Dance Screening practices in dance companies, dance schools and university dance programmes: an international survey of current practices

Abstract

Background: Dance performance requires the combination of both athletic and artistic demands. The health and well-being of dancers is of paramount importance, and one intervention that has been used to manage their health and performance is screening. There is a need to determine current screening practices to aid the management of dancers. Methods: The Bristol online survey was used to determine screening practices in dance companies/schools and university dance programmes. The survey was available online between April 2018 and September 2018 and consisted of 39 questions which were divided into the following sections: (1) screening details, (2) physical fitness and joint screening, (3) injury screening, (4) dance specific movement screening, (5) health screening. Respondents included those individuals involved in dance screening. Results: A total of 32 individuals participated in the study with physiotherapists and dance teachers most prevalent. Injury prevention (62.5%) and self-management (62.5%) were the most common aims of screening. Dancer screening occurred in a non-fatigued state in 90.63% of dancers. Flexibility (95.75%) was the most commonly assessed physical fitness component and the feet the most assessed joint (87.5%). Passive turnout (62.5%) and demi-plié (62.5%) were the most commonly assessed dance specific movements. Previous injury (87.5%) had the highest prevalence of general health questioning. Cardiovascular screening was performed by 21.88% of respondents and the Star Excursion Balance Test (34.38%) was the most commonly used movement screening tool. Hypermobility was screened by 75% of respondents and 28.13% of respondents used psychometric tests. Conclusion: Physiotherapists and dance teachers were most frequently involved in screening, and the main aims were to improve the dancers health and well-being. There may be a need to consider the potential influence of acute fatigue on screening and a greater assessment of the strength, aerobic fitness and speed is required. Passive and active turnout were frequently screened and may be important in identifying potential injury risk. Cardiac and psychometric screening was limited and may require greater consideration. Keywords: Dance screening, Injury prevention, Career longevity, Flexibility, Passive turnout, Cardiovascular screening, Star Excursion Balance Test, Hypermobility\u2029 Page of 1 14 *Correspondence Ross Armstrong Department of Sport and Physical Activity, Sports Injuries Research Group, Edge Hill University, Ormskirk, Lancashire, L39 4QP, England. Email: [email protected] Telephone: (+44) 01695 584246 Received: Sep 11, 2018 Accepted: Jan 4, 2019 Published: Jan 18, 2019 ©2019 Ross Armstrong; licensee OA Journal of Clinical Case Reports. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. Dance screening practices in dance companies, dance schools and university dance programmes: An international survey of current practices Ross Armstrong* Case Report Open Access OA Journal of Clinical Case Reports Ross Armstrong. OAJ Clini Case Rep 2019, 1:007 doi: 10.33118/oaj.clin.2019.01.007 Introduction Dance requires short sets of explosive movements requiring balance, athleticism and artistry [1], indicative of movement complexity and intensity. Due to these demands, physical attributes including strength, speed, power, agility, cardiovascular endurance, flexibility, coordination and balance contribute to effective performance. Vertical ground reaction forces increase with the intensity of the dance routine [2,3] and mechanical loading increases with movement difficulty [4] and dancers are required to exceed normal anatomical range [5]. One potential consequence of these demands is injury which is a challenge for Sports Medicine professionals due to its significant physical, psychological and financial impact and multifactorial nature [6]. Injuries in dance result from a complex interaction between intrinsic, extrinsic and situational variables [7]. Dance screening practices are a vital component of injury prevention with a recent systematic review and meta-analysis identifying range of motion (ROM), anthropometric data and posture, dance specific positions, hypermobility, clinical diagnostic tests, and musculoskeletal screening tools as current measurements that have been investigated as predictors of injury [7]. Injury rates range from 0.62 to 5.60 injuries/1000 hours with most injuries occurring in the lower limb [5, 8-10]. A general movement screen may lack specificity and value exists in developing screening practices that can predict the likelihood of injury to maximise the specificity and therefore ability of the test to determine injury [11]. Recent research has focussed on the potential effects of fatigue on screening performance and potential implications for injury [12,13] and the influence of fatigue may require greater consideration in screening practices. In addition to injury prevention, screening has previously been used to monitor performance deficits with the Star Excursion Balance Test reported to be a predictor of functional turnout angle [14] and used to assess proprioceptive training [15]. The implementation of effective injury screening tools could have positive physical and psychological impact for dancers by allowing participation with reduced injury risk. Traditionally within dance “screening” has sometimes been used as a term to describe the selection of dancers following an assessment of their performance at an audition. This study prefers to consider the term “screening” in a musculoskeletal and physical health domain. Currently it is unclear the extent to which dance companies and university dance programmes are performing screening of dancers prior to participation. Furthermore the demands of dance are varied e.g. ballet requires partner lifting and tap dancing utilises the lower extremity as a percussion instrument and such variations combined with the different levels of dance have implications for injury and performance. The primary aim of this study was to determine current screening practices in dance companies/ schools and university dance programmes including what tests are been performed, by whom and how the information is been utilised with the aim of providing information that can potentially be used to improve dancer’s health and performance. The study utilised a broad genre and level of dance and an online platform with the aim of developing an international perspective on current practices.