Abstracts from the 16Th Annual Meeting of the International Association for Dance Medicine & Science
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Abstracts Abstracts from the 16th Annual Meeting of the International Association for Dance Medicine & Science Thursday, 19 October, 2006 achieving optimal performance in dance, using specific assessment and therapeutic strategies. 1. The science of qualitative and quantitative research with Success in dance, particularly classical ballet, demands more dancers than talent, perseverance and a good body. It also depends on Lynda Mainwaring, PhD, CPsych., University of Toronto, Ontario, Canada; factors outside of one’s control, such as the arbitrary judgment of Steven Chatfield, PhD, Caroline Goodnight, BA, University of Oregon, others. Fortunately, dancers can reduce occupational stress by focus- Eugene, OR; Tom Welsh, PhD, Florida State University, Tallahassee, FL; irginia ing on their technical skills, emotional expression, interpretation Wilmerding, PhD, University of New Mexico, Albuquerque, NM, USA and creativity. In contrast, deficits in any of these areas can lead to Research informs dance medicine, science and practice by providing job related stress and a poor performance. understanding of a particular phenomenon brought into focus by a This presentation will demonstrate the practical application of particular question. Research questions asked by IADMS members are these principles associated with peak performance in a project with numerous and reach across varied interests, disciplines, and perspec- 24 senior students in a professional classical ballet school. During tives. Such diversity necessitates multiple approaches to the research Winter Term, 2006, these students were randomly divided into “in- process, which includes discipline-specific questions, cross-disciplinary tervention” and “control” groups. Each chose a personal performance questions, multidisciplinary and interdisciplinary foci, and diversity of goal, which was evaluated subjectively and objectively at baseline and method and methodology. The more methodological tools available three months later. The intervention group met with the psychological to dance science the better our chances of understanding the rich and coach each month and used one or more of the following strategies: complex issues related to dance and the dancer. The purpose of this in- fantasy, relaxation, visualization, mental rehearsal, thought stopping, teractive forum is to extend the current methodological repertoire for and other cognitive behavioral strategies. Effective interventions dance science by describing research methods within the framework ranged from cognitive techniques to address negative self-talk to that has been labeled “qualitative,” “alternative,” or “human science.” relaxation exercises for high anxiety. Outcome and process evaluations The methods of qualitative research will be juxtaposed with those of are discussed, as well as the choice of particular strategies. quantitative research to elucidate similarities and differences. Practical 3. Femoral neck and acetabular impingement syndrome: details of how to conduct research using these two approaches will be Review of the literature illustrated by two panelists, each employing a different methodological Peter E. Lavine, MD, INOVA Mount Vernon Hospital, Alexandria, VA, perspective to answer the question: “What is the psychological impact USA of injury on the professional dancer?” A third scientist on the panel In recent years there has been a burst of interest among orthopaedic will consider the implications of both approaches for research with hip and adult reconstructive surgeons in issues surrounding very dancers. The moderator will lead discussion among the panelists and early degenerative arthritic changes that lead to impingement of audience. The forum will emphasize the need for rigorous research functional range of motion at the hip. It is believed that this im- in dance science regardless of discipline or methodological approach, pingement leads to hip pain and decreased range of motion, and and builds upon previous forums dedicated to expanding competent actively promotes the degenerative arthritic process. This eventu- research with dancers. ally leads to severe arthritis of the hip, with the potential need for 2. The application of psychological principles to achieve total hip arthroplasty. optimal performance As this concept of hip impingement has advanced, hip surgeons Linda H. Hamilton, PhD, New York City Ballet Wellness Program; Bonnie on the “cutting edge” have begun to develop techniques to treat the E. Robson, MD, FRCP(C), Quinte Ballet School of Canada, Belleville, condition and slow down or prevent the progression of osetoarthritis, Ontario, Canada with the eventual goal of delaying or preventing