Study Design: Descriptive correlational study. Objectives: To determine relationships between aspects of turnout and injury history in preprofessional classical ballet dancers, and to determine the clinical utility of various methods used to assess turnout. Background: In Australia 50% of professional dancers currently have persistent or recurrent injuries, with 36% of these injuries commencing before 18 years of age (preprofessional level). Overuse or nontraumatic dance injuries are often attributed to faults in technique, with poor turnout and inappropriate compensatory strategies consistently cited as the main cause. Methods and Measures: Twenty-nine dancers (24 female), aged 15 to 22 years, were recruited from a preprofessional classical ballet program. Measurements were taken of passive and active hip external rotation (ER) range of motion (ROM) in supine, and functional turnout angles in standing. Three turnout variables were derived: active ER lag, compensated turnout, and static-dynamic turnout difference. Injury history over the previous 2 years was ascertained by interview. Pearson product moment and Spearman rank correlation coefficients were used to determine associations between turnout variables and injury history. Results: All dancers reported a history of injury, with 93.1% reporting a history of nontraumatic injuries and 41.4% reporting a history of traumatic injuries. Number and severity of nontraumatic injuries were associated with reduced functional turnout (r or rho Ͼ 0.38; P Ͻ .04), but not with hip ER ROM. Number and severity of traumatic injuries were not associated with turnout. No correlation was found between hip ER ROM and functional turnout. Conclusions: Functional measures of turnout are more relevant than hip ER ROM to prevalence of nontraumatic dance injuries. Control of turnout in classical ballet dancers should be assessed dynamically and in functional positions. J Orthop Sports Phys Ther 2005;35:307-318.
Functional instability of the ankle joint following an acute sprain has been well documented. The present study measured joint position sense of the ankle in subjects who had sustained recurrent ankle sprains but no sprain for at least three months prior to testing, and compared them with uninjured subjects. The testing device, a pedal goniometer, attempted to replicate the most common position of ankle injury (plantarflexion/inversion). Joint position sense was assessed using active and passive methods for reproducing predetermined positions in ankle inversion in plantarflexion. In both groups, passive judgment of joint position was more accurate than active judgment. Significant differences were recorded with the recurrently sprained ankle demonstrating greater errors in joint position sense for all passive testing positions.
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