Métodos utilizados para evaluar el <i>en dehors</i> o <i>turnout</i> de bailarines y bailarines clásicos: revisión de la literatura

Gontijo, Kaanda Nabilla Souza; Amaral, Maiane Almeida do; Santos, Gabriela Cristina dos; Candotti, Claudia Tarragô

doi:10.1590/1809-2950/17100124042017

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REVISÃO SISTEMÁTICA • Fisioter. Pesqui. 24 (4) • Oct-Dec 2017 • https://doi.org/10.1590/1809-2950/17100124042017 copiar

Métodos utilizados para evaluar el en dehors o turnout de bailarines y bailarines clásicos: revisión de la literatura

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

La técnica del ballet clásico exige la realización máxima del en dehors o turnout, caracterizado por la rotación externa de miembros inferiores. Considerando su importancia, varios protocolos para su evaluación y medición han sido propuestos. El objetivo de esta revisión ha sido investigar sistemáticamente los métodos utilizados para evaluar el turnout de bailarines clásicos y/o practicantes de ballet clásico existentes actualmente. Se hizo la búsqueda en las bases de datos Scopus, Science Direct y PubMed, en el mes de febrero de 2016, y los artículos encontrados deberían: estar redactados en la lengua inglesa, evaluar bailarines clásicos o bailarines que practicaran ballet clásico y medir el en dehors o turnout. Se encontraron 593 artículos, de los cuales se preseleccionaron 25 para esta revisión, presentándose 15 diferentes métodos e instrumentos de medición del turnout: cinemetría; inclinómetro; turnout protactor o transferidor para medir el turnout; goniómetro; Dupuis Tropometer; transferidor original; fotos de los sujetos; discos rotacionales; prueba de flexibilidad de Nicholas; flexímetro; diseño clínico de los pies; sujeto sobre un pedazo de papel o suelo o cuadro blanco; resonancia magnética; filmación del sujeto ejecutando secuencia de pasos; Daco Pro Angle Finder. Esta revisión presenta una fuerte evidencia para afirmar que no hay, hasta el momento, un método o instrumento estándar-oro para la medición del turnout de bailarines, de modo que ésta suele ser adaptada y elegida de acuerdo con el objetivo de cada estudio.