the need for total Most successful dancers use both mastery and learning goals to hip surgery in the young active patient (30-60 years old). perform at their peak. Within this milieu psychological techniques Although there are as yet no definitive data on the subject, it aimed at performance enhancement are effective in establishing is often anecdotally observed that many dancers in their 30’s–50’s obtainable goals in a step-wise progression. This presentation is develop hip problems. Hence, it is important for health profes- designed to educate the dance community about the process of sionals to be familiar with the possible treatment options available 8 Journal of Dance Medicine & Science • Volume 11, Number 1, 2007 9 to the dancer with early, often undiagnosed or misdiagnosed, 6. Self-report, clinical exam, and ultrasound of the degenerative changes of the hip. snapping hip syndrome in elite ballet dancers Paul Winston, MD;1 Raza Awan, MD, MHSc;2 J. David Cassidy, PhD, 4. Reliability and validity of goniometric turnout DrMedSci;3 Robert K. Bleakney4 (1Toronto Rehabilitation Institute, Division measurements compared with MRI and use of of Physiatry, University of Toronto; 2Department of Clinical Neurophysiology, retroreflective markers St. Michael’s Hospital; 3Al and Malka Green Artists’ Health Centre, Toronto Gayanne Grossman, PT, EdM, Muhlenberg College, Allentown; Kevin N. Western Hospital; 4University Health Network, University of Toronto) Waninger, MD, MS, St. Luke’s Hospital; Arkady Voloshin, PhD, Lehigh The purpose of this study was to determine the cause of snapping hip University, Bethlehem; William R. Reinus, MD, MBA, Temple University syndrome in ballet dancers and test the usefulness of physical exami- Hospital, Philadelphia; Renee Martino, RN, CRN, St. Luke’s Hospital, Bethlehem; Kathleen Bibalo, Muhlenberg College, Allentown; Rachael Ross, nation techniques and real-time ultrasound in making the diagnosis. SPT, Jefferson College of Health Professions, Philadelphia, PA, USA Twenty-six elite ballet dancers with 50 self-reported snapping hips participated in the study. Three physical examination techniques This study tested the validity and reliability of a single total pas- recommended in the literature were performed; then each dancer sive turnout (TPT) test taken with a goniometer. Fifteen female voluntarily reproduced the snap. The examiner recorded whether college dancers (30 legs) who began dancing before age ten were there was an audible or palpable snap with each technique. Real time recruited as volunteers. The components of turnout were tested ultrasound examinations of all hips were performed anteriorly and using various methods, including Magnetic Resonance Imaging laterally, and the diagnosis of snapping was recorded. (MRI), retroreflective markers with high speed photography, and Voluntary reproduction by the dancer produced a snap in 46 goniometric measurements, and then compared. Tibial torsion was hips, in contrast to 12 hips with the recommended maneuvers. calculated using T1 axial and coronal MRI images. The markers Inter-rater reliability for the recommended maneuvers was poor, testing rotation and torsion were located on the greater trochanter, but consistent for the voluntarily produced snap. Ultrasound di- adductor tubercle of the femur, tibial tubercle, medial malleolus of agnosed a snapping iliopsoas tendon in 59% of the hips and the the tibia, and second toe. Each leg was manually rotated from the o o o iliotibial band in 4%. A snap was felt by the radiologist through sagittal plane and photographs were taken at 15 , 30 , 45 , seated the transducer but not visualized in an additional 17%. and TPT supine, total active turnout standing, and turnout on It is concluded that: 1. iliopsoas snapping hip is very common rotational disks. Two physical therapists obtained blinded measure- in ballet dancers; 2. dancer reproduction of the snap was far more ments three times and reported the average. Promising results were useful than described examination techniques; 3. ultrasound was obtained with the pilot, and additional data collection is in progress. very useful in visualizing iliopsoas snapping hip; 4. iliotibial band These tests should catalyze progress toward a single measurement of snapping was evident by physical examination and ultrasound. passive turnout. This measurement will facilitate dance training to correct problems with over or under turning out, and prevent and 7. Am I going to be good enough for this profession? correct problems associated with turnout-related injuries. Emotional reactions to injury in ballet students Bonnie E. Robson, MD, DPsych, FRCP(C), Quinte Ballet School of Canada, 5. A psycho-educational model to facilitate the self- Belleville, Ontario, Canada development and mental health of the pre-professional This prospective study