PK7{ftbtbrefs.MYD i~?Alricsson, M. Werner, S.2004The effect of pre-season dance training on physical indices and back pain in elite cross-country skiers: a prospective controlled intervention study148-53Br J Sports Med382"Adolescent Adult Ankle Joint/physiology Back Pain/etiology/*prevention & control Dancing/*physiology Female Hip Joint/physiology Humans Male Muscle, Skeletal/physiology Physical Fitness/physiology Pliability Prospective Studies Range of Motion, Articular Skiing/*physiology Spine/physiologyApr?OBJECTIVE: To evaluate the effect of pre-season dance training on back pain, joint mobility, and muscle flexibility, and on speed and agility in elite cross-country skiers. METHODS: 26 skiers participated (mean (SD) age, 19 (3.9) years). An intervention group (n = 16) had 12 weeks of dance training; a control group (n = 10) did not dance; otherwise both groups followed a similar pre-season physical training programme. Joint mobility and muscle flexibility of the spine, hip, and ankle were measured. Two sports related functional tests (slalom and hurdle) were also done. All measurements/tests were carried out before and after the dancing period. RESULTS: Four (of six) subjects from the intervention group who initially complained of ski related back pain did not report back pain after the dance training; the three subjects with back pain from the control group were unchanged. At study onset the intervention group had a slightly impaired range of motion in the spine compared with the control group. After dance training, there was a better relation between kyphosis of the thoracic spine and lordosis of the lumbar spine, and a 7.1 degrees increase in hip flexion with the knee extended (p = 0.02). In the control group hip extension decreased by 0.08 m on average (p = 0.01). No positive effects of dance training on sports related functional tests were observed. CONCLUSIONS: Preseason dance training improved the range of hip motion and joint mobility and the flexibility of the spine. These improvements might explain the reduction in ski related back pain in the intervention group.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15039249 B0306-3674 Clinical Trial Controlled Clinical Trial Journal Article15039249XKarolinska Institutionen for Kururgisk Vetenskap, Stockholm, Sweden. Ericksson@telia.com~?,Kadel, N. Boenisch, M. Teitz, C. Trepman, E.20056Stability of Lisfranc joints in ballet pointe position394-400Foot Ankle Int265MayBACKGROUND: Ballerinas develop stress fractures at the second metatarsal base associated with dancing en pointe. The purpose of this study was to evaluate the relative importance of the pointe shoe and the tarsometatarsal ligaments in Lisfranc joint stability en pointe. METHODS: Eleven cadaver feet were dressed with pointe shoes, loaded in foot flat with ligaments intact, and loaded en pointe before and after sequential sectioning of the dorsal, interosseous, and plantar ligaments between the first and second metatarsals and cuneiforms. Relative motion between the first and second metatarsals and cuneiforms was determined radiographically. RESULTS: No significant displacement of the Lisfranc joints occurred when the shod foot with intact ligaments was loaded in the foot flat or en pointe positions. Serial sectioning of the ligaments from dorsal to plantar in the shod foot en pointe demonstrated no change in alignment after the dorsal and interosseous ligaments were cut, but a significant change in alignment between the second metatarsal and second cuneiform was noted after the plantar ligament was cut (p < 0.0001). Removal of the pointe shoe after cutting the ligaments and applying a minimal (1 to 2 kg) load resulted in complete subluxation and diastasis through the first-second intermetatarsal and intercuneiform region. Replacing the shoe improved alignment en pointe with similar loading. CONCLUSIONS: Both the pointe shoe and Lisfranc ligaments are important for Lisfranc region stability in feet en pointe. The plantar ligaments are major stabilizers of the Lisfranc region in the loaded, shod foot en pointe. Selection of a pointe shoe with adequate support may limit susceptibility to stress fracture of the second metatarsal base in ballerinas.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15913525 1071-1007 Journal Article15913525Department of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific Street, Box 356500, Seattle, WA 98195, USA. kadel@u.washington.edu ~?.McCormack, M. Briggs, J. Hakim, A. Grahame, R.2004cJoint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers173-8 J Rheumatol311 Arthralgia/diagnosis/epidemiology/physiopathology *Dancing Female Humans Joint Instability/*diagnosis/*epidemiology/physiopathology Male Occupational Diseases/*diagnosis/*epidemiology/physiopathology Prevalence Research Support, Non-U.S. Gov't Sex Distribution StudentsJaniOBJECTIVE: To ascertain the prevalence of hypermobility and the benign joint hypermobility syndrome (BJHS) in male and female student and professional ballet dancers, and explore whether BJHS has any effect on a dance career. METHODS: Students from the Royal Ballet School and professional dancers from the Royal Ballet Company, London, were compared with a control group of teenagers and adults from a local secondary school and The Royal Opera House, respectively. The data, examined by variance analysis, included anthropometric variables, the Beighton score, and clinical features constituting BJHS. Odds ratios for hypermobility and BJHS in dancers were calculated, and the prevalence and distribution of BJHS was examined. RESULTS: Hypermobility and BJHS were common in male and female dancers compared with controls. An OR of 11.0 (95% CI 3.3-31.8) was found for hypermobility in dancers for both the ballet school and the professional company. The prevalence of BJHS was found to decline both from student to professional and within the ballet company from corps de ballet to Principal. Odds ratios for BJHS in student dancers were significant, OR = 3.9 (95% CI 1.3-11.3), but not so in professional dancers: OR = 1.7 (95% CI 0.6-4.7). Arthralgia was common in dancers and was reported more often in males than females. In females, pain was reported most by dancers with other features of BJHS, in particular stretchy skin. CONCLUSION: Hypermobility and BJHS are common in both male and female student and professional ballet dancers. The fall in prevalence, and the greater reporting of arthralgia with other features of BJHS in young female dancers, suggests that BJHS may have an important negative influence, and this may have implications for training. The same pattern was not observed in males, suggesting that their pain-reporting and injury are related to factors other than BJHS.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14705238 0315-162x Journal Article14705238,Royal Ballet School, London, United Kingdom.~?,Wainwright, S. P. Williams, C. Turner, B. S.20052Fractured identities: injury and the balletic body49-66Health (London)91JanSocial worlds shape human bodies and so it is inevitable that there are strong relationships between the body, professional dance and identity. In this article we draw on Bourdieu's notions of habitus, and various forms of capital, as the main theoretical framework for our discussion. Our ethnography of the balletic body elicited dancers and ex-dancers' perceptions of their bodies and sought to reveal some of the facets of their embodied habitus. The sheer physicality of their working lives - of feeling exhausted, sweaty and out of breath - is something dancers (like all athletes) become 'addicted to'. Ageing and injury can reveal this compulsion to dance and so dancers invariably find it very difficult to, for example, give up class once they retire from the stage; or miss a performance if they have a 'slight injury'. In other words, the vocational calling to dance is so overwhelming that their balletic body is their identity. In addition, there is an unremitting loop between individual habitus and institutional habitus (the ballet company), which affects both the meaning and management of injury. All our informants at the Royal Ballet (London: n = 20) had suffered dance injuries. The injured, dancing body is perceived as an inevitable part of a career in ballet. Everyone spoke of the improved athleticism of dancers, and of the expansion in facilities to maintain healthy dancers. However, most dancers can expect several major injuries during their careers. Such epiphanies force dancers to confront their embodiment, and their thoughts invariably turn to their body, career and self. Critical injuries threaten to terminate a dancer's career and so endanger their embodied sense of self. On a more everyday level, dancing and performing with painful, niggling injuries is the norm.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15576424 1363-4593 Journal Article15576424^Florence Nightingale School of Nursing, King's College London, UK. steven.wainwright@kcl.ac.uk~?Brown, T. D. Micheli, L. J.2004 Foot and ankle injuries in dance303-9 Am J Orthop336'Ankle Injuries/*complications/surgery Cumulative Trauma Disorders/*complications/surgery Dancing/*injuries Foot Injuries/*complications/surgery Fractures, Stress/etiology/surgery Hallux Rigidus/complications Hallux Valgus/complications Humans Metatarsalgia/complications Tendinitis/complicationsJun/This review focuses on many of the foot and ankle injuries commonly seen among dancers. These unique athletes place extreme demands on their musculoskeletal system and thereby face a variety of acute and overuse injuries. Conservative treatment is successful in the majority of cases, but these patients often continue to dance while healing--commonly prolonging and at times complicating treatment. When surgery is being contemplated, the dancer's performance level and expectations about returning to dance after surgery should be thoroughly explored. Foot and ankle surgeries that routinely yield good to excellent results in the general population can prematurely end a dancer's otherwise promising career. The physician must consider all these factors when designing an appropriate treatment plan for a dancer.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15239359 11078-4519 Journal Article Review Review, Tutorial15239359Department of Orthopaedic Surgery, Division of Sports Medicine and Shoulder Reconstruction, Tulane University Medical School, New Orleans, Louisiana, USA.~?Shin, C. S. Davis, B. A.2005]Femoral neuropathy due to patellar dislocation in a theatrical and jazz dancer: a case report1258-60Arch Phys Med Rehabil866JunJAbstract Shin CS, Davis BA. Femoral neuropathy due to patellar dislocation in a theatrical and jazz dancer: a case report. Arch Phys Med Rehabil 2005;86:1258-60. This case report describes a teenage female, high-level modern dancer who suffered multiple left patellar dislocations. Her history is atypical in that after her fifth dislocation, her recovery was hindered secondary to persistent weakness and atrophy of her quadriceps out of proportion to disuse alone. Electrodiagnostic studies and magnetic resonance imaging showed evidence of a subacute femoral neuropathy correlating chronologically with her most recent patellar dislocation. This case suggests that further diagnostic study may be warranted in patients with persistent quadriceps weakness or atrophy after a patellar dislocation, because this may suggest the presence of a femoral neuropathy. This is important because the strength training goals and precautions differ in disuse atrophy and a neuropathy. We believe this is the first reported case of a femoral neuropathy associated with the mechanism of a patellar dislocation.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15954069 0003-9993 Journal Article15954069 ?i$Torstveit, M. K. Sundgot-Borgen, J. 2005?The female athlete triad: are elite athletes at increased risk?184-193'Medicine & Science in Sports & Exercise372 Purpose: The aim of this study was to examine the percentage of elite athletes and controls at risk of the female athlete triad. Methods: A detailed questionnaire, which included questions regarding training and/or physical activity patterns, menstrual history, oral contraceptive use, weight history, eating patterns, dietary history, and the Body Dissatisfaction (BD) and Drive for Thinness (DT) subscales of the Eating Disorder Inventory (EDI), was prepared. The questionnaire was administered to the total population of female elite athletes in Norway representing the national teams at the junior or senior level, 13-39 yr of age ( N = 938) and nonathlete controls in the same age group ( N = 900). After exclusion, a total of 669 athletes (88%) and 607 controls (70%) completed the questionnaire satisfactorily. Results: A higher percentage of controls (69.2%) than athletes (60.4%) was classified as being at risk of the Triad ( P < 0.01). A higher percentage of controls than athletes reported use of pathogenic weight-control methods and had high BD subscale scores ( P < 0.001). However, more athletes reported menstrual dysfunction and stress fractures compared with controls ( P < 0.05). A higher percentage of both athletes competing in leanness sports (70.1%) and the nonathlete control group (69.2%) was classified as being at risk of the Triad compared with athletes competing in nonleanness sports (55.3%) ( P < 0.001). Furthermore, a higher percentage of athletes competing in aesthetic sports (66.4%) than ball game sports (52.6%) was classified as being at risk of the Triad ( P < 0.001). Conclusions: More athletes competing in leanness sports and more nonathlete controls were classified as being at risk of the Triad compared with athletes competing in nonleanness sports. The Norwegian University of Sport and Physical Education, Oslo, Norway; and 2The Norwegian Olympic Training Centre, Oslo, Norway?/Whipple, T. Plafcan, D. Sebastianelli, W.J.2004DManipulative treatment of hip pain in a ballet student: a case study53-5#Journal of Dance Medicine & Science82A 14-year-old female ballet student was referred to physical therapy for examination and treatment of left inguinal region pain. A single session of non-thrust manipulation resulted in an immediate and lasting improvement in symptoms. This case report includes a description of the relevant examination and treatment procedures as well as a discussion of hip instability and the acetabular labrum.VPenn State Orthopaedics, 1850 East Park Ave, Suite 112, University Park, PA 16803-6705 x~? 3West, J. Otte, C. Geher, K. Johnson, J. Mohr, D. C.2004ZEffects of Hatha yoga and African dance on perceived stress, affect, and salivary cortisol114-8 Ann Behav Med282Adolescent Adult *Affect Africa Dancing/*psychology Female Humans Hydrocortisone/analysis Male Research Support, Non-U.S. Gov't Saliva/chemistry *Stress, Psychological Yoga/*psychologyOct!BACKGROUND: Dance and yoga have been shown to produce improvements in psychological well-being. PURPOSE: The aim of this study was to examine some of the psychological and neuroendocrine response to these activities. METHODS: Sixty-nine healthy college students participated in one of three 90-min classes: African dance (n = 21), Hatha yoga (n= 18), or a biology lecture as a control session (n = 30). Before and after each condition participants completed the Perceived Stress Scale (PSS), completed the Positive Affect and Negative Affect Schedule, and provided a saliva sample for cortisol. RESULTS: There were significant reductions in PSS and negative affect (ps < .0001) and Time x Treatment interactions (ps < .0001) such that African dance and Hatha yoga showed significant declines, whereas there was no significant change in biology lecture. There was no significant main effect for positive affect (p = .53), however there was a significant interaction effect (p < .001) such that positive affect increased in African dance, decreased in biology lecture, and did not change significantly in Hatha yoga. There was a significant main effect for salivary cortisol (p < .05) and a significant interaction effect (p < .0001) such that cortisol increased in African dance, decreased in Hatha yoga, and did not change in biology. Changes in cortisol were not significantly related to changes in psychological variables across treatments. There was 1 significant interaction effect (p = .04) such that change in positive affect and change in cortisol were negatively correlated in Hatha yoga but positively correlated in Africa dance and biology. CONCLUSIONS: Both African dance and Hatha yoga reduced perceived stress and negative affect. Cortisol increased in African dance and decreased in Hatha yoga. Therefore, even when these interventions produce similar positive psychological effects, the effects may be very different on physiological stress processes. One factor that may have particular salience is that amount of physiological arousal produced by the intervention.