Effect of ballet on kinematics in children with coxa antetorta: a pre-post intervention study

E Hamer; E Hamer; C Maguire; M Widmer; E Viehweger; M Odorizzi

doi:10.1055/s-0045-1812442

physioscience, Table of Contents

physioscience 2025; 21(S 03): S38
DOI: 10.1055/s-0045-1812442

Abstracts

Poster/Posters

Effect of ballet on kinematics in children with coxa antetorta: a pre-post intervention study

Authors

E Hamer

¹Rehab Basel – Klinik für Neurorehabilitation und Paraplegiologie, Basel, Switzerland
E Hamer

²REHAB, Clinic for Neurorehabilitation and Paraplegiology, Physiotherapy, Basel, Switzerland
C Maguire

²REHAB, Clinic for Neurorehabilitation and Paraplegiology, Physiotherapy, Basel, Switzerland
M Widmer

³Universitäts-Kinderspital beider Basel UKBB, Department of Paediatric Orthopaedics, Basel, Switzerland;
E Viehweger

⁴Department of Paediatric Orthopaedics, Department of Paediatric Neuroorthopaedics, Laboratory for Movement Analysis, Universitäts-Kinderspital beider Basel UKBB, Basel, Switzerland;
M Odorizzi

⁵Department of Paediatric Neuroorthopaedics, Universitäts-Kinderspital beider Basel UKBB, Basel, Switzerland;

Abstract

Full Text

Introduction Increased femoral anteversion (IFA) is rarely considered in healthy children and adolescents as it usually normalizes spontaneously. However, IFA can lead to several gait deviations, including in-toeing and increased knee flexion during midstance-phase (MSt). The available evidence indicates that IFA during childhood increases the risk of patella malalignment, femoropatellar complaints, and hip/knee osteoarthritis in adulthood. Therefore, IFA is not merely a cosmetic issue. Thus far, the impact of targeted training has not been investigated. What are the effects of a six-week ballet training on kinematics in children with idiopathic coxa antetorta (ICA)? Is the integration of a ballet training program into the everyday life of schoolchildren feasible?

Methods A pre(T1) / post(T2), intervention study without control was conducted, in which children with ICA participated in 1-h group ballet classes twice a week for six weeks. Additionally, the participants were provided with a diary containing instructions for home ballet exercises. A two-dimensional gait analysis was conducted on a C-Mill treadmill by Motek to measure knee flexion during MSt. The feasibility of the intervention was evaluated by analyzing six feasibility outcomes.

Results 5 healthy children (80% males; 9.6±1.5 years old) with femoral neck anteversion 30°<FNA<40° were included. There was a trend towards reducing excessive knee flexion during MSt (median value 17.7° (15.7-18.9°) at T1 and 13.8° (12.4-17.2°) at T2; p=0.06). 45,5% of eligible and contactable children were enrolled. The retention rate at each point was 100%. 96.7% of the ballet training sessions and 64.7% of the home exercises sessions were completed. There were no adverse events, and all diaries were returned after the intervention.

Discussion This pioneer study indicates that ballet training may be a useful intervention to reduce excessive knee flexion during MSt in children with ICA. The integration of ballet training program into the children's everyday lives, is feasible and safe with some modifications. Further studies including randomized controlled trials with larger sample sizes and three-dimensional gait analysis are required to gain understanding of the influence of ballet training on the reduction of IFA and compensatory gait mechanisms in children with ICA.