The Impact of Dance-Specific Neuromuscular Conditioning and Injury Prevention Training on Motor Control, Stability, Balance, Function and Injury in Professional Ballet Dancers: A Mixed-Methods Quasi-Experimental Study.

BACKGROUND: Professional ballet dancers suffer high injury rates and are less likely than other athletes to specifically train to improve muscular strength, coordination, agility, speed and motor control because of heavy training demands, aesthetic appearances and financial barriers. HYPOTHESIS/PURPOSE: The purpose of this study was to examine the effects of a supplemental conditioning program on professional and pre-professional contemporary ballet dancers. The authors hypothesized that those participating in a training program would reduce injury rate by improving their motor control, stability, balance and physical function. The authors aimed to observe the feasibility and qualitative phenomena related to a conditioning program from the dancer's perspective. STUDY DESIGN: A mixed-methods study; within subject quasi-experimental design and qualitative interviews. METHODS: Six professional classical and contemporary ballet dancers completed the five-week conditioning and injury prevention training program. Non-parametric analysis of baseline, posttest and four-month follow-up physical performance measures, subjective outcomes, and qualitative follow-up interviews, were reported. RESULTS: Significant post-test improvements included: The Dance Functional Outcome Survey (Z= -2.2, p= 0.04), composite Modified Star Excursion Balance Test (Z= -2.2, p= 0.03 bilaterally), Single Leg Hop for Distance (Z= -2.02, p= 0.04), and Upper Extremity Closed Kinetic Chain Test (Z=-2.03, p= 0.04). Significant changes from baseline to the four-month follow up remained for: (1) Dance Functional Outcome Survey (Z= -2.2, p= 0.03), (2) Single Leg Hop for Distance (Z= -2.2, p= 0.03), and (3) Modified Star Excursion Balance Test composite maximum reach for the left lower extremity (Z= -2.2, p= 0.03). CONCLUSION: Completing a conditioning and prevention program for professional ballet dancers was related to improved function, balance, hop distance/stability and upper extremity stability. Dancers found the program beneficial, identified barriers to participation, and elucidated factors making the program feasible and successful. More research is necessary to determine the effect of such programs on injury incidence. LEVEL OF EVIDENCE: 3b.

Competency-based validation of neurologic specialty practice.

INTRODUCTION: This paper describes a recent practice analysis of neurologic physical therapy. The purpose of the analysis was to describe the knowledge, skills, and abilities of a neurologic physical therapist and to distinguish elements that the neurologic specialist may perform differently from a nonspecialist. The analysis was done to revalidate and revise the Description of Specialty Practice used by the American Board of Physical Therapy Specialties (ABPTS). This Description supports the test plan for the neurologic certification examination. METHODS: A survey was developed by a subject matter expert group and was finalized by analysis of pilot survey data. The final survey consisted of 303 items about the duties, roles, procedures, and knowledge of neurologic physical therapists. Respondents were asked to rate items on frequency, importance, level of criticality, and level of judgment. Respondents were also asked to provide input about examination content percentages and their own clinical practice and demographics. RESULTS: The survey was sent to 590 members of the APTA's Neurology Section. The responses of 187 (32% return rate) physical therapists were combined with 30 responses to the pilot survey for analysis. The data yielded a new neurologic certification examination test plan and description of neurologic specialty practice. This description emphasizes the professional practice expectations, tests and measures, and intervention skills that characterize a neurologic specialist. SUMMARY: The results of this survey represent a summary of current neurologic specialty practice and therefore support an outline for the neurologic board certification examination.

The impact of function on work status for community dwelling disabled persons with arthritis: an analysis of the National Health Interview Survey Disability Supplement.

Arthritis is one of the most common diseases and a leading cause of disability in adults. Returning injured workers to work and preventing work disability is the primary mission of occupational health professionals. The purpose of this study was to identify risk factors associated with work disability and intervention strategies. This study is a retrospective cohort analysis of secondary individual level data. The data for the study were collected by the National Health Interview Survey, Disability Supplement (NHIS-D) 1995. Community dwelling disabled persons with functional limitations due to arthritic conditions were included in this analysis. A total of 286 records were available for logistic regression analysis. The outcome variable was work status, either working or not working. The significant predictors of working status were ability to lift 10 pounds (OR = 1.64), college education (OR = 0.21), age (OR = 1.03), and less than high school education (OR = 2.48). Thirty-four percent of the variance in working status was explained by the model that also included health status, difficulty standing, difficulty walking up steps, difficulty walking 1/4 mile, ethnicity, and gender. Younger disabled persons with arthritis, who have little difficulty lifting 10 pounds, and have some college education have better odds of working. Occupational health professionals need to look for ways to improve the educational status and functional lifting ability of disabled individuals with arthritis.