Effects of Dancer-Specific Biomechanics on Adolescent Ballet Dancers' Posture En Pointe and Factors Related to Pointe Readiness: A Cross-Sectional Study.

OBJECTIVE: There are no universally accepted requirements or uniform protocols to determine when dancers can safely commence dancing en pointe (shod relevé). The purpose of this study was to examine dancer-specific biomechanics of adolescent pointe dancers and explore factors that may help determine pointe readiness. METHODS: Dancers (n=26; median age 14 yrs [IQR=13-16]) were stratified into two groups based on the ability to stand on the pointe shoe box as per a plumb line (Group 1: on the box; Group 2: not on the box) during parallel, shod relevé. Measurements included unshod weight-bearing range of motion (ROM) of ankle plantarflexion (PF) and first metatarsophalangeal (MTP) extension and shod posture assessment during first position elevé (rising into relevé with turned out, straight legs). Qualisys 3D motion capture and AMTITM force plates recorded dancers performing 10-15 repetitions of first position elevé. Comparison of three kinematic and three kinetic variables aimed to describe group differences during unshod and shod conditions. Wilcoxon signed-rank test assumed no difference between groups with a Bonferroni correction (p<0.0083). RESULTS: During unshod parallel relevé, ROM was different between groups for first MTP extension (deg; MedGroup1: 90°, IQR 80°-90°; MedGroup 2: 70°, IQR: 70°-80°, p<0.0001) but no statistical difference in ankle PF (deg; p=0.0098). There were no differences in C7 displacement (m; p=0.5055), ankle PF moment (p=0.1484), or hip mediolateral and anteroposterior moments (p=0.8785 and 0.8785, respectively) during shod first position relevé, indicating that both groups tend to engage the same dominant muscle groups (trunk extensors, ankle dorsiflexors, hip flexors, and hip abductors) during elevé. CONCLUSION: Dancers in Group 1 demonstrated greater first MTP extension during unshod relevé compared to dancers in Group 2. Weight-bearing ROM could be a valuable tool in predicting pointe readiness of adolescent ballet dancers.

Home food access and children's heart healthy dietary intake at home and child care.

Background: About 12 million children under 5 years of age attend early care and education centers (ECEs). Child intake at home can be impacted by food insecurity, which is higher among low income, rural, and racially diverse families. Aim: Determine whether greater access to fruits, vegetables, and snacks at home was associated with heart-healthy diet score at home and at ECEs in preschool-age children, and to determine whether there is a difference in heart-healthy diet score between home and ECEs. Methods: Cross-sectional study involving children (3-to-5-year-old, n = 88) who attended 16 licensed ECEs across Oklahoma. Caregivers completed the Healthy Home Survey and 3-Dinner Dietary recall to report children's home food access and home dinner dietary intake, respectively. Researchers recorded children's ECE lunch consumption using the Dietary Observation for Child Care. Heart-healthy diet score was derived from composite scores for six variables: consumption of fish, fruits, vegetables, sodium, fiber, and sugary drinks. Results: Home access to total fruits and vegetables (16.2 ± 6.3) outnumbered snacks (5.5 ± 3.0). No difference in composite heart-healthy diet score between ECEs (1.50 ± 0.8) and home (1.27 ± 0.9, P = 0.0851). Children within neither environment met recommendations for most variables (vegetables [18-24%], fruit [6-10%], fish [5-10%], fiber [1%], sodium [22-39%]). No relationship between home food access variables and the heart-healthy diet scores at home or ECEs. Conclusion: Dietary intake of children at home and ECEs does not meet heart-healthy diet score recommendations. Interventions should support preschool aged children from families that are located rurally, low-income, racial minorities, and whose primary caregivers work outside the home.

Feasibility of Ideal Cardiovascular Health Evaluation in a Pediatric Clinic Setting.

The feasibility of "point-of-care" screening for ideal cardiovascular health was explored in a pediatric specialty clinic setting. Children and adolescents aged 9-18 years (n=91) with treated and stabilized diseases were recruited at a pediatric endocrinology clinic. A table-top device was used to assay fingerstick samples for non-HDL cholesterol (non-HDL-C), which was used to divide participants into two groups based on the non-HDL-C threshold for comparison of the remaining metrics between groups. A significant number of children had low scores, and score frequency distribution was similar to larger retrospective studies, with few participants achieving none or all of the health metrics. Healthy diet was the metric least often achieved. Those with a non-HDL-C above the ideal threshold of 3.1 mmol/L (120 mg/dl) had a higher BMI percentile (p<0.01) and diastolic blood pressure percentile (p<0.05). We conclude that pediatric risk factor screening and scoring can be performed in a specialty clinic with meaningful cardiovascular health scores for patients and providers. Association of abnormal "point-of care" non-HDL-C levels with elevated BMI and blood pressure supports evidence for risk factor clustering and use of the ideal health construct in pediatric clinic settings.