- Subjects were instructed to stand on
prior to data collection and the in- ted information of forces to a laptop the force plate with their support-
tervention. All hard and electronic computer equipped with Bioware ing leg in parallel position and their
copies of subjects’ data were stored System software version 4.1. dominant leg held in a parallel coup
in compliance with the Data Protec- de pied (the “ready position,”25 Fig.
tion Act of 1998, and anonymity was Methodology 2). They were then instructed to bend
maintained throughout the study. The researcher determined leg domi- the supporting leg and reach toward
Nineteen elite female pre-profes- nance by asking the subjects to declare each spoke, first in a clockwise, then
sional dancers from Central School of their favored “working leg” when counter-clockwise direction, lightly
Ballet (UK) volunteered and consent- dancing. Working leg was described “dabbing” the toe at the furthest point
ed to participate. The sample com- to participants as being that which they could reach. Distance reached,
prised the first year group, who had all they preferred to “practice exercises missed spoke, falls, and near falls were
been studying full time at the school with,” as opposed to “stand on.” Leg recorded on a testing sheet. The entire
for 9 months. Prior to testing, the length data were collected using mea- test was terminated if a participant
researcher documented the subjects’ surements from the greater trochanter hopped or fell due to loss of balance
heights using a Bodymeter Measur- to the distal lateral malleoli, in order or put excessive weight on the work-
ing Tape (Factory Direct, USA) and that measurements of reach could be ing foot when it was “dabbed” at each
recorded their mass in Newtons, taken normalized. spoke.
from a portable force plate (Kistler®, Testing procedures took place
Switzerland, threshold Fz < 10 mN, 3 days before and 3 days after a 4 Subsequent Variations of the Basic
model 9286AA) and converted to week intervention. Procedures were SEBT
kilograms in order to calculate BMI. explained to each subject, following On completion of the basic SEBT,
For the participants’ epidemiology see which five variations of the original the dancers were given instructions

Table 1 Participant Characteristics at the Start of the Study

Mean Height Mean Mass Mean BMI Mean Leg Length Mean Age Mean Years Dancing
(± SD) (cm) (± SD) (kg) (± SD) (± SD) (cm) (± SD) (yrs) (± SD) (yrs)
163.82 50.75 18.95 82.26 16.68 11.16
(5.55) (4.5) (1.2) (4.75) (0.48) (3.11)
6 Volume 18, Number 1, 2014 • Journal of Dance Medicine & Science