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15454358 (0883-6612 Clinical Trial Journal Article15454358+Reed College, USA. jeremy.west@stanford.edu~? 8Alricsson, M. Harms-Ringdahl, K. Eriksson, K. Werner, S.2003The effect of dance training on joint mobility, muscle flexibility, speed and agility in young cross-country skiers--a prospective controlled intervention study237-436Scandinavian Journal of Science and Medicine in Sports134AugWe evaluated a short-term (3 months) and a long-term (8 months) effect of dance training on joint mobility and muscle flexibility of the spine, hip and ankle and on speed and agility in young cross-country skiers. Twenty elite cross-country skiers - aged 12-15 years - participated in the study. Five males and five females received dance training (intervention group) and five males and five females did not dance (reference group). Joint mobility and muscle flexibility of the spine, hip and ankle joints were measured using a goniometer, a kyphometer, a measuring tape and a ruler. Two sports-related functional tests - the slalom-test and the hurdle-test - were also performed. These measurements/tests were performed before the start of the dancing period and after 3 and 8 months. The subjects from the intervention group increased their speed with 0.3 s after 3 (P = 0.05) and 8 months (P = 0.02), respectively, when measured with the slalom-test. They also improved their speed and agility according to the hurdle-test after 3 months with 0.8 s (P = 0.000) and 8 months with 0.6 s (P = 0.01). Furthermore, they increased flexion-extension of the thoracic spine with 7.5 degrees after 3 months (P = 0.05) and with 9 degrees degrees after 8 months (P = 0.03) and lateral flexion of the spine with 0.04 m (P = 0.005) and 0.03 m (P = 0.02) after 3 and 8 months, respectively. The reference group was impaired or unchanged in the studied parameters after both 3 and 8 months. We conclude that dance training has a positive effect on speed and agility and on joint mobility and muscle flexibility in flexion-extension and lateral flexion of the spine in young cross-country skiers.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12859606,0905-7188 Evaluation Studies Journal Article12859606fSection of Sports Medicine, Department of Orthopaedic Surgery, Karolinska Hospital, Stockholm, Sweden.~? 5Wyon, M. A. Abt, G. Redding, E. Head, A. Sharp, N. C.2004COxygen uptake during modern dance class, rehearsal, and performance646-9J Strength Cond Res183Adult Comparative Study Dancing/*physiology Female Heart Rate/physiology Humans Male Oxygen Consumption/*physiology Physical Education and Training/methodsAugThe aim of the present study was to examine whether the workload, expressed in oxygen uptake and heart rate, during dance class and rehearsal prepared the dancer for performance. Previous research on the demands of class and performance has been affected by equipment limitations and could only provide limited insight into the physiological demands placed on the dancer. The present study noted that dance performance had significantly greater mean oxygen uptake and heart rate than noted in both class and rehearsal (p < 0.05). Further analysis noted that, during class and rehearsal, heart rates were rarely within the aerobic training zone (60-90%HRmax, where HRmax is the maximum heart rate). Dance performance placed a greater demand on the aerobic and anaerobic glycolytic energy systems than seen during class and rehearsal, which placed a greater emphasis on the adenosine triphosphate-creatine phosphate system. Practical implications suggest the need to supplement training within dance companies to overcome this deficit in training demand.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15320648 (1064-8011 Clinical Trial Journal Article15320648kSchool of Sport, Performing Arts and Leisure, University of Wolverhampton, United Kingdom. m.wyon@wlv.ac.uk~? #Bronner, S. Ojofeitimi, S. Rose, D.2003hInjuries in a modern dance company: effect of comprehensive management on injury incidence and time loss365-73Am J Sports Med313GAdult Dancing/*injuries Female Humans Incidence Male Middle Aged New York/epidemiology Occupational Diseases/*epidemiology/*prevention & control Primary Prevention Prospective Studies Research Support, Non-U.S. Gov't Retrospective Studies Sick Leave/statistics & numerical data Workers' Compensation/statistics & numerical dataMay-JunBACKGROUND: Professional dancers experience high rates of musculoskeletal injuries. OBJECTIVE: To analyze the effect of comprehensive management (case management and intervention) on injury incidence, time loss, and patterns of musculoskeletal injury in a modern dance organization. STUDY DESIGN: Retrospective/prospective cohort study. METHODS: Injury data were analyzed over a 5-year period, 2 years without intervention and 3 years with intervention, in a modern dance organization (42 dancers). The number of workers' compensation cases and number of dance days missed because of injury were compared across a 5-year period in a factorial design. RESULTS: Comprehensive management significantly reduced the annual number of new workers' compensation cases from a high of 81% to a low of 17% and decreased the number of days lost from work by 60%. The majority of new injuries occurred in younger dancers before the implementation of this program. Most injuries involved overuse of the lower extremity, similar to patterns reported in ballet companies. Benefits of comprehensive management included early and effective management of overuse problems before they became serious injuries and triage to prevent overutilization of medical services. CONCLUSIONS: This comprehensive management program effectively decreased the incidence of new cases and lost time. Both dancers and management strongly support its continuance.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12750128 0363-5465 Journal Article12750128dAnalysis of Dance and Movement (ADAM) Center, Long Island University, Brooklyn, New York 11201, USA.~? (Kodama, N. Honjo, M. Maki, J. Hukuda, S.2004]Osteochondritis dissecans of the talus treated with the mosaicplasty technique: a case report195-8J Foot Ankle Surg433Adult Ankle Joint/surgery Cartilage, Articular/*transplantation Femur/transplantation Humans Knee Joint/surgery Male Osteochondritis Dissecans/*surgery Talus/*surgeryMay-Jun#The authors present the use of osteochondral autografting with mosaicplasty technique performed on a 20-year-old man for a large osteochondral talar dome lesion. The patient had sustained a right ankle sprain many times while playing rugby football. The lesion measured 15 mm in diameter and encompassed more than one-third of the articular surface. After exposing the talus to a medial malleolar osteotomy, 3 osteochondral grafts taken from the medial femoral condyle of the ipsilateral knee were press-fit into the lesion. One year postoperatively, the patient has returned to playing rugby football. Radiographically, there was incorporation of the grafts. The authors believe that the mosaicplasty technique presents a promising new option in the treatment of osteochondritis dissecans of the talus.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15181438 &1067-2516 Case Reports Journal Article15181438oThe Orthopedic Clinic, Tane General Hospital, 1-2-31 Sakaigawa Nishiku, Osaka 550-0024, Japan. ortho@tane.or.jp~?2Muscolo, L. Migues, A. Slullitel, G. Costa-Paz, M.2004_Stress fracture nonunion at the base of the second metatarsal in a ballet dancer: a case report1535-7Am J Sports Med326)Adult Bone Plates Bone Screws Dancing/*injuries Diagnosis, Differential Fracture Fixation/*methods Fractures, Malunited/*pathology/*surgery Fractures, Stress/*pathology/*radiography/*surgery Humans Magnetic Resonance Imaging Male Metatarsal Bones/*injuries/*surgery Pain/etiology Treatment OutcomeSepfhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15310583 &0363-5465 Case Reports Journal Article15310583`Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. luis.muscolo@hospitalitaliano.org.ar?f.Prasad, K.S.R. Parekh. S. Zafiropoulos. G.2005jClinical pathodynamics of plantar dislocation of the first metatarsophalangeal joint: Dancer's dislocation29-328The Foot: International Journal of Clinical Foot Science151Plantar dislocation of the first metatarsophalangeal joint is an extremely rare primary hyperflexion injury of forefoot with potential for more complex progression. Less severe injuries are common mainly in ballet dancers and to a lesser extent in footballers. We are proposing a new comprehensive biomechanical classification of the hallux metatarsophalangeal joint injuries by extending and modifying the classification of hallux metatarsophalangeal sprains by Clanton et al. We also believe that simulation can not always exactly recreate the clinical setting for pathodynamic analysis and interpretation of diverse variations of basic mechanism, progressive disruption of normal pattern of anatomy and final presentation of injury. Therefore, we analysed the dynamic progression of forces in the reported clinical scenarios of plantar dislocation of the first metatarsophalangeal joint in orthopaedic literature to facilitate strategic understanding of the sequence of forces contributing to the injury and provide the clinician with a clear plan for execution of management. Plantar dislocation of the first metatarsophalangeal joint is best described as Dancer's dislocation from the classic sur les pointe through our modification of the classification of Clanton et al.YPrince Charles Hospital, Merthyr Tydfil CF479DT, UK; Kodali.Prasad@nglam-tr.wales.nhs.uk. ~?GReijman, M. Hazes, J. M. Pols, H. A. Koes, B. W. Bierma-Zeinstra, S. M.2005UAcetabular dysplasia predicts incident osteoarthritis of the hip: the Rotterdam study787-93Arthritis Rheum523CAcetabulum/*radiography Aged Bone Diseases, Developmental/*complications/radiography Disease Progression Female Follow-Up Studies Humans Incidence Male Middle Aged Netherlands Osteoarthritis, Hip/*epidemiology/*etiology/radiography Predictive Value of Tests Prospective Studies Research Support, Non-U.S. Gov't Risk FactorsMarOBJECTIVE: To investigate the association between acetabular dysplasia and the incidence of radiographic osteoarthritis (OA) of the hip in a population-based sample of elderly subjects. METHODS: Radiographs of the hip at baseline and at followup (mean followup time 6.6 years) were evaluated in 835 men and women (age >or=55 years) from the Rotterdam Study. Subjects with a baseline Kellgren/Lawrence grade of 0 or 1 in both hips were included in the study. Incident radiographic OA of the hip was defined as a decrease of joint space width of the hip (>or=1.0 mm) at followup. Acetabular dysplasia was assessed using the center-edge angle and the acetabular depth. The association between acetabular dysplasia and incident radiographic hip OA was assessed by calculating odds ratios using multivariate regression analysis. RESULTS: In this study population with a mean +/- SD age of 65.6 +/- 6.5 years, 9.3% developed incident radiographic hip OA. Subjects with acetabular dysplasia (center-edge angle <25 degrees ) had a 4.3-fold increased risk for incident radiographic OA of the hip (95% confidence interval 2.2-8.7) compared with subjects without acetabular dysplasia. These associations were independent of known determinants of hip OA such as age, sex, and body mass index (BMI), but tended to be enhanced by female sex, heavy mechanical load, and low BMI. CONCLUSION: In a study population age >or=55 years, acetabular dysplasia is still a strong independent determinant of incident radiographic hip OA.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15751071 0004-3591 Journal Article15751071cErasmus Medical Center, Rotterdam, The Netherlands. m.reijman@erasmusmc.nl  ~? Wright, A.2005Dance: Einstein in motion741Nature4357043Jun 9fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15944680 1476-4687 Journal Article15944680.Alison Wright is the editor of Nature Physics. (?Monsma, E.V. Overby, L.Y.2004MThe relationship between imagery and competitive anxiety in ballet auditions.11-18#Journal of Dance Medicine & Science81Aligned with competitive anxiety research in athletics, this study explored audition anxiety and the role of imagery in the anxiety-performance relationship among 131 female auditioning ballet dancers. A better understanding of how auditioning dancers experience anxiety and associated image content can help train dancers preparing for anxiety-provoking, high-stakes performances. The CSAI-2 assessing competitive state anxiety and confidence and the SIQ assessing the cognitive and motivational functions of imagery were slightly modified for administration in the audition context. The MIQ-R was used to assess movement imagery. All instrument subscales, with the exception of the CG-Strategies subscale of the SIQ, demonstrated adequate internal consistency. Ballet dancers' scores were similar to those reported by aesthetic sport athletes. Obtaining a position with a dance company was used as a proxy for defining success. Successful dancers with prior audition success were more confident than those without prior success and unsuccessful dancers with, and without, prior success. As a group, successful dancers experienced less cognitive anxiety and more somatic anxiety than unsuccessful dancers. Although imagery ability and image content did not differentiate dancers by performance, confident dancers had higher kinesthetic imagery ability and used more mastery and less arousal imagery than less confident dancers. In contrast, cognitively and somatically anxious dancers used less mastery and more arousal imagery. The athletic paradigm appears to be an appropriate framework for studying performance-related anxiety among dancers. Dancers and practitioners are encouraged to focus on mastery images for increasing confidence and decreasing anxiety. Dancers with prior audition success may be incorporating theses experiences in generating arousal imagery shown to predicted somatic anxiety, anxiety that does not appear to be detrimental to performance when cognitive anxiety is controlled.|Assistant Professor, Department of Physical Education, 218 Blatt PE Center, University of South Carolina, Columbia, SC 29208? Grossman, G.2003-Measuring dancer's active and passive turnout49-55#Journal of Dance Medicine & Science72Degree of overall turnout in the lower extremity involves not only hip external rotation but contributions from the knee, tibia, foot, and ankle as well. There are valid and reliable methods to measure isolated joint passive range of motion (PROM) within the field of orthopaedics. Specialized approaches to measuring turnout in a manner useful to dancers have begun to appear in the literature. This article will discuss these methods and a strategy for combining them to provide useful information for clinicians and dancers.QTemple University, 309 Vivacqua Hall, 1700 North Broad St, Philadelphia, PA 19122~?/Hillier, J. C. Peace, K. Hulme, A. Healy, J. C.2004KPictorial review: MRI features of foot and ankle injuries in ballet dancers532-7 Br J Radiol77918Adolescent Adult Ankle Injuries/*diagnosis Dancing/*injuries Female Foot Injuries/*diagnosis Humans *Magnetic Resonance Imaging Male Sprains and Strains/*diagnosisJunFoot and ankle pain is common in ballet dancers. Although clinical examination often points to the underlying cause, imaging is often necessary to confirm the diagnosis and thus ensure appropriate future management. Factors predisposing to the increased incidence of injuries in this population include the classical position in which ballet dancers stand, which is on the tips of the toes in the en pointe position or on the balls of the feet in the demi-pointe position. Furthermore, the repetitious nature of ballet and the long hours spent rehearsing cause over-use injuries. The causes of foot and ankle pain can be thought of in four different groups: the impingement syndromes; tendon abnormalities; osseous pathology; and ligament abnormalities. These will be discussed and illustrated.