Ross Armstrong

Dual antibiotics for non-cystic fibrosis bronchiectasis

This is a protocol for a Cochrane Review. The objectives are to evaluate the effects of dual antibiotics for treatment of adults and children with non-cystic fibrosis bronchiectasis

Screening Tools as a Predictor of Injury in Dance: Systematic Literature Review and Meta-analysis

BackgroundDance involves movements of complexity and physical intensity which result in stress on the body. As a consequence, dancers are at risk of injury which can impact on their well-being. Screening tools are used for injury prevention to identify those dancers at risk of injury. The aim of this study was to investigate which screening tools can predict injury in dancers, encompassing all dance genres, levels and ages.MethodsAn electronic search of seven databases from their inception to December 2017 was conducted. The databases were the Allied and Complementary Medicine Database (AMED), CINAHL, eBOOK Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro: the Physiotherapy Evidence Base. The following search terms were used: (i) Dance AND injury AND Screening, (ii) Screening AND dance and (iii) Musculoskeletal AND Screening AND Dance. Studies were assessed using a 20-point scoring tool, and eligible studies were included in a meta-analysis.ResultsThe mean methodological quality score was 12.2 points. Injured dancers had a significantly higher compensated turnout range of motion than non-injured dancers: pooled mean difference of compensated turnout (23.29°; 95% CI 14.85–31.73; P < 0.00001; I2 = 0%). Injured dancers had significantly greater functional turnout range of motion when compared to non-injured dancers: pooled mean difference of functional turnout (14.08°; 95% CI 7.09–21.07; P < 0.0001; I2 = 0%). There also some evidence for use of hip range of motion as a predictor of dance injury.ConclusionsSome evidence exists for the potential use of dance-specific positions as a predictor of injury. A number of studies were limited by a lack of prospective injury design, injury definition and self-reporting of injury.

The Beighton score as a predictor of Brighton criteria in sport and dance

OBJECTIVES To determine the efficacy of using the Beighton joint hypermobility score as a predictor of Brighton criteria components, considering the influence of gender and sports participation. DESIGN Cross sectional study design. SETTING A University. PARTICIPANTS Sixty-five female rugby players, 38 male rugby players, 61 netball players, 42 female dancers, 40 male controls and 40 female controls. MAIN OUTCOME MEASURES The Beighton score was assessed using the Beighton and Horan Joint Mobility Index. The Brighton criteria was used to assess joint hypermobility syndrome. A binary logistic regression was performed for a pooled sample (n = 286), and subsequently for gender and sport to assess the Beighton score as a predictor of Brighton criteria. RESULTS Beighton scores were found to be a predictor of arthralgia (P = 0.002), dislocation and subluxation (P = 0.048) in the pooled analysis; a predictor of dislocation and subluxation (P = 0.047) in males and arthralgia (P = 0.001) in females. Beighton scores were a predictor of arthralgia in female rugby (P = 0.003) and in female controls (P = 0.012). CONCLUSIONS The potential of the Beighton score to predict joint arthralgia and dislocation/subluxation may allow clinicians to implement effective injury prevention strategies.

The Functional Movement Screen and modified Star Excursion Balance Test as predictors of T-test agility performance in university rugby union and netball players

OBJECTIVES Agility is a functional requirement of many sports, challenging stability, and commonly cited as a mechanism of injury. The Functional Movement Screen (FMS) and modified Star Excursion Balance Test (mSEBT) have equivocally been associated with agility performance. The aim of the current study was to establish a hierarchical ordering of FMS and mSEBT elements in predicting T-test agility performance. DESIGN Cross-sectional study design. SETTING University. PARTICIPANTS Thirty-two female rugby players, 31 male rugby players and 39 female netballers MAIN OUTCOME MEASURES: FMS, mSEBT, T-test performance. RESULTS The predictive potential of composite FMS and mSEBT scores were weaker than when discrete elements were considered. FMS elements were better predictors of T-test performance in rugby players, whilst mSEBT elements better predicted performance in netballers. Hierarchical modelling highlighted the in-line lunge (ILL) as the primary FMS predictor, whereas mSEBT ordering was limb and sport dependent. CONCLUSIONS The relationship between musculoskeletal screening tools and agility performance was sport-specific. Discrete element scores are advocated over composite scores, and hierarchical ordering of tests might highlight redundancy in screening. The prominence of the ILL in hierarchical modelling might reflect the functional demands of the T-test. Sport-specificity and limb dominance influence hierarchical ordering of musculoskeletal screens.

The hypermobility spectrum in rugby union players, netballers and dancers: Implications for injury and performance.

Objectives: Hypermobility has been associated with injury and performance and a new hypermobility framework has been introduced. This study aimed to report the prevalence of localised joint hypermobility, generalised joint hypermobility (GJH), peripheral joint hypermobility and hypermobility Ehlers-Danlos type in female rugby players, male rugby players, female netball players, female dancers, male and female controls. Methods: This study determined joint hypermobility via the Beighton score and the associated criteria of the hypermobility spectrum in 378 participants. Results: Localised joint hypermobility ranged from 61.11% (netballers), 57.33% (female rugby), 48.15% (male controls), 46.30% (male rugby), 38.33% (female controls) to 28.57% (female dancers). Significant differences existed for Beighton scores (p<0.001) between female dancers and all other cohorts, female rugby and male controls (p=0.005), male rugby and netball (p=0.001), netball and male controls (p=0.001) and female controls and male controls (p=0.021). Prevalence of GJH ranged from 69.84% (female dancers), 25% (netball), 21.67% (female controls), 18.67% (female rugby), 3.70% (male rugby) to 1.85% (male controls). In participants with GJH, dancers had the highest prevalence of pain and dislocation/subluxation. Significant differences existed between dancers and all other groups for hypermobility Ehlers-Danlos type criteria (p<0.001). Five participants met the criteria for diagnosis of hypermobility Ehlers-Danlos type. Male rugby players had the highest prevalence of peripheral joint hypermobility (29.63%). Conclusion: Significant findings between dance and other cohorts may highlight a potential performance adaptation. Significant findings between control groups for the Beighton score may indicate a gender effect. There is a need to consider these factors in relation to performance and injury.

The effect of fatigue on Functional Movement Screening performance in dancers

OBJECTIVE Dance is associated with a high risk of injury, with fatigue identified as a contributing factor. Functional movement screening (FMS) has been used to identify alterations in normal movement which may contribute to injury risk, though this test is not normally performed in a fatigued state. The aim of this study was to determine whether fatigue induced by the dance aerobic fitness test (DAFT) results in changes in FMS scores with implications for performance and injury risk. METHODS Forty-one university dancers completed the FMS before and immediately after completion of the DAFT. Rate of perceived exertion and heart rate were quantified as measures of fatigue. RESULTS Post-DAFT, the mean FMS composite score (15.39±1.86) was significantly less (p≤0.01) than the pre-exercise score (16.83±1.83). Element-specific analysis revealed that the deep squat, non-dominant lunge, and dominant inline lunge scores were all significantly impaired post-DAFT (all p≤0.01). CONCLUSION The identification of changes in quality of movement in a fatigued state suggests that movement screening should also be performed post-exercise to enhance screening for injury risk. The influence of dance-specific fatigue was FMS element-specific. Specifically, the deep squat and inline lunge were most susceptible to fatigue, with implications for injury risk and performance and reflective of the high level of neuromuscular control required.