dardize the test between subjects, tion should be the first center practice
an identical “randomized” order exercises following barre work for
of the direction toward which the sake of consistency and should
the subject should reach was used be performed 5 days per week for 4
by the researchers. Subjects were weeks. The sequences were to become
instructed to reach as far as they progressively challenging on a weekly
safely could, at their own pace. basis, without posing any unnecessary
The subjects were taught the risk to the dancers. The researcher
names given for the directions suggested examples of such progres-
for each spoke (Fig. 1) and told sions, including stationary sequences
that the direction to which they progressing to travelling and turning
should reach would be given as sequences; double leg stance exercises
soon as the working foot came progressing to single leg stance exercis-
back to the “ready position.” es; and sequences involving working
Wilson recommended the names legs a terre progressing to sequences
of the spokes in research using the with the working leg en l’air.
rSEBT (unpublished). It was con- When the dance-specific exer-
sidered that these terms would be cises had been choreographed by the
easier for the dancer to interpret dance teacher and approved by the
than the scientific terms used in researcher, the experimental group
standard research (e.g., anterior, was instructed to perform the exercises
Figure 2 The “ready” position. posterior, medial, and lateral). with their eyes closed throughout the
Distance reached, missed spoke, intervention period. They should only
on the variations of four subsequent falls, and near falls were recorded. open their eyes during the eyes-closed
tests and performed the following 4. Randomized SEBT—timed test sequence if they felt they were going
modifications: (rSEBTtimed): The rSEBTreach to fall, and in that event, they should
1. Modified SEBT—timed test was repeated as fast and as safely close their eyes and continue as soon
(mSEBTtimed): The basic SEBT as possible. For this variation of as they felt they had regained their
was performed as quickly and the test subjects were instructed balance sufficiently to continue safely
safely as possible. Participants to extend their leg to approxi- with the sequence. Throughout the
were instructed to reach as far as mately 45°, rather than dab their intervention period the control group
possible in the fastest time they toe to the floor. The researcher undertook the same program with
could. The time taken to finish recorded time taken to complete their eyes open, as they would under
one full circuit of the test in a the sequence, along with missed normal dance class conditions.
clockwise and counter-clockwise spokes, near falls, and falls.
direction was recorded, along Due to suggestions made by Bat- Data Analyses
with missed spokes, near falls, and son25 for future studies to observe Mean (± SD) measurements were
falls. quantitative force plate analysis, calculated for distance reached (cm),
2. Modified SEBT—timed test with measurements of sway around the time to completion (s), or sway (mm)
cognitive interference (mSEBT- center of pressure (COP) in anterior- around the center of pressure (COP),
cogint): The mSEBTtimed was posterior (AP) and medial-lateral depending on the balance test being
performed while the researcher (ML) direction were recorded during performed. Using SPSS software
asked a series of questions for cog- all variations of the test. The present (version 19; IBM, USA), with alpha
nitive interference; for example, study did not obtain data using the set to 0.05, paired samples t-tests
“Spell your surname backwards” foam modification of the mSEBT were carried out to assess for balance
and “What is one hundred minus used by Batson,25 as the force plate improvements following the interven-
thirteen?” Dancers with English would not transmit useful data of tion. Due to the use of multiple t-tests,
as a second language were invited forces through foam. Benjamini Hochberg corrections were
to answer the questions in their undertaken as a valid means of reduc-
own language. Again, time taken The Intervention ing the likelihood of creating a type
to finish one full circuit of the Prior to the study, the lead researcher 1 statistical error, following which all
test in a clockwise and counter- met with the participants’ regular p values were divided by two (alpha
clockwise direction was recorded, ballet teacher to discuss the balance level = 0.025) to reflect the directional
along with missed spokes, near exercises that were to be integrated nature of the hypotheses—that reach
falls, and falls. into the dancers’ daily class, forming distance and time would improve.
3. Randomized SEBT—reach dis- the basis of the intervention. The The statistical analyses used mean
tance test (rSEBTreach): To stan- researcher explained that the interven- data taken from each of the following
 Journal of Dance Medicine & Science • Volume 18, Number 1, 2014 7