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15151980 10007-1285 Journal Article Review Review, Tutorial15151980`Department of Radiology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. I~?"Negus, V. Hopper, D. Briffa, N. K.2005UAssociations between turnout and lower extremity injuries in classical ballet dancers307-18J Orthop Sports Phys Ther355MaySTUDY 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>0.38; P<.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.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15966542 0190-6011 Journal Article15966542kPhysiotherapist West Australian Ballet Company, Perth, Western Australia, Australia. vickinegus@hotmail.comC?Nielson, J.H. Micheli, L.J.2004(Acute plantar fascia rupture in a dancer116-7#Journal of Dance Medicine & Science84~?QLievense, A. M. Bierma-Zeinstra, S. M. Verhagen, A. P. Verhaar, J. A. Koes, B. W.2004JInfluence of hip dysplasia on the development of osteoarthritis of the hip621-6 Ann Rheum Dis636Aged Female Hip Dislocation/*complications Humans Male Middle Aged Osteoarthritis, Hip/*etiology Prognosis Research Design Research Support, Non-U.S. Gov'tJunBACKGROUND: It has been suggested that in some patients with primary hip osteoarthritis (OA), the disease occurs as a consequence of acetabular dysplasia or hip dysplasia (HD). OBJECTIVE: To carry out a systematic review to investigate the association between acetabular dysplasia and hip OA. METHODS: A database search of Medline, Embase, and the Cochrane library was carried out, and articles that aimed at studying the relationship between HD and hip OA were identified. The methodological quality of the selected studies was assessed using a standardised set of criteria, and a best evidence synthesis was used to summarise the results from the individual studies. RESULTS: Five cohort studies and four case-control studies were included in this review. One cohort study had the correct design to answer the question and was considered to be a high quality study. This study reported a positive association between HD and hip OA. Overall, limited evidence was found for a positive association between HD and hip OA. Most studies included older people. In younger age groups the relation between HD and OA or hip complaints may be much higher. CONCLUSION: The evidence for the influence of HD on the occurrence of hip OA, at age 50-60 or older, is limited.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15140766 0003-4967 Journal Article Review15140766Erasmus MC, Department of General Practice, Room WK 131, Post Box 1738, 3000 DR Rotterdam, The Netherlands. a.lievense@erasmusmc.nl?KWhyte, G.P. George, K. Redding, E. Wilson, M. Lane, A. Firooz, S.2003IElectrocardiography and echocardiography findings in contemporary dancers91-5#Journal of Dance Medicine & Science73XAlterations in cardiac structure and function as a result of chronic training have been extensively reported in the literature. To date, there is limited data on dancers. This study attempts to define cardiac electrical, structural, and functional characteristics in female contemporary dancers. Forty-four female full-time contemporary dance students (age: 23.0 +/- 5.6 years; height: 165.2 +/- 7.9 cm; body mass: 59.2 +/- 7.2 kg) volunteered for the study and underwent 12-lead electrocardiography and two-dimensional echocardiography. Echocardiographic results were compared with 30 age-matched and gendermatched controls. Sixteen percent (7/44) of dancers presented with sinus bradycardia (< 60 bpm) and seven percent (3/44) demonstrated shortened PR intervals (< 120 ms). Sokolow voltage criteria for left ventricular hypertrophy was observed in only 4% (2/44). Fourteen percent of dancers (6/44) demonstrated right axis deviation and nine percent (4/44) had incomplete right bundle branch block. One dancer exhibited nodal rhythm. Minor ST segment elevation (< 0.2 mV) was present in 7% (3/44) of dancers, and equally minor ST segment depression (< 0.2 mV) was present in 7% (3/44). Negative T waves and large T waves (> 1.0MV) were observed in 14% (6/44) and 4% (2/44) of the dancers respectively. QRS and QT duration were within normal limits for all dancers. Echocardiography revealed no significant differences between dancers and controls for all structural and functional indices. It is concluded that contemporary dancers demonstrate limited cardiac structure and function changes compared to matched controls.Director of Research, Applied Research Unit, British Olympic Medical Centre, Northwick Park Hospital, Watford Road, Narrow, Middlesex, England HA1 3UJ~?&Bronner, S. Ojofeitimi, S. Spriggs, J.20031Occupational musculoskeletal disorders in dancers57-68Physical Therapy Review8=dance injuries risk factors surveillance Intervention StudiesProfessional dancers are a medically under-served occupational group at high risk for work-related musculoskeletal disorders. Historically, a sports medicine approach has been used in the treatment of dancers and dance companies. Recently, health care providers have also applied occupational medicine concepts to the dance organization. Consideration of risk factors and the application of organizational programs to prevent work-related musculoskeletal disorders in dancers are discussed. Deficiencies in our understanding of the contribution of risk factors towards injury are outlined for future consideration. The majority of dance organizations are non-profit and have no injury prevention strategies in place, viewing medical programs as unaffordable luxury. The application of a customized sports-occupational medicine approach shows promise in reducing the human and financial costs of work-related musculoskeletal disorders.+~?FAnoop, P. Anjay, M. A. Rajendran, V. R. Vasu, C. K. Regi George, A. N.2004+A dancer with an unusual cause of neck pain948Indian J Pediatr7110*Cervical Vertebrae Child Combined Modality Therapy *Dancing Eosinophilic Granuloma/complications/*diagnosis/therapy Female Humans Movement/physiology Neck/physiology Neck Pain/*etiologyOctA girl presented with a dull ache in the neck and mild difficulty in neck movements. She had limited clinical signs and her initial work up failed to reveal the cause. With the help of imaging modalities and CT guided needle biopsy, she was diagnosed to have an eosinophilic granuloma of the fifth cervical vertebra. There were no neurological symptoms. She was successfully managed with immobilization of spine, local irradiation and systemic vinblastine. The literature is briefly reviewed for clinical features, diagnosis and management.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15531851 &0019-5456 Case Reports Journal Article15531851 Q~?XPotter, B. K. Freedman, B. A. Andersen, R. C. Bojescul, J. A. Kuklo, T. R. Murphy, K. P.2005nCorrelation of Short Form-36 and disability status with outcomes of arthroscopic acetabular labral debridement864-70Am J Sports Med336Jun BACKGROUND: Arthroscopic debridement is the standard of care for the treatment of acetabular labral tears. The Short Form-36 has not been used to measure hip arthroscopy outcomes, and the impact of disability status on hip arthroscopy outcomes has not been reported. HYPOTHESIS: Short Form-36 subscale scores will demonstrate good correlation with the modified Harris hip score, but patients undergoing disability evaluation will have significantly worse outcome scores. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The records of active-duty soldiers who underwent hip arthroscopy at the authors' institution were retrospectively reviewed. Forty consecutive patients who underwent hip arthroscopy for the primary indication of labral tear formed the basis of the study group. Patients completed the modified Harris hip score, the Short Form-36 general health survey, and a subjective overall satisfaction questionnaire. RESULTS: Thirty-three patients, with a mean age of 34.6 years, were available for follow-up at a mean of 25.7 months postoperatively. Fourteen (43%) patients were undergoing medical evaluation boards (military equivalent of workers' compensation or disability claim). Pearson correlation coefficients for comparing the Short Form-36 Bodily Pain, Physical Function, and Physical Component subscale scores to the modified Harris hip score were 0.73, 0.71, and 0.85, respectively (P < .001). The mean modified Harris hip score was significantly lower in patients on disability status than in those who were not (92.4 vs 61.1; P < .0001). The Short Form-36 subscale scores were significantly lower in disability patients (P < .02). Patient-reported satisfaction rates (70% overall) were 50% for those undergoing disability evaluations and 84% for those who were not (P < .04). There was no significant difference in outcomes based on patient age, surgically proven chondromalacia, or gender for military evaluation board status. CONCLUSION: The Short Form-36 demonstrated good correlation with the modified Harris hip score for measuring outcomes after arthroscopic partial limbectomy. Arthroscopic debridement yielded a high percentage of good results when patients undergoing disability evaluations were excluded. Disability status may be a negative predictor of success after hip arthroscopy.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15827367 0363-5465 Journal Article15827367Orthopaedic Surgery Service, Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Building 2, Clinic 5A, Washington, DC 20307, USA. Z~?=Verhagen, R. A. Struijs, P. A. Bossuyt, P. M. van Dijk, C. N.2003USystematic review of treatment strategies for osteochondral defects of the talar dome233-42, viii-ixFoot Ankle Clin82Ankle Joint/*surgery Humans Immobilization Joint Loose Bodies/surgery Osteochondritis Dissecans/surgery/*therapy Talus/*surgery Treatment OutcomeJunThe aim of this study was to summarize all eligible studies to compare the effectiveness of different treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from January 1966 to June 2000 were systematically screened. Based on our inclusion criteria, 39 studies describing the results of treatment strategies for OCD of the talus were included. No randomized clinical trials (RCT) were identified. Fourteen studies described the results of nonoperative treatment (NT); 4: the results of excision alone; 10: the results of excision and curettage (EC); 21: the results of excision, curettage, and drilling (ECD); 2: the results of cancellous bone grafting after EC; 1: the results of osteorchondral transplantation; 3: the results of fixation; and 1: the results of retrograde drilling. The average success rate of NT was 45%. Comparison of different surgical procedures showed that the highest average success rate is reached by excision, curettage, and drilling (ECD; 86%), followed by excision and curettage (EC; 78%) and excision alone (38%). On the basis of this systematic review, we conclude that NT and excision alone are not to be recommended in treating talar OCD. Both EC and ECD have been shown to lead to a high percentage good/excellent results. At the present time, ECD seems to be the most effective treatment strategy for osteochondral defect of the talus. Due to great diversity in the articles and variability in treatment results, however, no definitive conclusions can be drawn. Sufficiently powered randomized clinical trials with uniform methodology and validated outcome measures should be initiated to compare the outcome of surgical strategies for OCD of the talus.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12911238 11083-7515 Journal Article Review Review, Tutorial12911238Department of Orthopaedic Surgery, Ziekenhuis Hilversum, P.O. Box 10016, 1201 DA Hilversum, The Netherlands. rawverhagen@planet.nl~?Wyon, M. A. Redding, E.2005pPhysiological monitoring of cardiorespiratory adaptations during rehearsal and performance of contemporary dance611-4J Strength Cond Res193AugWyon, M., and E. Redding. Physiological monitoring of cardiorespiratory adaptations during rehearsal and performance of contemporary dance. J. Strength Cond. Res. 19(3):611- 614. 2005.-Previous research has shown that dance class and rehearsal stress different cardiorespiratory energy systems than dance performance. The aim of the present study was to monitor the physiological parameters of a number of dancers during a 12-week rehearsal period and an 8-week performance schedule. Seventeen dancers (8 men and 9 women) from 2 companies undertook the multistage dance specific aerobic fitness test before the rehearsal period, before the performance period, and after the performance period. Heart rate data were collected throughout the test; the mean heart rate during stage 5 and blood lactate levels were measured at the end of the test. No significant changes in heart rate or lactate parameters were noted between the prerehearsal and preperformance tests, but significant decreases during the preperformance and postperformance tests were shown in both parameters (p < 0.01 and p < 0.01, respectively), which suggests an increase in the subjects' aerobic capacities during the performance period. Implications from the present study suggest that dancers are not adequately physiologically prepared to perform to the same degree to which their skills are honed. The study suggests that supplemental training is required to bridge this physical gap and better prepare the dancer for performance.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16095410 1064-8011 Journal Article16095410iSchool of Sport, Performing Arts and Leisure, University of Wolverhampton, Wolverhampton, United Kingdom.~?/Yannakoulia, M. Keramopoulos, A. Matalas, A. L.2004ABone mineral density in young active females: the case of dancers285-97Int J Sport Nutr Exerc Metab143Adolescent Adult Body Composition/*physiology Bone Density/*physiology Calcium, Dietary/administration & dosage/metabolism Case-Control Studies Dancing/*physiology Densitometry, X-Ray *Diet Female Humans Menstruation/*physiology Research Support, Non-U.S. Gov'tJunThe aim of the study was to evaluate the combined effect of several environmental factors on bone mineral density (BMD) in a group of highly active young women. Body composition, total body and regional (arms, legs and trunk) BMD, dietary intake, menstrual status, training habits, and eating attitudes were assessed in 37 professional dance students, aged 18 to 26 years. Dancers had higher BMD values compared to age- and weight-matched reference population (mean total body BMD: 1.185 g/cm2, 9% higher than reference values). No differences were detected between currently eumenorrheic and noneumenorrheic dancers; subjects who encountered menstrual problems during adolescence had significantly lower BMD values compared to counterparts who did not. Regarding dietary intake, dancers in the highest quartile of calcium intake (1323 +/-113 mg/d) exhibited significantly higher total BMD values than subjects in the other 3 quartiles (p =.04). A moderate inverse relationship was found between protein intake and total BMD, after controlling for energy and calcium intake (r = - 0.37). Fat-free soft mass was the only significant predictor of total BMD, explaining 20% of the variance. High levels of calcium intake were associated with high total BMD values. These results confirm the beneficial role of long-term and intensive physical activity on BMD and further suggest that dancers are not at a greater risk compared to the general population for developing osteoporosis, despite their menstrual and eating problems.