Palabras clave
Danza; Estudios de Evaluación; Evaluación

Estudos 1º autor (ano)	Critérios Checklist STROBE																Total(n° de ✓)
Estudos 1º autor (ano)	1	2	3	5	6	7	8	10	11	12	13	14	18	19	20	21
Barnes et al.³⁴34. Barnes MA, Krasnow D, Tupling SJ, Thomas M. Knee rotation in classical dancers during the Grand Plié. Med Probl Perform Art. 2000;15(4):140-7.	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	14
Bennell et al.³⁵35. Bennell K, Khan KM, Matthews B, et al. Hip and ankle range of motion and hip muscle strength in young novice female ballet dancers and controls. Br J Sport Med. 1999;33(5):340-6.	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	15
Bennell et al.³⁶36. Bennell KL, Khan KM, Matthews BL, Singleton C. Changes in hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls: a 12 month follow up study. Br J Sport Med. 2001;35(1):54-9. doi: 10.1136/bjsm.35.1.54 https://doi.org/10.1136/bjsm.35.1.54...	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	15
Bronner et al.³⁷37. Bronner S, Ojofeitimi S. Pelvis and hip three-dimensional kinematics in grand battement movements. J Dance Med Sci. 2011;15(1):23-30.	×	✓	✓	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	14
Champion et al.³⁸38. Champion L, Chatfield S. Measurement of turnout in dance research: a critical review. J Dance Med Sci. 2008;12(4):121-35.	✓	✓	✓	?	?	✓	?	?	?	✓	✓	?	✓	✓	✓	✓	10
Cimelli et al.¹³13. Cimelli SN, Curran SA. Influence of turnout on foot posture and its relationship to overuse musculoskeletal injury in professional contemporary dancers: a preliminary investigation. J Am Podiatr Med Assoc. 2012;102(1):25-33. doi: 10.7547/1020025 https://doi.org/10.7547/1020025...	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	13
Coplan et al.²¹21. Coplan JA. Ballet dancer’s turnout and its relationship to self-reported injury. J Orthop Sports Phys Ther. 2002;32(11):579-84. doi: 10.2519/jospt.2002.32.11.579 https://doi.org/10.2519/jospt.2002.32.11...	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	×	14
Filipa et al.³⁹39. Filipa AR, Smith TR, Paterno MV, Ford KR, Hewett TE. Performance on the Star Excursion Balance Test predicts functional turnout angle in pre-pubescent female dancers. J Dance Med Sci. 2013;17(4):165-9. doi:10.12678/1089-313X.17.4.165 https://doi.org/10.12678/1089-313X.17.4....	×	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	13
Gilbert et al.⁴⁰40. Gilbert CB, Gross MT, Klug KB. Relationship between hip external rotation and turnout angle for the five classical ballet positions. J Ortho Sports Phys Ther. 1998;27(5):339-47. doi: 10.2519/jospt.1998.27.5.339 https://doi.org/10.2519/jospt.1998.27.5....	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	14
Girón et al.⁴¹41. Girón EC, McIssac T, Nilsen D. Effects of kinesthetic versus visual imagery practice on two technical dance movements: a pilot study. J Dance Med Sci. 2012;16(1);36-8.	✓	✓	✓	×	✓	×	×	×	×	×	✓	×	✓	✓	×	✓	8
Grossman et al.⁴²42. Grossman G, Waninger KN, Voloshin A, Reinus WR, Ross R, Stoltzfuz J, et al. Reliability and validity of goniometric turnout measurements compared with MRI and retro-reflective markers. J Dance Med Sci. 2008;12(4):142-52.	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	14
Hamilton et al.⁴³43. Hamilton D, Aronsen P, Løken J, Berg IM, Skotheim R, Hopper D, et al. Dance training intensity at 11-14 years in associated with femoral torsion in classical ballet dancers. Br J Sports Med. 2006;40(4):299-303. doi: 10.1136/bjsm.2005.020941 https://doi.org/10.1136/bjsm.2005.020941...	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	×	12