dependent variables: when undertaking four of the five vari- to be non-significant (Table 2, Fig. 4).
1. Basic SEBT (reach distance mea- ations of the test: basic SEBT (t [9] = Neither trend nor significant differ-
sured in cm), -3.256, p = 0.01), mSEBTtimed (t [9] ence was observed in any of the center
2. mSEBTtimed (time measured in = 3.086, p = 0.01), mSEBTcogint (t = of pressure measurements tested (con-
seconds), [9] 3.458, p = 0.01), and rSEBTtimed trol group: anterior-posterior – t [5]
3. mSEBTcogint (time measured in (t [9] = 4.643, p = 0.00). Conversely, = -1.478, p = 0.34; medial-lateral – t
seconds), no statistically significant differences [5] = 1.172, p = 0.19. Experimental
4. rSEBTreach (reach distance mea- were observed in the control group group: anterior-posterior – t [7] =
sured in cm), when undertaking any of the varia- 1.537, p = 0.12; medial-lateral – t
5. rSEBTtimed (time measured in tions of the balance tests (Table 2). [7] = -0.825, p = 0.22). Therefore, it
seconds), The control group demonstrated cannot be said that center of pressure
6. Center of pressure – anterior- a 0.1% deterioration (increase) in measurements differed following an
posterior (sway measured in mm), time to complete the mSEBTtimed, intervention to improve balance in
and an 8% improvement (decrease) in dancers.
7. Center of pressure – medial- time to complete the mSEBTcogint, In summary, results suggest that
lateral (sway measured in mm). and a 4% improvement in time to due to the observed trends in and
Center of pressure (COP) measure- complete the rSEBTtimed follow- largely significant improvements in
ments were only analyzed from data ing the intervention period. More the experimental group that were
collected during the rSEBTtimed, as impressively, the experimental group not present in the control group,
this was the only variation in which demonstrated a 14% improvement in the dynamic balance control of elite
the working foot did not touch the time to complete the mSEBTtimed, pre-professional ballet students did
floor. The act of “dabbing” the floor a 15% improvement in time to com- improve following a period of eyes-
during all other variations of the test plete the mSEBTcogint, and a 16% closed dance-specific training.
rendered force plate data unusable, improvement in time to complete the
due to extreme inter-subject variabil- rSEBTtimed test (Fig. 3). Discussion
ity of pressure with which the foot When observing reach distances The purpose of the present study was
was “dabbed.” achieved, the control group managed to determine whether a 4-week, eyes-
to reach an average of 4% further closed, dance-specific training pro-
Results during the basic SEBT and 0.3% gram would improve dynamic balance
Both groups appeared to improve in further during the rSEBTreach after in a sample of elite pre-professional
distance reached and time to comple- the 4-week period. These results dancers. To date, no other published
tion of the balance tests; however, the proved to be non-significant. In the research has reported the effectiveness
improvements were greater among the experimental group, the intervention of an eyes-closed training program on
experimental participants. Statistical elicited a significant increase of 5% balance abilities in dancers.
analysis using paired samples t-tests reach distance achieved during the The dominant statistical findings
revealed significant improvements in basic SEBT, but only a 0.9% increase revealed that when testing the dynamic
the balance of the experimental group during the rSEBTreach, which proved balance ability of dancers performing

Table 2 Timings and Reach Distance for All Variations of the SEBT
Basic SEBT (cm) mSEBTtimed (s) mSEBTcogint (s) rSEBTreach (cm) rSEBTtimed (s)
Pre Post Pre Post Pre Post Pre Post Pre Post
Descriptives
Control 69.9 72.4 16.5 16.5 18.1 16.6 74.3 74.5 29.2 28.1
Mean (± SD) (± 3.5) (± 4) (± 3.1) (± 3) (± 4.3) (± 3.6) (± 5.6) (± 3.5) (± 3.4) (± 2.8)
Experimental 79.4 83.4 17.9 15.5 18.1 15.5 82.6 83.4 29.2 24.7
Mean (± SD) (± 5.6) (± 7) (± 3.4) (± 3) (± 3.3) (± 3.1) (± 6.6) (± 6.5) (± 3.1) (± 2.3)
Paired samples t-test
Control
*Significance NS (p = 0.07) NS (p = 0.49) NS (p = 0.28) NS (p = 0.51) NS (p = 0.24)
T value -3.049 -.038 1.251 -.161 1.182
Experimental
*Significance SIG (p = 0.01) SIG (p = 0.01) SIG (p = 0.01) NS (p = 0.22) SIG (p = 0.00)
T value -3.256 3.086 3.458 0.857 4.643
*NS = no significance; SIG = significant
8 Volume 18, Number 1, 2014 • Journal of Dance Medicine & Science

Figure 3 Mean times for both groups’

timed tests.

Figure 4 Mean reach distance for both

groups’ reach tests.