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15256689 1526-484x Journal Article15256689Laboratory of Nutrition and Clinical Dietetics in the Department of Nutrition and Dietetics at Harokopio University, 17671 Athens, Greece. ~? EGupta, A. Fernihough, B. Bailey, G. Bombeck, P. Clarke, A. Hopper, D.2004yAn evaluation of differences in hip external rotation strength and range of motion between female dancers and non-dancers778-83Br J Sports Med386Adolescent Adult Anthropometry Cross-Sectional Studies Dancing/*physiology Female Hip Joint/*physiology Humans Laterality/physiology Muscle, Skeletal/*physiology *Range of Motion, ArticularDec OBJECTIVES: To evaluate the differences in hip external rotation (ER) strength and inner, outer, and total hip ER range of motion (ROM) between dancers and non-dancers and between left and right sides in each group. METHODS: Seventy one subjects (34 dancers and 37 non-dancers) volunteered for this study. The strength (truncated range average torque (TRAT), work, and angle specific torque (AST)) of the hip external rotator muscle group, through the full available active hip ER ROM, was evaluated using concentric isokinetic (30 degrees /s) testing on a KinCom dynamometer. Adjustment for lean body mass (LBM) was made for comparison of strength between groups. A two way repeated analysis of covariance was used to compare strength between groups. A two way repeated analysis of variance was used to compare strength between sides and ROM between groups and sides. Bonferroni correction was made for multiple analyses, and significance was accepted at p0Kish, R.L. Plastino, J.G. Martyn-Stevens, B.2003A young dancer survey161-5&Medical Problems of Performing Artists184`The purpose of this study was to determine, through self-reporting techniques, the training and injury rates among students studying dance in the private sector. The private studio provides the major venue for students to study dance. This is especially true for young students (ages 8-18) who study ballet, jazz, and tap and who participate in dance competitions. A private dance studio is defined as a studio open to the community with no audition requirements for entry that teaches various technique styles. Private studio dancers are not training specifically to be professional dancers in major ballet companies. Few data exist regarding the training or injury rates of these students in part because of difficulties with access and compliance. To date, 3,700 surveys have been distributed (January 2001-present) to students training in private studios throughout California. Information was requested concerning current and past injuries, dance training history, and competition schedules. This ongoing investigation currently has examined 173 (male = 6 and female = 167) completed surveys. The mean age of dancers who responded to the survey was 15.2 years. Of the dancers surveyed, 93% study at private dance studios, and 67% have studied in high school dance programs. The number of injuries reported (n = 226) included fractures, strains, sprains, and tendonitis. The ankle, knee, and back were found to be the most frequent injury sites. Correlations between the number of different techniques studied and the total hours danced, the number of different techniques studied and number of injuries for each individual, and the number of injuries for each individual and total hours danced all were significant at 0.01. Initial results support that dancers in the private dance studio are susceptible to injuries similar to those experienced by dancers in elite training centers.iDepartment of Theatre and Dance, California State University, Fullerton, California; rkish@fullerton.edu.U?" Glace, B.2004Recognizing eating disorders.19-25#Journal of Dance Medicine & Science81dAs many as one quarter of ballet dancers are estimated to suffer from either anorexia nervosa or bulimia. These diseases represent the most extreme end in a spectrum of eating pathology. Since the long-term mortality rate is quite high in anorexia and increases with duration of the disease, it is crucial that eating pathology be recognized, and intervention begun, as early as possible. There are both physical and behavioral changes associated with eating disorders that may aid concerned professionals, friends, or family members in distinguishing between illness and thinness, and dedication and compulsion.]Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, NY.U?#&Kadel, N.J. Donaldson-Fletcher, E.A.2004^Lisfranc fracture-dislocation in a male ballet dancer during take-off of a jump: a case report56-8#Journal of Dance Medicine & Science82While initiating a jump, a male profession-al ballet dancer (28 years old) sustained an acute injury to his midfoot. Radiographs revealed a fracture-dislocation of the first and second tarsometatarsal joints, with dorsal dislocation of the proximal second metatarsal. Surgical treatment included open reduction and internal fixation of the first and second tarsometatarsal joints and the intercuneiform joints. This injury caused the dancer to retire prematurely from professional ballet dancing, despite restoration of anatomical alignment and reacquisition of full mobility in the foot and ankle. Follow-up radiographs at three years post-injury indicated maintenance of the reduction and signs of mild arthritis in the midfoot. The dancer resumed ballet dancing at a non-professional level. It is important for dancers to realize that acute Lisfranc injuries can end dance careers despite immediate treatment. Proper footwear and floor-surface maintenance are important for prevention of this injury.yDept of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific, Box 356500, Seattle, WA 98915. Titlev~?$IMintz, D. N. Hooper, T. Connell, D. Buly, R. Padgett, D. E. Potter, H. G.2005oMagnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging385-93 Arthroscopy214AprPURPOSE: Traditional imaging techniques have limited ability to detect subtle chondral and labral injuries of the hip. We performed a retrospective review of patients who underwent magnetic resonance imaging (MRI) of the hip and subsequent hip arthroscopy in order to evaluate the ability of optimized, noncontrast MRI to identify tears of the acetabular labrum and defects in articular cartilage. TYPE OF STUDY: Retrospective review of a consecutive sample. METHODS: Between January 1997 and July 2000, 92 patients had MRI of the hip, followed by arthroscopic surgery of that hip by 1 of 2 surgeons (R.B., D.E.P.). Two musculoskeletal MR radiologists blinded to the initial MRI and surgical findings, independently interpreted the studies, looking for the location and degree of articular cartilage and acetabular labral pathology. RESULTS: Of the 92 patients studied, each of 2 radiologists correctly identified 83 (94%) and 84 (95%) of the 88 labral tears present at surgery, respectively. There was 92% interobserver agreement on the MRI studies. For articular cartilage defects on the femoral head and acetabulum, there was good agreement (92% and 86% within 1 grade) between MRI and surgical grading and between the 2 MR readers (kappa of 0.8 for femoral head cartilage and 0.7 for acetabular cartilage). CONCLUSIONS: This study shows that noncontrast MRI of the hip, using an optimized protocol, can noninvasively identify labral and chondral pathology. Such information may facilitate deciding which patients warrant surgical intervention, thus preserving hip arthroscopy as a therapeutic tool. LEVEL OF EVIDENCE: Level II, Development of Diagnostic Criteria Study.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15800516 1526-3231 Journal Article15800516aDepartment of Radiology and Imaging, Hospital for Special Surgery, New York, New York 10021, USA.?%QMyerscough, M. R. 2003HDancing for a decision: a matrix model for nest-site choice by honeybees577-582 Proceedings: Biological Sciences2701515 ~?&*Becker, J. H. Curtis, L. M. Grutter, A. S.2005KCleaner shrimp use a rocking dance to advertise cleaning service to clients760-4 Curr Biol158Apr 264Signals transmit information to receivers about sender attributes, increase the fitness of both parties, and are selected for in cooperative interactions between species to reduce conflict [1, 2]. Marine cleaning interactions are known for stereotyped behaviors [3-6] that likely serve as signals. For example, "dancing" and "tactile dancing" in cleaner fish may serve to advertise cleaning services to client fish [7] and manipulate client behavior [8], respectively. Cleaner shrimp clean fish [9], yet are cryptic in comparison to cleaner fish. Signals, therefore, are likely essential for cleaner shrimp to attract clients. Here, we show that the yellow-beaked cleaner shrimp [10] Urocaridella sp. c [11] uses a stereotypical side-to-side movement, or "rocking dance," while approaching potential client fish in the water column. This dance was followed by a cleaning interaction with the client 100% of the time. Hungry cleaner shrimp, which are more willing to clean than satiated ones [12], spent more time rocking and in closer proximity to clients Cephalopholis cyanostigma than satiated ones, and when given a choice, clients preferred hungry, rocking shrimp. The rocking dance therefore influenced client behavior and, thus, appears to function as a signal to advertise the presence of cleaner shrimp to potential clients.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15854910 0960-9822 Journal Article15854910`School of Integrative Biology, University of Queensland, St. Lucia, Australia. jbecker@uq.edu.au~?'%De Marco, R. J. Gil, M. Farina, W. M.2005xDoes an increase in reward affect the precision of the encoding of directional information in the honeybee waggle dance?413-95J Comp Physiol A Neuroethol Sens Neural Behav Physiol1915MayApis mellifera foragers perform waggle dances to communicate the presence of highly desirable nectar sources to their forager-mates. Each waggle dance consists of several waggle-runs (straight movements of the dancer closely aligned on the comb surface) that carry spatial information that the dance followers can use to locate the food source being advertised. To address how this complex motor display responds to unpredictable fluctuations in its main triggering stimulus, i.e., sucrose stimulation, we analyzed the effects of an increase in reward on the direction of consecutive waggle-runs as well as other components of the waggle dance. Results show that a sudden increase in reward may increase the directional scatter among consecutive waggle-runs, especially those performed at the beginning of the dance. However, a simultaneous and rapid increase in the duration of the signal--together with a more regular alignment of the later waggle-runs within the signal--seems to compensate the initial increase in directional scatter so that the transfer of directional information remains effective. These results point out that the regulation of dance maneuvers depends on the dancer's motivation to forage.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15778840 0340-7594 Journal Article15778840Departamento de Fisiologia, Biologia Molecular y Celular (IFIBYNE-CONICET), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina. rjdm02@yahoo.com.ar?(h@Feipel, V. Dalenne, S. Dugailly, P. Salvia, P. Rooze, M.2004=Kinematics of the lumbar spine during classic ballet postures174-80&Medical Problems of Performing Artists194Postural characteristics and three-dimensional (3D) kinematics of the lumbar spine were examined during classic ballet gestures in 25 expert dancers (17 females, 8 males; mean age, 21 +/- 4 yrs). The 3D displacements of the thorax to the pelvis were sampled with a 3D-electrogoniometer during right and left arabesque, developpe a la seconde, and pied-en-main, and a photographic technique was used to calculate lower-limb elevation, shoulder inclination, and tragus or C7 displacement. The incidence of low-back (43%) and hip pain (40%) was large. Arabesque was characterized by lumbar extension (20-25 degrees), ipsilateral bending ( approximately 20 degrees), and contralateral rotation ( approximately 10 degrees), and a 90 degrees angle between the thighs. During pied-enmain and developpe a la seconde, lumbar flexion ( approximately 30 degrees), ipsilateral bending (10-15 degrees), and contralateral rotation ( approximately 20 degrees) occurred. The angle between the thighs was 150 degrees and 120 degrees, respectively. There was poor correlation between medical history, anthropometrical characteristics, and postural and kinematics variables, except for shoulder inclination, which differed significantly between dancers with hip or low-back problems and those without complaints. We conclude that no relationship exists between hip flexibility and the lumbar spine contribution to various ballet tasks, suggesting that lower-limb elevation during arabesque and developpe a la seconde depends more on hip flexibility than on a lumbar contribution.Laboratory of Functional Anatomy, University of Brussels (CP 619), 808 route de Lennik, B-1070 Brussels, Belgium; vfeipel@ulb.ac.be.:~?)+Hiller, C. E. Refshauge, K. M. Beard, D. J.2004MSensorimotor control is impaired in dancers with functional ankle instability216-23Am J Sports Med321Adult Ankle Injuries/*physiopathology Case-Control Studies Chi-Square Distribution Dancing/*injuries Female Humans Joint Instability/*physiopathology *Proprioception Sprains and Strains/physiopathologyJan-FebBACKGROUND: Factors potentially causing chronic instability after ankle inversion sprains have rarely been examined during the injuring movement. PURPOSE: To compare control of ankle movement during quiet stance and after inversion perturbation in chronically unstable ankles (n = 16) with healthy controls (n = 26). METHODS: Movement control was measured as magnitude of lateral ankle oscillation, using 3SPACE Fastrak during single leg stance (baseline oscillation) in two foot positions, flat and demi-pointe. In both positions, time to resume baseline oscillation after inversion perturbation (perturbation time) of 15 degrees for the flat foot and 7.5 degrees on demi-pointe was also determined. RESULTS: Baseline oscillation on demi-pointe was significantly smaller (P < 0.005) for the sprained group (2.5 +/- 0.5 mm) than for controls (4.0 +/- 2.3 mm). Perturbation time for the flat foot was significantly longer (P < 0.05) for the sprained group (2.2 +/- 0.4 seconds) than for controls (1.8 +/- 0.5 seconds). However, failure rate was higher (P < 0.05) among the sprained group than controls for perturbation with the foot flat and baseline oscillation on demi-pointe. CONCLUSIONS: Findings demonstrated altered sensorimotor control in chronically unstable ankles. Those sprainers who successfully completed the tasks minimized oscillation. The impairments in the sprained group may reflect deficits in either movement detection, peroneal muscle response, or both.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14754747 0363-5465 Journal Article14754747YSchool of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia. |~?*#Hungerford, B. Gilleard, W. Lee, D.2004kAltered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers456-64Clin Biomech (Bristol, Avon)195Adaptation, Physiological Adult Hip Joint/*physiopathology Humans Image Interpretation, Computer-Assisted/methods Joint Instability/etiology/*physiopathology Lower Extremity/*physiopathology Male Middle Aged *Movement Pelvic Bones/*physiopathology Pelvic Pain/complications/*physiopathology Physical Examination/methods Range of Motion, Articular Skin/physiopathology Video Recording/methods *Weight-BearingJunOBJECTIVE: To determine whether the pattern of pelvic bone motion, determined by skin markers, differs between control subjects and subjects with posterior pelvic pain. DESIGN: Cross-sectional study of three-dimensional angular and translational motion of the innominates relative to the sacrum in two subject groups. BACKGROUND: Comparative in vivo analysis of the 3D patterning of pelvic motion in subjects with posterior pelvic pain and controls is limited. METHODS: Fourteen males with posterior pelvic pain and healthy age and height matched controls were studied. A 6-camera motion analysis system was used to determine 3D angular and translational motion of pelvic skin markers during standing hip flexion. RESULTS: Posterior rotation of the innominate occurred with hip flexion in control subjects and pelvic pain subjects as previously reported in the literature. On the supporting leg, the innominate rotated posteriorly in controls and anteriorly in symptomatic subjects. CONCLUSION: Posterior rotation of the innominate, as measured using skin markers during weight bearing in controls may reflect activation of optimal lumbo-pelvic stabilisation strategies for load transfer. Anterior rotation occurred in symptomatic subjects, suggesting failure to stabilise intra-pelvic motion for load transfer. RELEVANCE: This study found that posterior rotation of the innominate occurred during weight bearing in controls. This movement pattern is thought to optimise stability of the pelvic girdle during increased loading. Conversely, anterior rotation occurred in symptomatic subjects during weight bearing. This is a non-optimal pattern and may indicate abnormal articular or neuromyofascial function during increased vertical loading through the pelvis.