Development of a Multidimensional Pain Questionnaire in Professional Dance (MPQDA): a pilot study.

BACKGROUND: Pain is part of the everyday life of professional dancers. It can indicate health risks and impair the ability to work. Suitable screening tools can be used to identify pain and its risk potential. A comprehensive, multidimensional, differentiated assessment tool for pain in professional dance does not currently exist. METHODS: An initial questionnaire was developed in German and English and was assessed in a qualitative pretest. In a field study with a cross-sectional design including n = 72 dancers from Germany (n = 36 responses each in the English and German language versions), the questionnaire was optimized by item analysis, its psychometric properties (dimensionality, construct validity, reliability) were examined and the ability of the pain dimensions to classify the subjective ability to work in training was analyzed (ROC analysis). RESULTS: The developed Multidimensional Pain Questionnaire in Professional Dance (MPQDA) was reduced and optimized in its psychometric properties. Following questions were reduced in their items or answer categories: pain localizations (from 20 to 15 regions), accompanying symptoms (from 6 to 3 items), sensory and affective pain quality (from 20 to 10 items), pain frequency (from 4 to 3 answer categories), and the motives of working with pain (from 14 to 12 items). Regarding the subjective ability to work in training, the variables of the ability to work in rehearsals and in performances, as well as the accompanying symptoms of tension and mobility restrictions, showed a relatively good classification ability (Area under the Curve (AUC) ≥ 0.7 in the 95% confidence interval) and significant, moderate to strong correlations (Somers' D > 0.25, p < 0.05). The classification ability of the other pain dimensions was largely absent or poor. CONCLUSION: The MPQDA differentiates various pain dimensions in professional dancers and is available in a compatible manner in German and English. The clinical relevance needs to be explored further in the future.

Lumbar movement control in non-specific chronic low back pain: Evaluation of a direction-specific battery of tests using item response theory.

QUESTION: What tests are most useful to identify poor lumbar movement control (LMC) and what are the dimensional and psychometric properties of these tests? DESIGN: Multicenter, cross-sectional cohort study. PARTICIPANTS: Adults with non-specific chronic low back pain (NSCLBP). METHODS: A literature review was conducted to identify LMC tests with good reliability (κ≥ 0.61) and their dimensionality was examined. Based on item response theory, psychometric properties of individual items and the entire battery of LMC tests were determined. RESULTS: 277 participants with NSCLBP were included and tested by 21 physiotherapists in 19 clinics in Germany and Austria. 15 tests for LMC were assessed. The battery of LMC tests showed a direction-specific structure representing extension, flexion and rotation/lateral flexion control, for which unidimensionality and local independence were confirmed (eigenvalue >1; factor loading >0.4, Yen's Q3 <0.2). 4 items for flexion control, 4 items for extension control and 5 items for rotation/lateral flexion control were extracted. The flexion control items were the easiest items (item difficulty: 1.98 to -1.31). The rotation/lateral flexion control items were the most difficult (-1.3 to -0.08). More than 80% of all participants showed at least one incorrect direction of LMC. CONCLUSIONS: A battery of LMC tests is proposed as the most appropriate to examine individuals with precise to poor LMC. Each direction of LMC should be examined separately. Tests can be sorted according to test difficulty, so that only three tests are initially required to screen for poor LMC.

Determinants of Pain Intensity in Physical Education Teachers Focusing on Dance Teachers: A Cross-Sectional Study.

(1) Background: Dance teachers (DT) are dependent on their functional body. Pain can hardly be avoided during the professional practice of dance. Pain can become so intense that it impairs, or even prevents, the professional practice. The aim of this study was to identify the determinants of pain intensity of the most severely affected body regions of DT in pain during the three-month period prior to the survey. (2) Methods: This cross-sectional study was conducted by an online survey. A total of 166 DT participated in the study; 143 of the DT were in pain during the three-month period and were included in the analysis. Using multiple linear regression, the determinants of pain intensity were identified from population parameters, occupational data, pain localisation, and temporal pain course. (3) Results: Regions of the lower extremity and head/trunk regions were most frequently indicated as the body regions with the most severe pain. The multiple regression model generated with the factors "functional impairment", "biomechanical exposure", and "pain at rest" explains a statistically significant, moderate proportion of the variance in pain intensity (R2 = 0.22, F (3, 106) = 10.04, p < 0.001). (4) Conclusions: Intensity of pain in DT seems to be related to the physical demands of professional practice.

Determinants of pain occurrence in dance teachers.

OBJECTIVES: Dance teachers are strongly dependent on their functional body in their professional practice. As yet, it has largely been unclear whether the musculoskeletal system is endangered by a dance teaching activity. Pain can be a warning signal for a health hazard. The aims of the study were (a) to determine the pain prevalence, location and assessment of dance teachers and (b) to identify determinants of pain occurrence over a 3-month period prior to the survey. METHODS: The quantitative, retrospective cohort study was conducted with n=166 dance teachers by an anonymous online survey. The data on the study sample, professional practice and pain prevalence, location and assessment were presented descriptively. A binary logistic regression was used to identify determinants of pain occurrence in the last 3 months from the sample parameters and the data of professional practice. RESULTS: In the 3-month period n=143 (86.1%) of dance teachers had been in pain, often localized in the lower back and lower extremities. In the binary logistic regression model, the Body mass index (BMI) (odds ratio (OR)=1.15, 95% CI: 0.93-1.42, p=0.18), age (OR=1.03, 95% CI: 0.99-1.08, p=0.11) and the presence of disease (OR=2.81, 95% CI: 0.78-10.15, p=0.12) were identified as determinants of pain occurrence (LR-Chi2=7.8, p<0.05, pseudo R2=0.06, n=160). CONCLUSIONS: Pain occurs in dance teachers under multifactorial conditions. Pain occurrence seems to be favored by context factors, such as the BMI, age and the presence of diseases. However, none of these factors could be identified as a significant, clear risk factor for the occurrence of pain in this sample. Education and preventive measures, that consider pain as a warning signal, should take effect early in the dance career.