variations of the mSEBT and rSEBT, system to generate appropriate motor changing, the biomechanical chal-
time to complete all variations of the responses. Indeed, Huxham, Goldie, lenges to maintain balance control
balance tests significantly improved and Patla 16 stated that increasing were increased. The current study
following the intervention. Reach the speed of a moving limb requires found inconclusive results when con-
distances significantly improved when greater equilibrium control to main- sidering reach as an isolated measure
performing the basic SEBT but not tain balance control, thus justifying of balance, with only the basic SEBT
during the rSEBTreach. There were the inclusion of a test of speed in variation of the reach tests (and not
no significant improvements observed the mSEBT, rSEBT, and the pres- the rSEBTreach) revealing significant
among the control group across all ent study. Interestingly, all variations improvements. However, the addi-
variations of the balance tests. Theoriz- of the timed tests performed in the tional challenge produced by random-
ing that the test variations collectively present study revealed significant ization involved in the rSEBTreach
represent dynamic balance, overall improvements; therefore, it may have may have caused the more variable
these results suggest that a 4-week, been the dancers’ equilibrium control results. These additional challenges
eyes-closed, dance-specific training component of balance that improved could be explained by Huxham, Gold-
program can improve the dynamic to the greatest extent. ie, and Patla’s16 description of two
balance ability of dance students. The reach component of the ba- mechanisms, proactive and reactive,
Reach distance and timing may sic SEBT and rSEBTreach involves by which environmental factors in-
not be considered direct measures of changes in the magnitude, direction, fluence the biomechanical properties
balance. However, tasks such as these and combination of forces acting on of balance. Proactive balance control
create perturbations that increase and produced by the body. As the involves information received through
the challenge to the central nervous direction of the reach was constantly the eyes but also includes a form of
 Journal of Dance Medicine & Science • Volume 18, Number 1, 2014 9

control known as predictive control. the present study saw this as a limita- investigators deduce that increased
Predictive balance control relies on tion to Batson’s study that may have postural dynamics enhance the abil-
anticipatory postural adjustments in resulted in the observed inter-subject ity of the body to adapt to imposed
response to internal representations of variability and consequently chose to postural disturbances.
the body and learned movement.16 In demonstrate the balance tests to the While the precise neurophysiologi-
the case of predictive control, muscle subjects prior to data collection. Per- cal adaptations behind the balance
activity begins before the actual move- haps as a result of this, the execution improvements observed in the pres-
ment takes place, with the magnitude of the tests was generally consistent ent study have not been identified, it
of these muscle responses being de- among dancers. could be postulated that they were due
pendent upon the direction and speed Interestingly, the greatest vari- to a trained (chronic) shift in sensory
of the movement. The randomization ability in test execution was observed organization from visual to proprio-
of direction used in the rSEBTreach among dancers who had 5 years or less ceptive dependency to maintain bal-
variation would have certainly dis- dance experience. Wilmerding and ance control. Future studies might
rupted anticipatory mechanisms, Krasnow31 state that perception (the observe EMG activity to analyze
as the anticipatory muscle activity dancer’s observation and attention to muscular activity in response to the
could not have been able to respond a given demonstration) and execution potential shift in sensory organization.
in anticipation of a predicted direc- (the dancer’s replication of the given
tion, a factor that could account for demonstration) are essential stages Study Limitations
the non-significant improvements involved in motor learning. These The present study did not assess the
when performing the rSEBTreach. stages are likely to be less refined in range of ankle dorsiflexion available
Despite the lack of significance, it dancers with fewer years of experi- to each participant, as did Batson.25
is noteworthy that the experimental ence. Such concepts are supported It is conceivable that several danc-
group achieved greater improvements by the variability of test execution ers reached the limit of dorsiflexion
in reach distances for the rSEBTreach seen by Batson,25 who studied dancers on their supporting leg before reach
than the control group, and it may with a mean of only 2.6 (± 2.7) years distance became sufficient to disturb
only have been a matter of time before training in participants from the UK their balance. In this case, it is un-
significance was achieved. and 9.6 (± 4.6) years training in those likely that reach measurements would
Testing durations of balance stud- from the USA. However, further re- change following an intervention, as
ies among healthy adolescents have search would be required to confirm it would not be balance itself that was
ranged from 4 to 7 weeks,27-30 suggest- a relationship between variability of limiting the reach distance achievable
ing that 4 weeks of training, as used execution of balance tests and years but rather the range of motion avail-
in the present study, is sufficient time of dance experience. able at the ankle.
to stimulate an effect. Many of these Following suggestions for future The present study determined
studies reported non-compliance to research by Batson,25 the present study leg dominance in an unorthodox
the training program as a limitation analyzed force plate data to investi- manner, by asking participants what
of the intervention. Dancers’ daily gate postural sway as represented by their favored “working leg” was when
training loads are high, and interven- COP measurements. No trends were practicing dance. Traditional methods
tions that impose exercises in addition observed in this way, and inter- and of determining leg dominance are
to daily practice may not be adhered intra-participant results elicited con- varied, and there are disparities be-
to. The present study boasts excellent siderable variability. One explanation tween “functional” (for example, the
compliance, as the exercises were in- for this may be “exploratory activity” kicking leg in football) and “strength”
corporated into the dancers’ morning in response to a new movement pat- (for example, the standing leg during
ballet class 5 days per week for the tern. However, such activity is not postural control tasks) definitions of
duration of the study. Compliance is necessarily destablizing 32; indeed, leg dominance.33 Failure to use an
likely to be greater when the training the notion of increased sway being established method for determining
can be incorporated into the daily a reflection of instability is a com- leg dominance in the present study
training activities, as ancillary practice mon misconception, and postural may have resulted in variability of test
will rely heavily on individual dedica- sway may not be a direct indicator of results among the participants.
tion to the research program. postural stability.33 Alternatively, large The entire sample of dancers used
Batson25 reported variable execu- sway may be due to deliberate actions in the present study was female.
tion of the balance tests during her taken to maintain balance, rather than When testing one gender it cannot be
preliminary study; however, her a measure of instability.32 van Em- assumed that results are transferrable
study’s protocol dictated that testers merick and van Wegen34 suggest that to the other, yet there is no literature
should not demonstrate the test to increased oscillations identified by to suggest that balance training affects
the subjects, but rather the testers in- force plate data may be an indication genders differently. When testing
structed the subjects by reciting from of greater dynamic neuromuscular dynamic balance Golomer35 observed
a learned script. The researchers of function to reduce instability. The that males are more dependent on vi-
10 Volume 18, Number 1, 2014 • Journal of Dance Medicine & Science