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15182980 B0268-0033 Clinical Trial Controlled Clinical Trial Journal Article15182980eSchool of Exercise and Sport Science, University of Sydney, Sydney, Australia. barbhungerford@aol.com ~~?+Nolan, L. Kerrigan, D. C.20034Keep on your toes: gait initiation from toe-standing393-401 J Biomech363uAcceleration Adult Ankle/physiology Comparative Study Electromyography/methods Female Gait/*physiology Heel/*physiology Human Male Muscle Contraction/*physiology Muscle, Skeletal/physiology Musculoskeletal Equilibrium/physiology Posture/*physiology Pressure Sensitivity and Specificity Stress, Mechanical Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Toes/*physiologyMarcGait initiation from toe-standing is common in patients with upper motor neurone (UMN) pathology as well as in able-bodied subjects during certain dance and athletic situations. It is unclear whether balance problems in patients who toe-walk are due to the underlying pathology, or due to initiating gait from toe-standing. The aim of this study was to compare the biomechanics of gait initiation from toe-standing to that from heel-toe standing in healthy able-bodied subjects. Data were collected for three seconds prior to, and three seconds after, a visual signal to initiate gait. Ground reaction force and centre of pressure (COP) data were collected with an AMTI force platform, and electromyographic and kinematic data were collected from each limb with a Vicon motion analysis system. When initiating gait from toe-standing, there was a smaller backward displacement of the COP compared to heel-toe standing. In addition, greater forward momentum was generated, and there was an increase in gastrocnemius, rectus femoris and biceps femoris muscle activity. There were no differences in COP displacement or momentum generated in the mediolateral direction for the two conditions. Thus, initiating gait from toe-standing allows one to generate greater amounts of forward momentum but not at the expense of generating excessive stance-side momentum. This may be an advantageous method of initiating movement for dancers and athletes in certain situations. This work also suggests that balance problems in patients with UMN pathology are likely due to the underlying pathology and are not due to initiating gait from toe-standing.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12594987(0021-9290 Clinical Trial Journal Article12594987uCenter for BioDynamics and Department of Biomedical Engineering, Boston University, Boston, MA, USA. lee.nolan@ihs.se~?,-Perrin, P. Deviterne, D. Hugel, F. Perrot, C.2002YJudo, better than dance, develops sensorimotor adaptabilities involved in balance control187-94 Gait Posture152Adult Biomechanics Case-Control Studies Comparative Study *Dancing Female Humans Male *Martial Arts *Musculoskeletal Equilibrium Posture *Psychomotor PerformanceAprOBJECTIVES: Training allows sportsmen to acquire new balance control abilities, possibly differing according to the discipline practised. We compared, by means of static and dynamic posturographic tests, the postural skills of high-level judoists, professional dancers and controls, in order to determine whether these sports improved postural control. RESULTS: With eyes open, judoists and dancers performed better than controls, indicating a positive effect of training on sensorimotor adaptabilities. Yet, with eyes closed, only judoists retained a significantly better stance. CONCLUSIONS: These data indicate that the practice of a high-skill activity involving proprioceptive afferences especially improves both performance and balance control.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11869913 0966-6362 Journal Article11869913Equilibration et Performance Motrice, UFR STAPS, University Henri Poincare - Nancy 1, 30 rue du Jardin Botanique, 54 600 Villers-les-Nancy, France. philippe.perrin@staps.uhp-nancy.frQ~?-ARiley, J. R. Greggers, U. Smith, A. D. Reynolds, D. R. Menzel, R.2005;The flight paths of honeybees recruited by the waggle dance205-7Nature4357039*Animal Communication Animal Feed Animals Bees/*physiology Cues Feeding Behavior/*physiology Flight, Animal/*physiology Models, Biological Odors Research Support, Non-U.S. Gov't Sensitivity and Specificity Smell/physiology Vision/physiology WindMay 12In the 'dance language' of honeybees, the dancer generates a specific, coded message that describes the direction and distance from the hive of a new food source, and this message is displaced in both space and time from the dancer's discovery of that source. Karl von Frisch concluded that bees 'recruited' by this dance used the information encoded in it to guide them directly to the remote food source, and this Nobel Prize-winning discovery revealed the most sophisticated example of non-primate communication that we know of. In spite of some initial scepticism, almost all biologists are now convinced that von Frisch was correct, but what has hitherto been lacking is a quantitative description of how effectively recruits translate the code in the dance into flight to their destinations. Using harmonic radar to record the actual flight paths of recruited bees, we now provide that description.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15889092 1476-4687 Journal Article15889092Plant and Invertebrate Ecology Division, Rothamsted Research, Harpenden, Hertfordshire AL5 2JQ, UK. joe@radarent.freeserve.co.ukN~?.Sherman, G. Visscher, P. K.20021Honeybee colonies achieve fitness through dancing920-2Nature4196910*Animal Communication Animals Bees/*physiology California Dancing/physiology Environment Evolution Female Flowers/chemistry *Food Gravitation Lighting Models, Biological Motor Activity/*physiology Odors Research Support, Non-U.S. Gov't Seasons SunlightOct 31The honeybee dance language, in which foragers perform dances containing information about the distance and direction to food sources, is the quintessential example of symbolic communication in non-primates. The dance language has been the subject of controversy, and of extensive research into the mechanisms of acquiring, decoding and evaluating the information in the dance. The dance language has been hypothesized, but not shown, to increase colony food collection. Here we show that colonies with disoriented dances (lacking direction information) recruit less effectively to syrup feeders than do colonies with oriented dances. For colonies foraging at natural sources, the direction information sometimes increases food collected, but at other times it makes no difference. The food-location information in the dance is presumably important when food sources are hard to find, variable in richness and ephemeral. Recruitment based simply on arousal of foragers and communication of floral odour, as occurs in honeybees, bumble bees and some stingless bees, can be equally effective under other circumstances. Clarifying the condition-dependent payoffs of the dance language provides new insight into its function in honeybee ecology.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12410309 0028-0836 Journal Article12410309UDepartment of Entomology, University of California, Riverside, California 92521, USA.~?/Simmons, R. W.2005QSensory organization determinants of postural stability in trained ballet dancers87-97Int J Neurosci1151\Adult Analysis of Variance Case-Control Studies Comparative Study Computer-Aided Design Dancing/*physiology Female Humans Musculoskeletal Equilibrium/*physiology Posture/*physiology Proprioception/*physiology Psychomotor Performance/*physiology Range of Motion, Articular/physiology Reflex, Vestibulo-Ocular/physiology Task Performance and AnalysisJanTrained ballet dancers and nondancer controls completed six balance tests using computerized dynamic posturography. The tests facilitated assessment of the type of sensory organization used to maintain postural control under conditions ranging from quiet standing to a situation in which visual and/or somatosensory information was systematically removed or made unreliable. Results indicated that ballet dancers and controls have comparable balance ability during eyes open and eyes closed conditions. However, when somatosensory information alone or in combination with visual information was made unreliable, dancers were significantly less stable than controls and utilized a hip strategy to maintain postural control.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15768854 0020-7454 Journal Article15768854Motor Control Laboratory, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California 92182, USA. rsimmons@mail.sdsu.edut~?0Simmons, R. W.2005KNeuromuscular responses of trained ballet dancers to postural perturbations1193-203Int J Neurosci1158lAdult *Dancing Electromyography Female Humans *Learning Muscle, Skeletal/*innervation *Posture Reaction TimeAug3The balance of trained ballet dancers and non-dancer controls was mechanically perturbed in order to evaluate the time of onset of muscle activation and the consistency of muscle activation. Results supported the prediction that ballet dancers have significantly faster long-latency (LL) neuromuscular responses than controls and are significantly more consistent in muscle activation. These findings indicate a superior postural control mechanism in trained dancers and may explain the ability of dancers to maintain static balances over a small base of support.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16040361 0020-7454 Journal Article16040361Motor Control Laboratory, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California 92182, USA. rsimmons@mail.sdsu.edu~?1Thullier, F. Moufti, H.2004*Multi-joint coordination in ballet dancers80-4 Neurosci Lett3691Anthropometry Biomechanics/methods Case-Control Studies Comparative Study Dancing/*physiology Foot Joints/*physiology Humans Movement/physiology Musculoskeletal Equilibrium Orientation/physiology Posture/*physiology Range of Motion, Articular/*physiology Statistics, NonparametricOct 7In upright posture, we analyzed the multi-joint coordination during drawing ellipses with the foot in a horizontal plane in classical ballet dancers (Elite) and gymnasts who had no dance training (Novice). In both groups, the stability of the head and the trunk was similar. Furthermore, a comparatively simple synergy inter-relating the movements in the hip, knee and ankle joints, was revealed by the kinematic analysis. However, novices made larger errors in the eccentricity and orientation of ellipses than ballet dancers. Ankle angular excursions were smaller in novices than in dancers whereas hip angular excursions were larger. This study illustrates some rules underlying the ability of the nervous system to integrate multiple degrees of freedom of the body to master body balance while producing complex leg movement trajectories. This study offers a dynamical approach of the problem of redundancy.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15380312 0304-3940 Journal Article15380312Laboratoire de Neurosciences de l'Homme en Mouvement, UPRES EA 2131 and ModeSCoS, Maison de la Recherche en Sciences Humaines UMS CNRS 843, Universite de Caen Basse-Normandie, Campus II, Bd Mal Juin, 14032 Caen, France. thullier@staps.unicaen.fr?2Wilson, M. Lim, B. Kwon, Y.2004lA three-dimensional kinematic analysis of grand rond de jambe en l'air: skilled versus novice ballet dancers108-15#Journal of Dance Medicine & Science84The purpose of this study was twofold: to perform an in-depth three-dimensional kinematic analysis of grand rond de jambe en l'air en dehors and to identify different strategies employed between the skilled and novice dancers in performing grand rond de jambe. Ten female college dance students, ranked as skilled (N = 5) or novice (N = 5), performed grand rond de jambe while video-taped for three-dimensional motion analysis in a six-camera setup (60 Hz). Events and phases for the movement were determined to establish a protocol for biomechanic analysis of this movement. Orientation angles of the trunk and pelvis and horizontal and vertical angles of the gesture leg were computed for inter-group comparison. The results of this investigation show differences between skilled and novice dancers in terms of the vertical angle (height) of the gesture leg, horizontal angle of the leg at the transition of pelvic rotation, and increased pelvic motion in all three planes. No significant difference was observed in the trunk motion and orientation. It was concluded that the skilled group secured the required gesture leg motion via a pelvic strategy.UDepartment of Dance, P.O. Box 425708, Texas Woman's University, Denton, TX 76204-5708?3$Gamboa, J. M. Hagins, M. Manal, T.J.2005VAn analysis to define the clinical practice of physical therapy for performing artists41-55%Journal of Dance Medicine and Science92~?5GCalvo-Merino, B. Glaser, D. E. Grezes, J. Passingham, R. E. Haggard, P.2005OAction observation and acquired motor skills: an FMRI study with expert dancers1243-9 Cereb Cortex158AugWhen we observe someone performing an action, do our brains simulate making that action? Acquired motor skills offer a unique way to test this question, since people differ widely in the actions they have learned to perform. We used functional magnetic resonance imaging to study differences in brain activity between watching an action that one has learned to do and an action that one has not, in order to assess whether the brain processes of action observation are modulated by the expertise and motor repertoire of the observer. Experts in classical ballet, experts in capoeira and inexpert control subjects viewed videos of ballet or capoeira actions. Comparing the brain activity when dancers watched their own dance style versus the other style therefore reveals the influence of motor expertise on action observation. We found greater bilateral activations in premotor cortex and intraparietal sulcus, right superior parietal lobe and left posterior superior temporal sulcus when expert dancers viewed movements that they had been trained to perform compared to movements they had not. Our results show that this 'mirror system' integrates observed actions of others with an individual's personal motor repertoire, and suggest that the human brain understands actions by motor simulation.