Sports Medicine Research: In the Lab & In the Field: Prescreenings as Possible Genesis of I Can’t Dance (Sports Med Res)

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Wednesday, March 14, 2018

Prescreenings as Possible Genesis of I Can’t Dance

Risk factors for musculoskeletal injury in elite-professional modern dancers: A prospective cohort prognostic study

Bronner S & Bauer NG. Physical Therapy in Sports. 2018; Online Ahead of Print January xx, 2018.  Doi: 10/1016/j.ptsp.2018.01.008

Take Home Message: Dancers who had low or high hypermobility score, muscular tightness, poorer technique, or a recent injury history (as assessed through preparticipation screening) had higher injury risk.

https://upload.wikimedia.org/wikipedia/commons/3/3e/KOCIS_Korean_Modern_Dance_%286890005709%29.jpg
Clinicians are increasingly using screening visits to determine injury risk in many settings/sports, and this includes elite-modern dancers.  The extreme demands of dance may predispose someone to injury; but, we know very little about risk factors for dance-related injuries.  Therefore, the authors of this study retrospectively investigated some common risk factors (hypermobility, technique, muscular tightness, recent injury history) among participants in a university modern dance program.  The researchers screened 180 students as freshmen in a fine arts pre-professional modern dance program and followed them through their four-year program.  Baseline screening consisted of height, weight, blood pressure, postural analysis, range of motion, muscle strength, flexibility, balance, joint laxity, aerobic fitness, and dance technique analysis (various dance positions: binary yes/no).  Over the four years – 84% suffered at least one injury (defined as needing medical attention), most commonly in the lower extremity, and overuse injuries were significantly more frequent than acute injuries.  A dancer with a low or high hypermobility (Beighton) score was at greater risk for injury and missed more time due to injuries than those with medium scores.  Dancers with poorer technique scores were more likely to sustain an injury, as well as dancers with tight muscle groups (e.g., hamstrings, hip flexors, quadriceps) – specifically for overuse injuries.  The authors reported an apparent positive relationship between the numbers of tight muscle groups and the overuse injury risk.  Lastly, dancers who reported 2 to 4 injuries in the prior year were 40% more likely to sustain a new injury compared to those with no history of injury.

This study shows that there are some clear risk factors that should be screened for within a modern dance cohort.  The findings of this study identify possible areas of intervention prior to or simultaneous to participation in a pre-professional modern dance program.  It may be advantageous to develop injury prevention programs for dancers that start upon entry into the program and focuses on flexibility, neuromuscular control, and dance technique. I would be curious to see if these baseline screening scores change at all over their four years in the program and how that might play into injury risk.  It was also interesting to see the high number of injuries within this cohort; especially in the lower extremity and with overuse injuries.  It was also fascinating to see the very specific technique assessment, and how those with good technique were less likely to get injured.  This may show an importance towards technique specific assessments by sport/duty rather than standardized assessments performed across all activities.  The uniqueness of dance tasks may also explain why those with low hypermobility scores are at risk for injury too.  The authors did not report on this – but I wonder whether these individuals were more likely to suffer an acute injury than the other groups.  This study demonstrates clear links between baselines assessments and injury risk including hypermobility, technique, tightness, and recent injury history. Baseline assessments may be very valuable and an athletic trainer who works directly with these participants may be able to individualize prevention interventions for modern dancers.       

Questions for Discussion:  What baseline assessments do you use within your patients?  What things might you typically see and how do you use this information for possible intervention?

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

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2 comments:

Juli Jimenez said...

I have used Fusionetics testing with track athletes to screen them. It includes different movements such as an overhead squat, push ups and different shoulder movements to assess for body compensatory patterns. From there the program gives examples of ways people will do the movement incorrectly and give exercise suggestions to help correct these. I wonder if a program like this would be beneficial to use with a dancer population due to the uniqueness in dance tasks as described in the article. I went to a conference once where an ATC who works with a dance program had to modify the Maddocks questions used in concussion assessment to make them practical for a recital or rehearsal. Should the same modification be made for programs such as functional movement screening FMS or fusionetics? Or can those basic movement patterns still give the necessary information to create a prevention program for dancers?

Nicole Cattano said...

Hi Juli - That's great that you have the resources are are using Fusionetics. How long have you been using it and do you think that it seems to be working/improving outcomes?

I think you bring up a great point about the modifications to existing protocols. We need to remember the patient centered approach to evidence based practice.

How did the AT modify the Maddocks questions for the dancers?

Thanks for sharing!

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