sion than females; therefore, research It is noteworthy that by chance P. Postural control of ballet dancers: a
into the effects of eyes-closed training there was a difference in balance specific use of visual input for artistic
for dancers of both genders is mer- abilities between the experimental purposes. Int J Sports Med. 1999
ited. and control groups pre-intervention, Feb;20(2):86-92.
While the present study provides despite the random selection of par- 3. Yim-Chiplis PK, Talbot LA. Defin-
ing and measuring balance in adults.
valuable information about balance ticipants. This difference proved to be Biol Res Nurs. 2000 Apr;1(4):321-
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at different ages. Therefore, the re- sophisticated balance strategies pre- 5. Mouchnino L, Ayrenty R, Massion
sults from the present study cannot testing, which may have reduced any J, Pedotti A. Coordination between
be generalized to dancers of all age potential effects of the intervention equilibrium and head-trunk orienta-
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pre-professionals” and demonstrated Conclusion 7. Lephart SM, Fu FH. Proprioception
similar abilities in dance classes, vari- To the best of the researchers’ knowl- and Neuromuscular Control in Joint
ability of execution of the balance tests edge, this study is the first to assess Stability. Champaign, IL: Human
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fewer years of dance experience. ing on the dynamic balance abilities 8. Roberts TD. Understanding Balance:
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All balance tests were performed of dancers. The research used speed motion. London, UK: Chapman &
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felt uncomfortable in the required ers. These results imply that closing 10. Martini FH. Fundamentals of Anat-
parallel position. In fact, for some the eyes during dance training is an omy and Physiology (5th ed). Upper
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population36 and increased foot pro- However, further research is needed to 12. Golomer E, Crémieux J, Dupui P,
gression angles (or “out toeing”).37 To investigate the precise neural and bio- et al. Visual contribution to self-
maintain specificity to dance, future mechanical mechanisms by which the induced body sway frequencies and
studies could consider allowing ballet- improvements observed in this study visual perception of male professional
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