Can turnout measurements be used to predict physiotherapist-reported injury rates in dancers?

BACKGROUND: Research has suggested that dancers may be more at risk of injury when they excessively utilise non-hip components of turnout to compensate for deficits in hip external rotation when trying to achieve maximal total turnout. However, recently different measures of turnout have been cited in the literature as well as suggestions for derived variables to account for shortfalls in particular components of turnout. This study aimed to assess whether measurements of turnout can predict the number of injuries (0 or 1 injury, or 2+ injuries) over a 10-month period. METHODS: At the beginning of the academic year, 47 female, full-time, contemporary dance students (mean age 19.9 ± 2.51 yrs; height 1.65 ± 0.05 cm; weight 56.23 ± 6.51 kg) were screened as part of a biannual screening process. Measurements, summed of both legs, were obtained for passive hip external rotation (pER), total passive turnout (TPT), and total active turnout (TAT). From these, three further variables were derived: compensated turnout, muscular turnout, and active ER lag. At the end of 10 months, the dancers' physiotherapist-reported and self-reported injuries were obtained. RESULTS: Binary regression analyses for the six turnout variables identified compensated and muscular values as having significant positive effects. For every 1% increase in compensated and muscular values, there was a corresponding 9% or 8.4% increase in the odds that the dancer would sustain 2 or more injuries compared to 0 or 1 injury. CONCLUSION: Screening compensated and muscular values may be useful to address shortfalls to prevent injuries in the future.

The reasons for the epilepsy treatment gap in Kilifi, Kenya: using formative research to identify interventions to improve adherence to antiepileptic drugs.

Many people with epilepsy (PWE) in resource-poor countries do not receive appropriate treatment, a phenomenon referred to as the epilepsy treatment gap (ETG). We conducted a qualitative study to explore the reasons for this gap and to identify possible interventions in Kilifi, Kenya. Focus group discussions (FGDs) were carried out of PWE and their caregivers. Individual interviews were conducted of PWE, their caregivers, traditional healers, community health workers and leaders, nurses and doctors. In addition, a series of workshops was conducted, and four factors contributing to the ETG were identified: 1) lack of knowledge about the causes, treatment and prognosis of epilepsy; 2) inaccessibility to antiepileptic drugs; 3) misconceptions about epilepsy derived from superstitions about its origin; 4) and dissatisfaction with the communication skills of health providers. These data indicated possible interventions: 1) education and support for PWE and their caregivers; 2) communication skills training for health providers; 3) and improved drug provision.