Iunes et al.⁴⁴44. Iunes DH, Elias IF, Carvalho LC, Dionísio VC. Postural adjustments in young ballet dancers compared to age matched controls. Phys Ther Sport. 2016;17:51-7. doi: 10.1016/j.ptsp.2015.04.004 https://doi.org/10.1016/j.ptsp.2015.04.0...	×	✓	×	×	✓	✓	✓	×	✓	✓	×	×	✓	✓	✓	×	9
Khan et al.²²22. Khan K, Roberts P, Nattrass C, Bennell K, Mayes S, Way S, et al. Hip and ankle range of motion in elite classical ballet dancers and controls. Clin J Sport Med. 1997;7(3):174-9. doi: 10.1097/00042752-199707000-00004 https://doi.org/10.1097/00042752-1997070...	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	×	13
Khan et al.⁴⁵45. Khan KM, Bennell K, Ng S, Matthews B, Roberts P, Nuttrass C, Way 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):98-103.doi: 10.1097/00042752-200004000-00003 https://doi.org/10.1097/00042752-2000040...	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	14
Khoo Summers et al.⁴⁶46. Khoo-Summers LC, Prather H, Hunt DM, Van Dillen. Predictors of first position turnout in collegiate dancers: the role of tibiofemoral esternal rotation and hip external rotation. Am J Phys Med Rehabil. 2013;92(2):136-42. doi: 10.1097/PHM.0b013e3182465dff https://doi.org/10.1097/PHM.0b013e318246...	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	15
Kushner et al.¹⁶16. Kushner S, Saboe L, Reid D, Penrose T, Grace M. Relationship of turnout to hip abduction in professional ballet dancers. Am J Sports Med. 1990;18(3):286-91. doi: 10.1177/036354659001800312 https://doi.org/10.1177/0363546590018003...	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	14
Lin et al.⁴⁷47. Lin CF, Lee IJ, Liao JH, Wu HW, Su FC. Comparison of postural stability between injured and uninjured ballet dancers. Am J Sports Med. 2011;39(6):1324-31. doi: 10.1177/0363546510393943 https://doi.org/10.1177/0363546510393943...	✓	✓	✓	×	✓	×	✓	×	✓	✓	×	×	✓	✓	✓	×	10
Merkensteijn et al.⁴⁸48. van Merkensteijn GG, Quin E. Assessment of compensated turnout characteristics and their relationship to injuries in university level modern dancers. J Dance Med Sci. 2015;19(2):57-62. doi: 10.12678/1089-313X.19.2.57 https://doi.org/10.12678/1089-313X.19.2....	×	✓	×	×	×	×	✓	×	✓	✓	×	✓	✓	✓	✓	✓	9
Negus et al.¹1. Negus V, Hopper D, Briffa NK. Associations between turnout and lower extremity injuries in classical ballet dancers. J Orthop Sports Phys Ther. 2005;35(5):307-18. doi:10.2519/jospt.2005.35.5.307 https://doi.org/10.2519/jospt.2005.35.5....	✓	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	14
Pata et al.⁴⁹49. Pata D, Welsh T, Bailey J, Range V. Improving turnout in university dancers. J Dance Med Sci. 2014;18(4):169-77. doi: 10.12678/1089-313X.18.4.169 https://doi.org/10.12678/1089-313X.18.4....	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	13
Sherman et al.⁵⁰50. Sherman A, Mayall E, Tasker S. Can a prescribed turnout conditioning program reduce the differential between passive and active turnout in preprofessional dancers? J Dance Med Sci. 2014;18(4):159-68. doi: 10.12678/1089-313X.18.4.159. https://doi.org/10.12678/1089-313X.18.4....	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	13
Shippen et al.⁵²52. Shippen J. Turnout is an Euler angle. Arts Biomechanics. 2011;1(1):33-43.	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	✓	✓	✓	✓	✓	14
Sutton-Traina et al.⁵¹51. Sutton-Traina K, Smith JA, Jarvis DN, Lee SP, Kulig K. Exploring active and passive contributors to turnout in dancers and non-dancers. Med Probl Perform Art. 2015;30(2):78-83.	✓	✓	×	✓	✓	✓	✓	×	✓	✓	×	✓	✓	✓	✓	×	12
Welsh et al.²⁰20. Welsh RTM, Rodriguez M, Beare LW, Barton B, Judge T. Assessing turnout in university dancers. J Dance Med Sci. 2008;12(4):136-41.	×	✓	✓	✓	✓	✓	✓	×	✓	✓	✓	×	✓	✓	✓	✓	13

