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Lecture: Injury Prediction - Results from four years of prospective injury surveillance (Marijeanne Liederbach)Purpose: Injuries in dance are commonplace and distressing in terms of human and financial impact. The goal of dance medicine healthcare professionals and educators is to detect injury risk prospectively, often through screening efforts. It is known that screening has been useful for rapport building, improving health literacy and wayfinding into local healthcare systems. However screening, as we have been conducting it, has still not proven to be predictive of injury despite implementation of preventative interventions such as preseason conditioning programs. The purpose of this study was to test the predictive validity of four patient reported outcomes (PROs) in addition to an array of clinical performance based outcomes (CPBOs) collected during preseason screening in forecasting subsequent season time-loss injury.
Participants: 241 elite dancers (69 men, 172 women, 21.5 ± 5.0 years of age at study enrollment) from five different organizations (three professional ballet companies, one professional modern dance company and one university conservatory of dance) consented to participate. Design/Procedure: Injuries were tracked prospectively for four years. Data were analyzed with a multivariate logistic regression model for the outcome variables “injured in subsequent season” and “increased number of same season clinician visits”. The PROs utilized were the Discomfort Rating Scale (DRS); the modified World Health Organization Functional Disability Scale (WHO); the Profile of Mood State (POMS) and the Eating Attitudes Test-26 (EAT). Results: EAT scores were associated with subsequent injury. DRS, WHO and two CPBOs which emphasized gross motor control versus task behavior qualified for the final statistical model predicting increased number of same season visits. Conclusions: Dancer health is best assessed when a combination of physical, psychodynamic and participation factor data points are co-evaluated. Subjective patient reported outcome measures continue to demonstrate predictive validity and should be part of routine screening content in addition to clinical measures that emphasize gross motor coordination. Relevance to Conference Theme: Tests and measures used in this study were created and validated by the primary author and data were collected collaboratively by an interdisciplinary team of professionals. |
Marijeanne Liederbach |
Marijeanne Liederbach, PhD, PT, ATC, CSCS is Director of the Harkness Center for Dance Injuries at NYU Langone Orthopedic Hospital and Research Assistant Professor in the Department of Orthopedic Surgery at NYU School of Medicine. Prior to her current appointment, she headed the Dance Medicine Services for The Joffrey Ballet while serving as Supervisor of Sports Physical Therapy at the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital and Instructor of Kinesiology at Columbia University. Dr. Liederbach is a physical therapist and certified athletic trainer with a doctorate in biomechanics and ergonomics. She has provided backstage therapy for hundreds of dancers, dance companies and Broadway shows and has authored numerous papers and chapters as well as lectured internationally on topics pertaining to the prevention and care of sports and dance injuries. Dr. Liederbach has long served on the Editorial Review Board of the Journal of Dance Medicine and Science, the National Advisory Committee for the American Physical Therapy Association's Performing Arts Practice Analysis and the DanceUSA Task Force on Dancer Health. She is also an elected Affiliate Member of the American Orthopaedic Society for Sports Medicine, a Founding Member of the International Association for Dance Medicine and Science as well as Chair of its Standard Measures Consensus Initiative. Prior to her career in Dance Medicine, Dr. Liederbach danced professionally for many years and worked as a choreographer. Her critically acclaimed work has been shown in Europe and throughout the United States. In 2010, she was inducted into the Hall of Fame of the Dance Library of Israel by Broadway sensation, Ben Vereen |