Readiness for Pointe Shoes in Ballet: A Delphi Consensus Study

Background A ballet dancer’s first pair of pointe shoes marks a significant milestone in ballet training. Pointe shoes are synonymous with classical ballet and allow dancers to perform on the tips of their toes. Beginning pointe training is a multifactorial decision, but consensus is lacking regarding the abilities a dancer must demonstrate to progress to pointe training safely. Guidelines have been established by the International Association for Dance Medicine and Science, however, are largely broad and subjective. We aimed to establish a consensus on key factors a dancer should demonstrate before commencing pointe work via a scoping review and Delphi method. Results A scoping review identified existing criteria, followed by a three-round Delphi method with 21 experts (ballet teachers, health professionals and experienced researchers). Combining scoping review criteria with panel responses, three themes and 10 areas of assessment were identified, along with 22 reasons to complete a pointe readiness assessment. The panel rated their level of agreement for each criterion on a 4-point Likert scale (strongly-disagree to strongly-agree) to determine consensus (≥ 80% agreement). 48/99 of identified criteria to assess pointe readiness reached consensus. Single-leg heel-rise (SLHR) repetitions, balance and control and injury history reached the highest consensus in influencing the decision to progress a dancer to pointe. 18/22 reasons to conduct a pointe assessment reached an agreeable consensus. Conclusion This study provides a comprehensive evaluation of pointe readiness criteria and explores the differing perspectives of a range of stakeholders. It also offers a foundation for developing standardised, evidence-informed guidelines. Further research is needed to validate measures and improve the effectiveness of pointe readiness assessments.