Screening Tools as a Predictor of Injury in Gymnastics: Systematic Literature Review.

BACKGROUND: Gymnastics requires a high level of physical ability and technical skill which utilises short sets of athleticism and artistry to perform complex and intense movements which can overload musculoskeletal tissues and result in acute injuries which can develop into chronic injuries. The aim of this systematic literature review was to investigate which screening tools predict injury in gymnasts and encompasses all genres, levels and ages. METHODS: An electronic search of seven databases from their inception until March 2021 was conducted. The databases were the Allied and Complementary Medicine Database, CINAHL, eBook Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro (the Physiotherapy Evidence Base). A combination of the following search terms was used: (1) Gymnastics AND injury AND Screening, (2) Screening AND Gymnastics and (3) Musculoskeletal AND Screening AND Gymnastics. These terms were searched in all text, abstract, title and subject terms. Studies were assessed using a 20-point scoring tool. RESULTS: The mean methodological quality score was 13.1 points (range 10-17 points). Range of motion, anthropometric and postural measurements, hypermobility, clinical diagnostic tests, movement screening tools, muscle strength, power and endurance were reported in the included studies. Some evidence existed for screening measurement of height and mass as taller and heavier gymnasts might be more susceptible to injury; however, the different methodologies utilised and lack of acknowledgment of confounding variables limit the clinical relevance of these findings. CONCLUSIONS: Height and mass should be recorded during the screening process. A lack of heterogeneity in study methodology prevented a meta-analysis. Studies were limited by a lack of prospective injury design, poor injury definition, self-reporting of injury and only 2 studies reported reliability of screening tools. Further research is required to determine the role of injury screening in gymnastics. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020218339.

Effect of Kinesiology Tape on Tri-Axial Accelerometry During the Dance Aerobic Fitness Test.

OBJECTIVES: Kinesiology tape (KT) is thought to provide greater mechanical support during physical activity, however, there is a paucity of research investigating its application in dance. The study aimed to determine whether KT reduces PlayerLoad (PL) during the Dance Aerobic Fitness Test (DAFT) in addition to examining the relative sensitivity of accelerometer site locations.
Methods: University-level dancers (N = 11; age 18 ± 0.45 years, height 168.17 ± 12.25 cm, body mass 57.50 ± 9.91 kg) participated in two trials of the DAFT protocol in two conditions: no tape (NT) and kinesiology tape (KT). Global positioning systems (GPS) and accelerometer units were attached onto the seventh vertebra (C7) at the mid-scapula region and lower limb (LL) located at the midgastrocnemius of the dominant leg calculating measurements of triaxial (PLTotal) and uniaxial measures (anteroposterior [PLAP], mediolateral [PLML], and vertical [PLV]) measures of PlayerLoad during the DAFT.
Results: No significant main effect was observed for the taping condition in all measures of PlayerLoad (P > 0.10). A significant main effect (p < 0.01) was observed for unit location and time, with greater loading at the LL compared to C7 and during each consequent stage of the DAFT. No significant (p > 0.52) location*taping, nor location*taping*time (p > 0.36) interactions were observed for all variables measured.
Conclusions: Kinesiology tape does not reduce loading patterns in healthy dancers during a fatigue protocol. However, triaxial accelerometers provide adequate sensitivity when detecting changes in loading, suggesting the LL may be deemed as a more relevant method of monitoring training load in dancers.

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

BACKGROUND: Dance 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. METHODS: An 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. RESULTS: The 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. CONCLUSIONS: Some 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.

Dual antibiotics for bronchiectasis.

BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation of the smaller airways and associated with a mortality rate greater than twice that of the general population. Antibiotics serve as front-line therapy for managing bacterial load, but their use is weighed against the development of antibiotic resistance. Dual antibiotic therapy has the potential to suppress infection from multiple strains of bacteria, leading to more successful treatment of exacerbations, reduced symptoms, and improved quality of life. Further evidence is required on the efficacy of dual antibiotics in terms of management of exacerbations and extent of antibiotic resistance. OBJECTIVES: To evaluate the effects of dual antibiotics in the treatment of adults and children with bronchiectasis. SEARCH METHODS: We identified studies from the Cochrane Airways Group Specialised Register (CAGR), which includes the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine (AMED), and PsycINFO, as well as studies obtained by handsearching of journals/abstracts. We also searched the following trial registries: US National Institutes of Health Ongoing Trials Register, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. We imposed no restriction on language of publication. We conducted our search in October 2017. SELECTION CRITERIA: We searched for randomised controlled trials comparing dual antibiotics versus a single antibiotic for short-term (< 4 weeks) or long-term management of bronchiectasis diagnosed in adults and/or children by bronchography, plain film chest radiography, or high-resolution computed tomography. Primary outcomes included exacerbations, length of hospitalisation, and serious adverse events. Secondary outcomes were response rates, emergence of resistance to antibiotics, systemic markers of infection, sputum volume and purulence, measures of lung function, adverse events/effects, deaths, exercise capacity, and health-related quality of life. We did not apply outcome measures as selection criteria. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the titles and abstracts of 287 records, along with the full text of seven reports. Two studies met review inclusion criteria. Two review authors independently extracted outcome data and assessed risk of bias. We extracted data from only one study and conducted GRADE assessments for the following outcomes: successful treatment of exacerbation; response rates; and serious adverse events. MAIN RESULTS: Two randomised trials assessed the effectiveness of oral plus inhaled dual therapy versus oral monotherapy in a total of 118 adults with a mean age of 62.8 years. One multi-centre trial compared inhaled tobramycin plus oral ciprofloxacin versus ciprofloxacin alone, and one single-centre trial compared nebulised gentamicin plus systemic antibiotics versus a systemic antibiotic alone. Published papers did not report study funding sources.Effect estimates from one small study with 53 adults showed no evidence of treatment benefit with oral plus inhaled dual therapy for the following primary outcomes at the end of the study: successful management of exacerbation - cure at day 42 (odds ratio (OR) 0.66, 95% confidence interval (CI) 0.22 to 2.01; 53 participants; one study; very low-quality evidence); number of participants with Pseudomonas aeruginosa eradication at day 21 (OR 2.33, 95% CI 0.66 to 8.24; 53 participants; one study; very low-quality evidence); and serious adverse events (OR 0.48, 95% CI 0.08 to 2.87; 53 participants; one study; very low-quality evidence). Similarly, researchers provided no evidence of treatment benefit for the following secondary outcomes: clinical response rates - relapse at day 42 (OR 0.57, 95% CI 0.12 to 2.69; 53 participants; one study; very low-quality evidence); microbiological response rate at day 21 - eradicated (OR 2.40, 95% CI 0.67 to 8.65; 53 participants; one study; very low-quality evidence); and adverse events - incidence of wheeze (OR 5.75, 95% CI 1.55 to 21.33). Data show no evidence of benefit in terms of sputum volume, lung function, or antibiotic resistance. Outcomes from a second small study with 65 adults, available only as an abstract, were not included in the quantitative data synthesis. The included studies did not report our other primary outcomes: duration; frequency; and time to next exacerbation; nor our secondary outcomes: systemic markers of infection; exercise capacity; and quality of life. We did not identify any trials that included children. AUTHORS' CONCLUSIONS: A small number of studies in adults have generated high-quality evidence that is insufficient to inform robust conclusions, and studies in children have provided no evidence. We identified only one dual-therapy combination of oral and inhaled antibiotics. Results from this single trial of 53 adults that we were able to include in the quantitative synthesis showed no evidence of treatment benefit with oral plus inhaled dual therapy in terms of successful treatment of exacerbations, serious adverse events, sputum volume, lung function, and antibiotic resistance. Further high-quality research is required to determine the efficacy and safety of other combinations of dual antibiotics for both adults and children with bronchiectasis, particularly in terms of antibiotic resistance.