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15616133 1047-3211 Journal Article15616133Institute of Movement Neuroscience, University College London and Department of Basic Psychology, Faculty of Psychology, Universidad Complutense, Madrid, Spain. ?6/Adam, M.U. Brassington, G.S. Matheson, G.O.2004bPsychological factors associated with performance-limiting injuries in professional ballet dancers43-6#Journal of Dance Medicine & Science82^The purpose of this study was to assess the relationship between a broad range of psychosocial variables and performance-limiting physical injuries in a sample of elite ballet dancers in order to identify potential factors that could be included in interventions to prevent and treat dance injuries. Participants were asked to complete a battery of questionnaires assessing psychological well-being and social support. Participants also participated in a structured interview designed to solicit information about dance-related injuries in the 10-month period preceding the study. Study was conducted at the workplace of a 60-member professional ballet company. The company is part of a large, government-funded state theatre in Germany. Participants were 30 female and 24 male (mean age: 26.59 years; SD: 6.2 years) ballet dancers, representing 20 countries. Participants were employed in the company for the 2000-2001 performance season and were not injured at the time of participation in the study. Participants were asked to complete a battery of questionnaires including: a demographics questionnaire, the Cohen Perceived Stress Scale, the Social Support Appraisal Scale, the Profile of Mood States, and the Pittsburgh Sleep Quality Index. Percent of performance and rehearsal days missed due to injury was computed as follows: (number of days missed due to injury/scheduled days) X 100. To identify potential correlates of injuries, Pearson Product-moment Correlation Coefficients were computed between the injury variable and each of the psychosocial variables. Absence due to injury was significantly positively correlated with stress, sleep disturbances, daytime sleepiness, and negative mood states (i.e., tension, depression, anger, fatigue, and confusion). However, absence due to injury was significantly negatively associated with social support. Future interventions designed to prevent and treat injuries in elite ballet dancers should include the assessment and treatment of psychological distress (i.e., perceived stress, negative mood states, sleep problems) as well as the enhancement of social support in their programs.NDept of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA.b?7Barrell, G.M. Terry, P.C.20038Trait anxiety and coping strategies among ballet dancers59-64&Medical Problems of Performing Artists182RThis study examined relationships between competitive trait anxiety and coping strategies among ballet dancers. Participants were 104 classical dancers (81 females and 23 males) ranging in age from 15 to 35 years (mean 19.4 years; SD 3.8 years) from three professional ballet companies, two private dance schools, and two university dance courses in Australia. Participants completed the Modified COPE scale and the Sport Anxiety Scale. Trait anxiety scores, in particular for somatic anxiety and worry, were significant predictors of 7 of the 12 coping strategies (wishful thinking, R[2] = 42.3%; selfblame, R[2] = 35.7%; suppression of competing activities, R[2] = 27.1%; venting of emotions, R[2] = 23.2%; denial, R[2] = 17.7%; effort, R[2] = 16.6%; active coping, R[2] = 14.3%). Approximately 96% of dancers could be classified correctly as high or low trait-anxious from their reported coping style. No significant effects of gender or status (professional versus students) were found. Findings showed that high trait-anxious athletes tend to use more maladaptive, emotion-focused coping strategies compared with low trait-anxious athletes, a tendency that has been proposed to lead to negative performance effects. Dancers who are by nature anxious about performance may need special attention to help them to learn to cope with performance-related stress.KDept of Psychology, University of Southern Queensland, Toowoomba, AustraliaO~?8 Dobson, R.2005:Eight in 10 dancers have an injury each year, survey shows594Bmj3317517IDancing/*injuries Female Great Britain/epidemiology Humans Incidence MaleSep 17fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16166121 1468-5833 News16166121?9z#Mayers, L. Judelson, D. Bronner, S.2003*The prevalence of injury among tap dancers121-125#Journal of Dance Medicine & Science72_A literature search revealed no information on the prevalence of tap dance injuries, one of several dance styles involving percussive footwork. We conducted a retrospective survey to determine the rates and patterns of injury among a cohort of experienced tap dancers enrolled in "advanced" or "master" classes at the New York City Tap Festival. Demographic factors, dance/performance, exercise, and injury histories were recorded and analyzed and the injury rate per 1000 dance exposures calculated. Calculated injury rates among the tap dancers were substantially lower than those previously reported for other dance and athlete populations. We conclude that kinetic and kinematic analysis is required to explain the apparent decreased risk of injury among tap dancers. Comparison data may lead to improved strategies for injury prevention in these other areas.gDirector of Sports Medicine, Athletics Dept, Pace University, 861 Bedford Road, Pleasantville, NY 10570N~?:Maquirriain, J.2005$Posterior ankle impingement syndrome365-71J Am Acad Orthop Surg136OctPosterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16224109 !1067-151X (Print) Journal Article16224109_Orthopaedic Department, Centro Nacional de Alto Rendimiento Deportivo, Buenos Aires, Argentina.w~?;Martinez, S. F. Murphy, G. A.2005=Tibial stress fracture in a male ballet dancer: a case report124-30Am J Sports Med331Adult *Bone Nails Dancing/*injuries Equipment Failure Fracture Fixation/*methods Fractures, Malunited Fractures, Stress/etiology/*pathology/*surgery Humans Male Tibial Fractures/etiology/*pathology/*surgeryJanfhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15611009 &0363-5465 Case Reports Journal Article15611009jDepartment of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Memphis, Tennessee 38104, USA.m~?<Aktas, G. Ogce, F.2005(Dance as a therapy for cancer prevention408-11Asian Pac J Cancer Prev63Jul-SepEven though the field of medicine has developed tremendously, the wide variety of cancer is still among chronic and life threatening disease today. Therefore, the specialists constantly research and try every possible way to find cure or preventive ways to stop its further development. For this reason, studies concerning the chronic disease such as cancer have been spread to many different fields. In this regard, many other alternative ways besides medicine, are used in prevention of cancer. Nutritional therapy, herbal therapy, sportive activities, art therapy, music therapy, dance therapy, imagery, yoga and acupuncture can be given as examples. Among these, dance/movement therapy which deals with individuals physical, emotional, cognitive as well as social integration is widely used as a popular form of physical activity. The physical benefits of dance therapy as exercise are well documented. Studies have shown that physical activity is known to increase special neurotransmitter substances in the brain (endorphins), which create a state of well-being. And total body movement such as dance enhances the functions of other body systems, such as circulatory, respiratory, skeletal, and muscular systems. Regarding its unique connection to the field of medicine, many researches have been undertaken on the effects of dance/movement therapy in special settings with physical problems such as amputations, traumatic brain injury, and stroke, chronic illnesses such as anorexia, bulimia, cancer, Alzheimer's disease, cystic fibrosis, heart disease, diabetes, asthma, AIDS, and arthritis. Today dance/movement therapy is a well recognized form of complementary therapy used in hospitals as well as at the comprehensive clinical cancer centres.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16236009 1513-7368 Journal Article16236009vState Conservatory of Turkish Music, Department of Dance, Ege University, Izmir, Turkey. ummuhan.filiz.ogce@ege.edu.tr I~?=%Holm, A. K. Lepp, M. Ringsberg, K. C.2005RDementia: involving patients in storytelling--a caring intervention. A pilot study256-63 J Clin Nurs142WAged Caregivers/*psychology *Communication *Dementia/nursing/psychology *Empathy Female *Folklore Human Development Humans Interpersonal Relations *Life Change Events Male *Memory Nursing Methodology Research Pilot Projects Program Evaluation Psychotherapy, Group/*organization & administration Research Support, Non-U.S. Gov't Self DisclosureFebAIMS AND OBJECTIVES: The aim of this study was to explore the potential therapeutic role of storytelling in patients with dementia and, if so, to formulate pedagogic implications for the field of nursing with the focus on dementia care. BACKGROUND: The present study is part of a larger project, Drama-Ger (Lepp et al. 2003: Journal of Clinical Nursing 12, 873-881), consisting of a cultural drama programme designed for patients with dementia and their caregivers. The programme consisted of two groups (A and B). Group A focused on dance, rhythm and songs, group B focused on storytelling and conversations. The present pilot study deals with group B. DESIGN: The study was an intervention study. METHODS: Six strategically selected patients, five women and one man, with intermediate and severe dementia, and their three female paid caregivers participated in the programme. They met on six occasions for 1.5 hours once a week for two months. The leader of the group, a Registered Nurse, who was also trained as a symbol pedagogue/teacher, told stories that were related to Erikson's development theory. She continuously kept a reflective diary which was qualitatively analysed. RESULTS: This pilot study clearly indicates that storytelling invited the patients to take part in associative conversations. The storytelling appeared to help them to remember and make associations with situations they had previously experienced in their lives. Erikson's stages of development could be traced in the conversations. The patients interacted with each other, their caregivers and the leader. CONCLUSIONS: A drama programme using storytelling appears to stimulate patients with dementia to communicate and interact with other people. Ten implications four statements about storytelling as a pedagogic tool and six statements to facilitate a pedagogic approach have been drawn from this study. RELEVANCE TO CLINICAL PRACTICE: The implications can be used as a guide when using storytelling for caring intervention with the focus on dementia care.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15669935 L0962-1067 (Print) Clinical Trial Journal Article Randomized Controlled Trial15669935xSahlgrenska Academy, Goteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Goteborg, Sweden.I~?>$Beekman, M. Doyen, L. Oldroyd, B. P.2005Increase in dance imprecision with decreasing foraging distance in the honey bee Apis mellifera L. is partly explained by physical constraints1-75J Comp Physiol A Neuroethol Sens Neural Behav PhysiolJul 281Honey bee foragers communicate the direction and distance of both food sources and new nest sites to nest mates by means of a symbolic dance language. Interestingly, the precision by which dancers transfer directional information is negatively correlated with the distance to the advertised food source. The 'tuned-error' hypothesis suggests that colonies benefit from this imprecision as it spreads recruits out over a patch of constant size irrespective of the distance to the advertised site. An alternative to the tuned-error hypothesis is that dancers are physically incapable of dancing with great precision for nearby sources. Here we revisit the tuned-error hypothesis by studying the change in dance precision with increasing foraging distance over relatively short distances while controlling for environmental influences. We show that bees indeed increase their dance precision with the increase in foraging distance. However, we also show that dances performed by swarm-scouts for a nearby (30 m) nest site, where there could be no benefit to imprecision, are either without or with only limited directional information. This result suggests that imprecision in dance communication is caused primarily by physical constraints in the ability of dancers to turn around quickly enough when the advertised site is nearby.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16049698 0340-7594 Journal article16049698qSchool of Biological Sciences, University of Sydney, A12, Sydney, NSW, 2006, Australia, mbeekman@bio.usyd.edu.au.~??Bronner, S. Ojofeitimi, S.2006FGender and limb differences in healthy elite dancers: passe kinematics71-9 J Mot Behav381JanSymmetry of skill development is emphasized in dance training, and many movements are well learned by both genders. The authors conducted a 2-dimensional kinematic analysis of a complex dance movement, the passe, in 12 healthy professional male and female dancers to determine whether there are differences between genders or limbs during the performance of that task. Only peak hip angular displacement differed in men and women. No differences were found between limbs in any of the dependent variables. Dancers displayed consistent temporal and spatial proximal-to-distal sequencing of movement coordination. Despite an indication of limb preference, as defined by gesture or stance limb, there were no differences in proficiency.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16436364 !0022-2895 (Print) Journal Article16436364Analysis of Dance and Movement Center at Long Island University, 122 Ashland Place No. 1A, Brooklyn, NY 11201, USA. sbronner@liu.edu,?@IMasso, N. German, A. Rey, F. Costa, L.L. Romero, D. Guitart, S.2004CStudy of muscle activity during releve in first and sixth positions101-7#Journal of Dance Medicine & Science84To assess differences in the muscular activation related to position when performing releve, a kinetic and kinematic analysis was performed on 18 professional classical ballet dancers aged 14 to 32. The degree of plantar flexion and the involvement of the peroneus longus, soleus, gastrocnemius, and abductor hallucis muscles were analyzed. The results in sixth position (parallel) against external rotation of the hip or turnout and the correct first position against first position with foot pronation were compared. All comparisons were evaluated using the Wilcoxon test. When in releve, the plantar flexion values were greater in sixth position than in first and also greater in the correct first position than in first with pronated feet. The medial gastrocnemius muscle had more electromyographical activity when the releve is done in first position. However, the abductor hallucis exerted greater activity when in the sixth position. The low activity of this muscle when in first position may reflect deficient stability of the internal arch and the first ray, thereby leading to increased risk of injury. With foot pronation, the peroneus longus and gastrocnemius muscles presented their highest activity levels.nBiomechanics Laboratory, EUIF Blanquerna, Ramon Llull University, C/Padilla, 326-332, E-08025 Barcelona, Spain z~?AKoutedakis, Y. Jamurtas, A.2004@The dancer as a performing athlete: Physiological considerations651-61 Sports Med3410Athletic Injuries/*prevention & control Body Composition/physiology Body Constitution/physiology Cardiovascular Physiology Dancing/injuries/*physiology Energy Intake/physiology Exercise/physiology Female Humans Male Musculoskeletal Physiologic Processes Sports/*physiologyThe physical demands placed on dancers from current choreography and performance schedules make their physiology and fitness just as important as skill development. However, even at the height of their professional careers, dancers' aerobic power, muscular strength, muscular balance, bone and joint integrity are the 'Achilles heels' of the dance-only selection and training system. This partly reflects the unfounded view, shared by sections of the dance world, that any exercise training that is not directly related to dance would diminish dancers' aesthetic appearances. Given that performing dance itself elicits only limited stimuli for positive fitness adaptations, it is not surprising that professional dancers often demonstrate values similar to those obtained from healthy sedentary individuals of comparable age in key fitness-related parameters. In contrast, recent data on male and female dancers revealed that supplementary exercise training can lead to improvements of such fitness parameters and reduce incidents of dance injuries, without interfering with key artistic and aesthetic requirements. It seems, however, that strict selection and training regimens have succeeded in transforming dance to an activity practised by individuals who have selectively developed different flexibility characteristics compared with athletes. Bodyweight targets are normally met by low energy intakes, with female dance students and professional ballerinas reported to consume below 70% and 80% of the recommended daily allowance of energy intake, respectively, while the female athlete 'triad' of disordered eating, amenorrhoea and osteoporosis is now well recognised and is seen just as commonly in dancers.An awareness of these factors will assist dancers and their teachers to improve training techniques, to employ effective injury prevention strategies and to determine better physical conditioning. However, any change in the traditional training regimes must be approached cautiously to ensure that the aesthetic content of the dance is not affected by new training techniques. Since physiological aspects of performing dance have been viewed primarily in the context of ballet, further scientific research on all forms of dance is required.