Estudo	Tamanho da amostra	Intervalo de idade (Média)	Gênero F/M	Métodos usados para avaliar o turnout dos bailarinos
Barnes et al.³⁴34. Barnes MA, Krasnow D, Tupling SJ, Thomas M. Knee rotation in classical dancers during the Grand Plié. Med Probl Perform Art. 2000;15(4):140-7.	14	17-34	14/-	Cinemetria: 3D technology and analyses.
Bennell et al.³⁵35. Bennell K, Khan KM, Matthews B, et al. Hip and ankle range of motion and hip muscle strength in young novice female ballet dancers and controls. Br J Sport Med. 1999;33(5):340-6.	77 bailarinos; 63 não bailarinos	8-11	140/-	Inclinômetro; turnout protactor (transferidor para medir o turnout).
Bennell et al.³⁶36. Bennell KL, Khan KM, Matthews BL, Singleton C. Changes in hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls: a 12 month follow up study. Br J Sport Med. 2001;35(1):54-9. doi: 10.1136/bjsm.35.1.54 https://doi.org/10.1136/bjsm.35.1.54...	53 ; 40 não bailarinos	8-11	93/-	Inclinômetro; turnout protactor (transferidor para medir o turnout).
Bronner et al.³⁷37. Bronner S, Ojofeitimi S. Pelvis and hip three-dimensional kinematics in grand battement movements. J Dance Med Sci. 2011;15(1):23-30.	17	18-27	10/7	Cinemetria: 5-camera Motion Capture System
Champion et al. ³⁸38. Champion L, Chatfield S. Measurement of turnout in dance research: a critical review. J Dance Med Sci. 2008;12(4):121-35.	Artigo de revisão: 24 artigos publicados que reportaram métodos originais de mensuração do turnout em bailarinos			Goniômetro padrão; goniômetro modificado com um nível; inclinômetro; Dupuis Tropometer; transferidor original; fotos dos sujeitos em pé em pedais livres de fricção para os pés; teste de flexibilidade: Nicholas lower extremity torquet; flexímetro.
Cimelli et al.¹³13. Cimelli SN, Curran SA. Influence of turnout on foot posture and its relationship to overuse musculoskeletal injury in professional contemporary dancers: a preliminary investigation. J Am Podiatr Med Assoc. 2012;102(1):25-33. doi: 10.7547/1020025 https://doi.org/10.7547/1020025...	12	21-36	5/7	Traçado/desenho clínico dos pés.
Coplan et al.²¹21. Coplan JA. Ballet dancer’s turnout and its relationship to self-reported injury. J Orthop Sports Phys Ther. 2002;32(11):579-84. doi: 10.2519/jospt.2002.32.11.579 https://doi.org/10.2519/jospt.2002.32.11...	30	16-50	27/3	Goniômetro; sujeito em pé sobre um pedaço de papel em 1ª posição de pés do ballet.
Filipa et al.³⁹39. Filipa AR, Smith TR, Paterno MV, Ford KR, Hewett TE. Performance on the Star Excursion Balance Test predicts functional turnout angle in pre-pubescent female dancers. J Dance Med Sci. 2013;17(4):165-9. doi:10.12678/1089-313X.17.4.165 https://doi.org/10.12678/1089-313X.17.4....	10	5-9	10/-	Sujeito em pé sobre um pedaço de papel.
Gilbert et al.⁴⁰40. Gilbert CB, Gross MT, Klug KB. Relationship between hip external rotation and turnout angle for the five classical ballet positions. J Ortho Sports Phys Ther. 1998;27(5):339-47. doi: 10.2519/jospt.1998.27.5.339 https://doi.org/10.2519/jospt.1998.27.5....	20	11-14	20/-	Goniômetro universal.
Girón et al.⁴¹41. Girón EC, McIssac T, Nilsen D. Effects of kinesthetic versus visual imagery practice on two technical dance movements: a pilot study. J Dance Med Sci. 2012;16(1);36-8.	3	Média: 19,7	3/-	Cinemetria: 8-camera three-dimensional optical motion capture system.
Grossman et al.⁴²42. Grossman G, Waninger KN, Voloshin A, Reinus WR, Ross R, Stoltzfuz J, et al. Reliability and validity of goniometric turnout measurements compared with MRI and retro-reflective markers. J Dance Med Sci. 2008;12(4):142-52.	14	Idade: 10	14/-	Discos rotacionais; ressonância magnética; goniômetro.
Hamilton et al.⁴³43. Hamilton D, Aronsen P, Løken J, Berg IM, Skotheim R, Hopper D, et al. Dance training intensity at 11-14 years in associated with femoral torsion in classical ballet dancers. Br J Sports Med. 2006;40(4):299-303. doi: 10.1136/bjsm.2005.020941 https://doi.org/10.1136/bjsm.2005.020941...	64	14-25	64/-	Inclinômetro eletrônico digital; sujeito em pé sobre um pedaço de papel.
Iunes et al.⁴⁴44. Iunes DH, Elias IF, Carvalho LC, Dionísio VC. Postural adjustments in young ballet dancers compared to age matched controls. Phys Ther Sport. 2016;17:51-7. doi: 10.1016/j.ptsp.2015.04.004 https://doi.org/10.1016/j.ptsp.2015.04.0...	52 bailarinos; 59 não bailarinos	7-24	111/-	Fotos.