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15335242 0112-1642 Journal Article Review15335242hSchool of Sport, Performing Arts and Leisure, Wolverhampton University, Walsall, UK. y.koutedakis@uth.gr?B/Meck, C. Hess, RA. Helldobler, R. Roh, J.20046Pre-pointe evaluation components used by dance schools37-42#Journal of Dance Medicine & Science82This study sought to identify the components of the current screening protocols used by dance schools to determine the readiness of a student to begin dancing en pointe. The subjects surveyed (N = 200) were the individuals who were responsible for performing the pre-pointe evaluation. An e-mail was sent to dance schools with an instruction letter to request it be forwarded to the pre-pointe evaluation administrator. Frequency tables were used to analyze the gathered data. A group of eight components were reported to be used by more than 75% of the institutions responding to the survey. Those institutions using an allied healthcare practitioner averaged 11.9 components per evaluation while institutions without an allied healthcare professional aver-aged 9.6 components. There were eight commonly reported components of the pre-pointe evaluation. At nearly 96% frequency, age was the most common component. Institutions affiliated with a company conduct a pre-pointe evaluation similar to those not affiliated with a company. The presence or absence of a healthcare professional had the most influence on the components used in the pre-pointe evaluation.1Athletic Trainer, Walt Disney World, Orlando, FL.~?CArendt, Y. D. Kerschbaumer, F.2003;[Injury and overuse pattern in professional ballet dancers]349-56Z Orthop Ihre Grenzgeb1413|Adult Ankle Injuries/epidemiology/etiology Athletic Injuries/*epidemiology/etiology Cross-Sectional Studies Cumulative Trauma Disorders/*epidemiology/etiology Dancing/*injuries English Abstract Female Germany Humans Incidence Knee Injuries/epidemiology/etiology Low Back Pain/epidemiology/etiology Male Physical Education and Training Research Support, Non-U.S. Gov't Risk FactorsMay-Jun!AIM: The purpose of the study was to show the injury profile and common discomforts of professional ballet dancers and to examine factors that affect the frequency of the injuries, like age, gender, regeneration activities. METHOD: 42 female and 35 male dancers in German theaters were evaluated by a questionnaire, training observation, and physical examination. RESULTS: Common discomfort was described frequently in the lumbar spine (88%), the knee (80.5%), and the ankle (74%). 285 injuries occurred in the female, 282 in the male dancers during a 5-year period. The most frequent injuries were muscle strains and inflammations, mostly of the lower extremity (64%) and the torso (24%). Gender differences were found in shoulder injuries, which occurred in 9% of cases in men, compared to 2.5% in women. 73% of the injuries considered as severe were traumatically caused when performing jumps and lifts. Severe overuse injuries were mostly found in the lower extremity and the lumbar spine, caused by technical deficiencies. 54% still suffered from the consequences of the injury by returning pain, swelling or instability. CONCLUSION: This high amount of injuries can be reduced by continuous technical improvement, the use of auxiliary material like joint-protectors or mats and enough time for regeneration.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12822086 0044-3220 Journal Article12822086FVerletzungen und Uberlastungserscheinungen im professionellen Ballett.Orthopadische Universitats- und Poliklinik, Johann Wolfgang Goethe-Universitat Frankfurt am Main, Abteilung fur Rheumaorthopadie. y.arendt@gmx.net :~?D(Askling, C. Saartok, T. Thorstensson, A.2006dType of acute hamstring strain affects flexibility, strength, and time to return to pre-injury level40-4Br J Sports Med401|Adolescent Adult Dancing/*injuries Female Follow-Up Studies Hip Injuries/etiology/physiopathology Humans Knee Injuries/etiology/physiopathology Male Muscle, Skeletal/*injuries/physiopathology Pliability Range of Motion, Articular/physiology Recovery of Function/physiology Recurrence Research Support, Non-U.S. Gov't Running/*injuries Sprains and Strains/*etiology/physiopathologyJanOBJECTIVES: To investigate possible links between aetiology of acute, first time hamstring strains in sprinters and dancers and recovery of flexibility, strength, and function as well as time to return to pre-injury level. [figure: see text]. METHODS: Eighteen elite sprinters and 15 professional dancers with a clinically diagnosed hamstring strain were included. They were clinically examined and tested two, 10, 21, and 42 days after the acute injury. Range of motion in hip flexion and isometric strength in knee flexion were measured. Self estimated and actual time to return to pre-injury level were recorded. Hamstring reinjuries were recorded during a two year follow up period. RESULTS: All the sprinters sustained their injuries during high speed sprinting, whereas all the dancers were injured while performing slow stretching type exercises. The initial loss of flexibility and strength was greater in sprinters than in dancers (p<0.05). At 42 days after injury, both groups could perform more than 90% of the test values of the uninjured leg. However, the actual times to return to pre-injury level of performance were significantly longer (median 16 weeks (range 6-50) for the sprinters and 50 weeks (range 30-76) for the dancers). Three reinjuries were noted, all in sprinters. CONCLUSION: There appears to be a link between the aetiologies of the two types of acute hamstring strain in sprinters and dancers and the time to return to pre-injury level. Initially, sprinters have more severe functional deficits but recover more quickly.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16371489 &1473-0480 (Electronic) Journal Article16371489=Karolinska Institutet, Stockholm, Sweden. carl.askling@ihs.se~?EFliegel, L. S.2005P"I love ballet": arts incentives for adolescent health and community development49-60, 5New Dir Youth Dev106 Adolescent *Adolescent Behavior Adolescent Health Services/*organization & administration *Art Therapy Boston Community Health Planning/*organization & administration *Community Networks Culture *Dance Therapy Female Humans Social Change *Social Support United StatesSummer Art can be a transformative process that not only offers youth opportunities for self-expression, but enables them to connect to their communities as part of the healing process. Having a public role offers those who are often without power to have a voice and a presence. This chapter provides information on the Arts Incentives Program at the United South End Settlements, a therapeutic, arts-based youth and community development program working with high-risk girls ages eleven to eighteen. Young people engage in community building within the program and become agents of positive community change. In revitalizing their communities, they rebuild a sense of self as essential, valued, and creative, bringing together the resources of participants, agencies, and the community.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16170930 !1533-8916 (Print) Journal Article16170930CArts Incentives Program, United South End Settlements, Boston, USA.~?FDe Marco, R. Menzel, R.20050Encoding spatial information in the waggle dance3885-94 J Exp Biol208Pt 20OctApis mellifera bees execute waggle dances to recruit other bees to desirable food sources. Several components of the waggle dance are correlated with the direction of and the distance to food. Moreover, recruits use the spatial information encoded in the dance to locate the signalled food. However, although dance communication has been studied extensively, little is known about how the dancers combine the compass (direction) and the odometric (distance) information they acquire during the foraging flight. In the present study, we analysed the encoding of spatial information in the waggle dance by manipulating the navigational information provided to dancing bees. To this end, we took advantage of the bees' visually driven odometer. We found that the waggle dance basically encodes information on the distance gauged during the outbound (hive-to-food) flight. However, it does not necessarily refer to a global vector based on path integration of the outbound flight. Whenever the direction connecting the subjective food location and the hive does not match the direction of the global vector, dancers refer to a direction close to that of the shortcut connecting the actual food location and the hive. Moreover, in our experiments, this direction was close to that of the inbound (food-to-hive) flight, indicating that landmark-based information is computed during the inbound flight and that it may strongly affect the encoding of directional information in the waggle dance. Moreover, we found that the bees' experience of the terrain modulates the encoding of spatial information in the waggle dance, suggesting that interactions between path integration and visual landmarks are computed in the context of dance communication.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16215216 !0022-0949 (Print) Journal Article16215216Freie Universitat Berlin, Fachbereich Biologie/Chemie/Pharmazie, Institut fur Biologie--Neurobiologie, Konigin-Luise-Strasse 28-30, 14195 Berlin, Germany. rjdm02@yahoo.com.arp~?G#Anderson, R. B. McBryde, A. M., Jr.19975Autogenous bone grafting of hallux sesamoid nonunions293-6Foot Ankle Int185Adult Athletic Injuries/surgery *Bone Transplantation Evaluation Studies Female Fractures, Ununited/*surgery *Hallux Humans Male Sesamoid Bones/*injuries/surgeryMayFWe first performed autogenous bone grafting for lesions of the hallux sesamoid in 1984. During the next 9 years, 21 patients (11 men and 10 women with an average age of 34 and 32 years, respectively) underwent this surgical procedure for symptomatic tibial hallux sesamoid non-unions. Successful bony union was achieved in all but two patients. The majority of patients obtained concomitant relief of preoperative symptomatology and returned to their preinjury level of activity. We believe that this procedure serves as an alternative to hallux sesamoid excision in selected cases.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9167930 1071-1007 Journal Article9167930ZMiller Orthopaedic Clinic, Carolinas Medical Center, Charlotte, North Carolina 28203, USA. ~?HBiedert, R. Hintermann, B.2003>Stress fractures of the medial great toe sesamoids in athletes137-41Foot Ankle Int242Adolescent Adult Female *Fractures, Stress/diagnosis/surgery Gymnastics/*injuries Hallux Humans Sesamoid Bones/*injuries/surgery Track and Field/injuriesFeb=The purpose of this study was to determine whether specific symptoms and findings are present in patients with symptomatic stress fractures of the sesamoids of the great toe and, if so, whether partial sesamoidectomy is sufficient for successful treatment. Five consecutive athletes (five females; mean age 16.8 years [range, 13 to 22 years]) with six feet that were treated for symptomatic stress fractures of the sesamoids of the great toe were included in this study. Four athletes (five feet) performed rhythmic sports gymnastics; the fifth athlete was a long jumper. Some swelling to the forefoot and activity-related pain that increased in forced dorsiflexion, but disappeared at rest was found in all patients. While plain X-rays evidenced fragmentation of the medial sesamoid, MRI (n=2) and frontal plane CT scan (n=3) did not always confirm the diagnosis, but bone scan (n=3) and axial as well as sagittal CT scan were useful to detect the pathology. After failure of conservative treatment measures, surgical excision of the proximal fragment was successful in all patients, and there were no complications. All patients were pain free and regained full sports activity within six months (range, 2.5 to six months). At final follow-up which averaged 50.6 months (range, 20 to 110 months), the overall clinical results were graded as good/excellent in all patients, and there was only one patient with of restriction sports activities. The obtained AOFAS-Hallux-Score was 95.3 (75 to 100) points. Apparently, stress fractures occur more often at the medial sesamoid, and females are mainly involved. When a stress fracture is suspected, bone scan and CT scan are suggested as more reliable in confirming the diagnosis than other imaging methods. When conservative treatment has failed, surgical excision of the proximal fragment is recommended.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12627621 1071-1007 Journal Article12627621University of Basle, Orthopaedics and Sports Traumatology, Institute of Sport Sciences, CH-2532 Magglingen, Switzerland. roland.biedert@baspo.admin.chB~?I-Blundell, C. M. Nicholson, P. Blackney, M. W.2002MPercutaneous screw fixation for fractures of the sesamoid bones of the hallux1138-41J Bone Joint Surg Br848Adolescent Adult Athletic Injuries/*surgery *Bone Screws Female Fractures, Bone/radiography/*surgery Hallux/*injuries/radiography/*surgery Humans Male Middle Aged Sesamoid Bones/*injuries/radiography/*surgery Treatment OutcomeNovOver a period of one year we treated nine fractures ofhe sesamoid bones of the hallux, five of which were in the medial sesamoid. All patients had symptoms on exercise, but only one had a recent history of injury. The mean age of the patients was 27 years (17 to 45) and there were six men. The mean duration of symptoms was nine months (1.5 to 48). The diagnosis was based on clinical and radiological investigations. We describe a new surgical technique for percutaneous screw fixation for these fractures using a Barouk screw. All the patients were assessed before and after surgery using the American Orthopaedic Foot and Ankle Society Hallux Score (AOFAS). There was a statistically significant improvement in the mean score from 46.9 to 80.7 (p = 0.0003) after fixation of the fracture with a rapid resolution of symptoms. All patients returned to their previous level of activity by three months. We believe that this relatively simple technique is an excellent method of treatment in appropriately selected patients.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12463658 !0301-620X (Print) Journal Article12463658~?JCortes, Z. E. Baumhauer, J. F.2004LTraumatic lateral dislocation of the great toe fibular sesamoid: case report164-7Foot Ankle Int253Adult Dislocations/complications/*diagnosis/therapy Female Fibula Fractures, Bone/complications Hallux Humans Ligaments/injuries Magnetic Resonance Imaging Metatarsal Bones/injuries Sesamoid Bones/*injuriesMarTraumatic dislocation of the hallucal sesamoids is uncommon. This case involves a 17-year-old female driver involved in a head-on collision who sustained traumatic lateral dislocation of the fibular sesamoid associated with intersesamoidal ligament disruption, partial plantar plate avulsion, and impaction fracture of the metatarsal head. The diagnosis was delayed due to incorrect interpretation of initial radiographs. In addition, the severity of the soft-tissue injury was not appreciated, possibly further delaying the diagnosis. The patient was treated with open reduction of the fibular sesamoid and reconstruction of the intersesamoidal ligament. Eight months after surgery, she had mild persistent symptoms, decreased range of motion, and near full resumption of prior activities.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15006339 51071-1007 (Print) Case Reports Journal Article Review15006339rDepartment of Orthopaedic Surgery, University of Rochester, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, USA.z~?KFleischli, J. Cheleuitte, E.1995-Avascular necrosis of the hallucial sesamoids358-65J Foot Ankle Surg344Foot Diseases/radiography/surgery Hallux/radiography/*surgery Humans Osteonecrosis/radiography/*surgery Sesamoid Bones/radiography/*surgery Tomography, X-Ray ComputedJul-Aug\The authors present a literature review and systematic approach to the diagnosis and treatment of avascular necrosis of the sesamoids of the flexor hallucis brevis tendon. Renander, in 1924, was one of the earliest authors to call attention to this condition. Since that time, many other authors have written about this entity, some even questioning its existence. Many different treatment regimes have been postulated, encompassing both the conservative and surgical modalities. Most literature advocates attempted conservative treatment followed by surgical excision, only if conservative methods fail.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7488993 11067-2516 Journal Article Review Review, Tutorial74889938Midwestern Regional Medical Center, Zion, IL 60099, USA.