Khan et al.²²22. Khan K, Roberts P, Nattrass C, Bennell K, Mayes S, Way S, et al. Hip and ankle range of motion in elite classical ballet dancers and controls. Clin J Sport Med. 1997;7(3):174-9. doi: 10.1097/00042752-199707000-00004 https://doi.org/10.1097/00042752-1997070...	66 bailarinos; 47 não bailarinos	F - média: 16,9; M - média: 18	Bailarinos: 36/30; não bailarinos: 31/16	Goniômetro; turnout protactor (transferidor para medir o turnout).
Khan et al.⁴⁵45. Khan KM, Bennell K, Ng S, Matthews B, Roberts P, Nuttrass C, Way 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):98-103.doi: 10.1097/00042752-200004000-00003 https://doi.org/10.1097/00042752-2000040...	48	16-18	28/20	Goniômetro; turnout protactor (transferidor para medir o turnout).
Khoo-Summers et al.⁴⁶46. Khoo-Summers LC, Prather H, Hunt DM, Van Dillen. Predictors of first position turnout in collegiate dancers: the role of tibiofemoral esternal rotation and hip external rotation. Am J Phys Med Rehabil. 2013;92(2):136-42. doi: 10.1097/PHM.0b013e3182465dff https://doi.org/10.1097/PHM.0b013e318246...	23	18-21	23/-	Goniômetro universal; sujeito em pé sobre um pedaço de papel na 1ª posição de pés do ballet.
Kushner et al.¹⁶16. Kushner S, Saboe L, Reid D, Penrose T, Grace M. Relationship of turnout to hip abduction in professional ballet dancers. Am J Sports Med. 1990;18(3):286-91. doi: 10.1177/036354659001800312 https://doi.org/10.1177/0363546590018003...	22	F - média: 19,4; M - média: 24	14/8	Goniômetro.
Lin et al.⁴⁷47. Lin CF, Lee IJ, Liao JH, Wu HW, Su FC. Comparison of postural stability between injured and uninjured ballet dancers. Am J Sports Med. 2011;39(6):1324-31. doi: 10.1177/0363546510393943 https://doi.org/10.1177/0363546510393943...	22 bailarinos; 11 não bailarinos	Bailarinos lesionados - média: 19,7; bailarinos sem lesão - média: 18,8; não bailarinos - média: 20	33/-	Goniômetro; sujeito em pé sobre um pedaço de papel na 1ª e na 5ª posição de pés do ballet.
Merkensteijn et al.⁴⁸48. van Merkensteijn GG, Quin E. Assessment of compensated turnout characteristics and their relationship to injuries in university level modern dancers. J Dance Med Sci. 2015;19(2):57-62. doi: 10.12678/1089-313X.19.2.57 https://doi.org/10.12678/1089-313X.19.2....	22	19-23	20/2	Goniômetro; sujeito em pé sobre um pedaço de papel na 1ª posição de pés do ballet.
Negus et al.¹1. Negus V, Hopper D, Briffa NK. Associations between turnout and lower extremity injuries in classical ballet dancers. J Orthop Sports Phys Ther. 2005;35(5):307-18. doi:10.2519/jospt.2005.35.5.307 https://doi.org/10.2519/jospt.2005.35.5....	29	15-22	24/5	Goniômetro; sujeito em pé sobre um pedaço de papel.
Pata et al.⁴⁹49. Pata D, Welsh T, Bailey J, Range V. Improving turnout in university dancers. J Dance Med Sci. 2014;18(4):169-77. doi: 10.12678/1089-313X.18.4.169 https://doi.org/10.12678/1089-313X.18.4....	6	Não informado	6/-	Discos rotacionais; filmagem do sujeito executando individualmente uma sequência pelo lado direito e pelo lado esquerdo.
Sherman et al.⁵⁰50. Sherman A, Mayall E, Tasker S. Can a prescribed turnout conditioning program reduce the differential between passive and active turnout in preprofessional dancers? J Dance Med Sci. 2014;18(4):159-68. doi: 10.12678/1089-313X.18.4.159. https://doi.org/10.12678/1089-313X.18.4....	16	13-17	16/-	Goniômetro articulado; Dasco Pro Angle Finder; sujeito em pé sobre um pedaço de papel na 1ª posição de pés do ballet; discos rotacionais.
Shippen⁵²52. Shippen J. Turnout is an Euler angle. Arts Biomechanics. 2011;1(1):33-43.	10	18-28	10/-	Cinemetria: 12-cameras 3-dimensional optical tracking system MX40.
Sutton-Traina et al.⁵¹51. Sutton-Traina K, Smith JA, Jarvis DN, Lee SP, Kulig K. Exploring active and passive contributors to turnout in dancers and non-dancers. Med Probl Perform Art. 2015;30(2):78-83.	23 bailarinos; 13 não bailarinos	18-30	36/-	Discos rotacianais; goniômetro.
Welsh et al.²⁰20. Welsh RTM, Rodriguez M, Beare LW, Barton B, Judge T. Assessing turnout in university dancers. J Dance Med Sci. 2008;12(4):136-41.	17	18-32	Não informado	Sujeito em pé sobre um quadro branco; discos rotacionais.

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