^~?LJulsrud, M. E.1997KOsteonecrosis of the tibial and fibular sesamoids in an aerobics instructor31-5J Foot Ankle Surg361Adult Dancing/injuries Female Fractures/diagnosis/etiology Humans Osteonecrosis/*etiology/therapy Sesamoid Bones/injuries/*pathology/surgeryJan-Feb1Osteonecrosis of the sesamoids is a fairly uncommon clinical entity. The development of this condition involving both sesamoids has never been presented in the American literature. After extirpation of the sesamoids and interdigital fusion, the patient returned to her regular activities, including dance.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9031025 &1067-2516 Case Reports Journal Article9031025^Department of Podiatric Medicine, Gundersen/Lutheran Medical Center, LaCrosse, Wisconsin, USA.F~?MGKanatli, U. Ozturk, A. M. Ercan, N. G. Ozalay, M. Daglar, B. Yetkin, H.2006LAbsence of the medial sesamoid bone associated with metatarsophalangeal pain Clin AnatFeb 27iPain at the first metatarsophalangeal (MTP) joint can result from inflammation, chondromalacia, flexor hallucis brevis tendinitis, osteochondritis dessecans, fracture of a sesamoid bone, avascular necrosis of sesamoids, inflamed bursae, intractable keratoses, infection, sesamoiditis, gout arthropathy, and rheumatoid arthritis. Congenital absence of a sesamoid bone is extremely rare. We present a 17-year-old male patient with pain at the plantar aspect of the right MTP joint associated with congenital absence of the medial sesamoid. There was tenderness and the range of motion was minimally restricted. He described the pain as necessitating changes in his social life. On radiographs, the medial hallucial sesamoid was absent on the right side. The MTP joint was also evaluated using magnetic resonance imaging (MRI). A metatarsal pad was prescribed and the patient was satisfied with the treatment at the 2 months follow-up period. MRI revealed no pathological tissue at the medial sesamoid site. Hallucial sesamoids absorb pressure, reduce friction, protect the tendons, act like a fulcrum to increase the mechanical force of the tendons, and provide a dynamic function to the great toe by elevating first metatarsal head. Congenital absence of these bones is very rare but we must consider it in a patient with MTP joint pain. Clin. Anat. 19:, 2006. (c) 2006 Wiley-Liss, Inc.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16506237 !0897-3806 (Print) Journal article16506237LDepartment of Orthopedics and Traumatology, Gazi University, Ankara, Turkey. ~?N>Lee, S. James, W. C. Cohen, B. E. Davis, W. H. Anderson, R. B.2005ZEvaluation of hallux alignment and functional outcome after isolated tibial sesamoidectomy803-9Foot Ankle Int2610OctBACKGROUND: Functional loss and clinical evidence of hallux malalignment have been reported to follow isolated tibial sesamoidectomy. METHODS: Thirty-two patients with isolated tibial sesamoidectomies were identified. Patients with a diagnosis of peripheral neuropathy, diabetes mellitus, inflammatory arthropathy or previous foot surgery were excluded as were patients who had concomitant joint realignment procedures. Twenty patients were available for followup with the Short Form-36 (SF-36), Foot Function Index (FFI) disability scale, visual analog scale (VAS), and questionnaire at an average of 62 (range 10 to 157) months after surgery. Fourteen patients returned for physical examination, radiographs, and pedographic and isokinetic examination. RESULTS: Physical examination of the 14 patients did not reveal any significant change in clinical alignment, range of motion or tenderness. Preoperative and postoperative comparison radiographs did not reveal significant differences in the intermetatarsal (IM) angle, hallux valgus (HV) angle distal metatarsal articular angle (DMAA), or sesamoid alignment (sesamoid station). Postoperative outcome measurements (VAS, SF36, and FFI) for 20 patients found significant relief of pain and improved functional outcome. Computerized dynamic pedographic measurements (Performance Orthotic) for 12 patients did not reveal any altered plantar pressures in the region of the hallux metatarsophalangeal joint. Isokinetic measurements of ankle plantar flexion push-off strength in eight patients did not reveal significant differences in side-to-side measurements. Eighteen of 20 (90%) patients indicated that they were able to resume all preoperative activities; six (30%) had extreme difficulty or an inability to stand on tip toe, but this did not impact their activities of daily living or their athletic endeavors. Two patients (14.3%) developed transfer metatarsalgia, but only one was symptomatic. CONCLUSION: Isolated tibial sesamoidectomy is a safe and effective treatment for recalcitrant tibial sesamoiditis. Hallux malalignment and deformity resulting in functional loss and change in hallux alignment can be avoided by meticulous surgical technique with repair of the soft tissues.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16221451 1071-1007 Journal Article16221451Rush University Medical Center, Orthopaedic Surgery, 1725 W. Harrison Street, Suite 1063, Chicago, IL 60612, USA. simon.lee@rushortho.com|~?OOloff, L. M. Schulhofer, S. D.1996Sesamoid complex disorders497-513Clin Podiatr Med Surg133Diagnosis, Differential Foot Injuries/diagnosis/etiology Fractures, Bone/complications/diagnosis *Hallux Humans *Metatarsophalangeal Joint Osteonecrosis/diagnosis/etiology *Sesamoid Bones/abnormalities/anatomy & histology/injuries Tendinopathy/diagnosisJulDisorders of the hallux sesamoids and associated soft-tissue structures are commonly seen. With a differential diagnosis consisting of no fewer than 30 conditions, establishing an accurate diagnosis can be challenging but is important to appropriate treatment implementation. An understanding of first metatarsophalangeal joint anatomy, function, and current diagnostic technology aids the practitioner in the diagnosis and successful treatment of these often overlooked and anecdotally managed disorders.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8829038 (0891-8422 (Print) Journal Article Review8829038_Department of Functional Restoration, Stanford University Hospital, Palo Alto, California, USA.~?P^Ozkoc, G. Akpinar, S. Ozalay, M. Hersekli, M. A. Pourbagher, A. Kayaselcuk, F. Tandogan, R. N.2005EHallucal sesamoid osteonecrosis: an overlooked cause of forefoot pain277-80J Am Podiatr Med Assoc953Adult Female Forefoot, Human *Hallux Humans Male Middle Aged Osteonecrosis/*complications/surgery Pain/etiology Sesamoid Bones/*pathology/surgeryMay-JunxFour cases of osteonecrosis of hallucal sesamoids are reported here. Surgical excision of necrotic sesamoid tissue yielded satisfactory results, with the patients reporting no residual pain. Although it has not been frequently addressed in the literature, avascular necrosis of the sesamoid bones should be considered in the differential diagnosis of persistent forefoot pain.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15901816 &8750-7315 Case Reports Journal Article15901816pDepartment of Orthopedics and Traumatology, Baskent University School of Medicine, Adana Medical Center, Turkey.~?Q?Perez Carro, L. Echevarria Llata, J. I. Martinez Agueros, J. A.1999=Arthroscopic medial bipartite sesamoidectomy of the great toe321-3 Arthroscopy153Adult Arthralgia/etiology/radiography/surgery Arthrography *Arthroscopy Endoscopy/*methods Female Follow-Up Studies Humans Metatarsophalangeal Joint/radiography/*surgery Sesamoid Bones/*surgery Toes/*surgeryAprThis is the first report of a successful first metatarsophalangeal joint medial bipartite sesamoidectomy using great toe arthroscopy. The surgical trauma associated with open operative sesamoidectomy can be minimized using minimally invasive techniques under arthroscopic control. The authors describe the surgical principles and discuss the advantages compared with traditional surgery.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10231114 &0749-8063 Case Reports Journal Article10231114@Servicio de Traumatologia, Hospital de Laredo, Cantabria, Spain.b~?RRichardson, E. G.19995Hallucal sesamoid pain: causes and surgical treatment270-8J Am Acad Orthop Surg743Athletic Injuries/etiology/radiography/*surgery Fractures, Stress/etiology/radiography/surgery Hallux/*injuries/radiography/surgery Hallux Valgus/etiology/radiography/*surgery Humans Osteochondritis/etiology/radiography/surgery Pain/*etiology/radiography/surgery Sesamoid Bones/*injuries/radiography/surgeryJul-AugThe hallucal sesamoids, although small and seemingly insignificant, play an important role in the function of the great toe by absorbing weight-bearing pressure, reducing friction, and protecting tendons. However, the functional complexity and anatomic location of these small bones make them vulnerable to injury from shear and loading forces. Injury to the hallucal sesamoids can cause incapacitating pain, which can be devastating to an athlete. Although traumatic injuries usually can be diagnosed easily, other pathologic conditions may be overlooked. Careful physical and radiologic examinations are necessary to determine the cause of pain and allow a recommendation of the optimal treatment. Surgical treatment may include partial or complete resection of the sesamoid, shaving of a prominent tibial sesamoid, or autogenous bone grafting for nonunion. Excision of both sesamoids should be avoided if possible.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10434081 11067-151x Journal Article Review Review, Tutorial10434081YDepartment of Orthopaedic Surgery, University of Tennessee/Campbell Clinic, Memphis, USA.~?SRiley, J. Selner, M.20019Internal fixation of a displaced tibial sesamoid fracture536-9J Am Podiatr Med Assoc9110Accidents, Traffic Adolescent Bone Wires Dislocations/radiography/*surgery Female Follow-Up Studies Fracture Fixation, Internal/*methods Fracture Healing/physiology Humans Sesamoid Bones/*injuries/radiography Tibial Fractures/radiography/*surgery Treatment OutcomeNov-DecThe authors present a surgical technique for the preservation and repair of an acutely fractured sesamoid using internal fixation of the sesamoid. A case report demonstrating the technique for the open reduction and internal fixation of a fractured tibial sesamoid is presented. The authors recommend this procedure as a viable alternative to surgical excision of the tibial sesamoid. The use of the procedure as an adjunct for the surgical treatment of recalcitrant traumatic sesamoiditis is also discussed.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11734611 &8750-7315 Case Reports Journal Article11734611HKaiser Permanente Orthopedics Department, Woodland Hills, CA 91365, USA.~?TSaxena, A. Krisdakumtorn, T.2003JReturn to activity after sesamoidectomy in athletically active individuals415-9Foot Ankle Int245Adolescent Adult Aged Athletic Injuries/rehabilitation/surgery Comparative Study Female Fibula Humans Male Methods Middle Aged Postoperative Complications Sesamoid Bones/*surgery *Sports TibiaMayySesamoidectomy of the first metatarsophalangeal joint in athletically active patients may be indicated in cases of chronic sesamoiditis resistant to nonsurgical care or symptomatic displaced fractures or nonunion. Painful scar, hallux deviation, and delayed return to activity are all potential complications. These need to be considered especially when performing surgery in the athletically active individual. Twenty-six sesamoidectomies in 24 patients (21 females and 3 males) were reviewed for type of sesamoidectomy, incision location, time to return to activity, and complications. Mean age was 35.4 years (range, 16-68 years) with mean follow-up 86.4 months. Eleven athletes (defined as professional or varsity level sports) operated on had a mean return to activity of 7.5 weeks (range, 4-10 weeks), while 13 "active" patients had a mean return to activity of 12.0 weeks. This difference was statistically significant using the t-test, (p < .02). There were 10 fibular and 16 tibial sesamoids excised. Complications included one hallux varus and two cases of postoperative scarring with neuroma-like symptoms, all associated with fibular sesamoidectomy; there was one case of hallux valgus deformity with tibial sesamoidectomy. Despite the functional importance of tibial and fibular sesamoids, athletically active individuals can return to sports after a sesamoidectomy as early as 7.5 weeks.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12801198 1071-1007 Journal Article12801198eDepartment of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA. HeySax@aol.com~?UTalbot, K. D. Saltzman, C. L.1998>Assessing sesamoid subluxation: how good is the AP radiograph?547-54Foot Ankle Int198Comparative Study Dislocations/physiopathology/*radiography Evaluation Studies Hallux Valgus/physiopathology/*radiography Humans Radiography/standards Reproducibility of Results Rotation Tarsal Bones/*injuries/physiopathology/*radiographyAugSubluxation of the metatarsosesamoid joints frequently occurs with the development of hallux valgus deformity, and the restoration of a normal metatarsosesamoid articulation has been proposed as essential for achieving a biomechanically sound operative result. The position of the sesamoid bones on the AP radiograph is used often to assess the pre- and postoperative relationship between the hallucal sesamoids and the metatarsal sulci. We evaluated the validity of this approach. Thirty subjects with hallux valgus and 30 control subjects participated in this study by undergoing both AP and tangential weightbearing radiographs. The sesamoid station on the AP radiographs was compared with the position of the sesamoids on tangential radiographs, using a new continuous measure to estimate subluxation. In approximately half of the cases, we found a difference between the apparent sesamoid station on the AP radiograph and the true position on the tangential one. Increased metatarsal rotation was associated with misclassification of the sesamoid station on the AP radiograph. We conclude that the standard method for measuring the sesamoid station on the AP radiograph is not valid. Surgeons wishing to evaluate the metatarsosesamoid joint should obtain weightbearing tangential radiographs.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9728703 !1071-1007 (Print) Journal Article9728703LDepartment of Orthopaedic Surgery, University of Iowa, Iowa City 52242, USA.K~?V=Toussirot, E. Jeunet, L. Michel, F. Kantelip, B. Wendling, D.2003VAvascular necrosis of the hallucal sesamoids update with reference to two case-reports307-9Joint Bone Spine704Adult Crutches Female *Hallux Humans Magnetic Resonance Imaging Male Middle Aged Osteonecrosis/*pathology/radiography/therapy Sesamoid Bones/*pathology/radiography/surgery Tomography, X-Ray ComputedAugWe report two cases of nontraumatic metatarsal pain with sclerosis and fragmentation of the lateral sesamoid bone on roentgenographs and computed tomography images. One patient underwent magnetic resonance imaging (MRI), which showed low signal from the sesamoid bone. These imaging findings suggested osteonecrosis. Histology of the sesamoidectomy specimen confirmed this diagnosis in one patient. Avascular necrosis of the metatarsal sesamoid is an uncommon disorder. The suggestive roentgenographic and MRI findings rule out the other painful conditions of the sesamoid bone. The features are reviewed and the treatment options discussed.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12951318 &1297-319x Case Reports Journal Article12951318Rheumatology department, CHU Hopital Jean-Minjoz, boulevard Fleming, 25030 Besancon, cedex, France. eric.toussirot@ufc-chu.univ-fcomte.fr~?WLin, C. F. Su, F. C. Wu, H. W.2005>Ankle biomechanics of ballet dancers in releve en pointe dance23-35Res Sports Med131oAdult Ankle Joint/*physiology Biomechanics Dancing/*physiology Humans Laterality/physiology Movement/physiologyJan-MarThe objective of this study was to study the ankle biomechanics in releve en pointe of ballet dancers and to investigate the symmetry between dominant and nondominant sides. A three-dimensional motion analysis system and two force platforms were used to collect segmental motion and ground reaction force data during releve en pointe dancing. Thirteen ballet dancers, each of whom had over 5 years' dance experience (11.37 +/- 3.9 years), were recruited for this study. The results showed that ankle movement patterns were highly correlated (ICC = 0.99) in bilateral comparisons, but only moderate correlation was found in ankle joint moment patterns (ICC = 0.66). The nondominant ankle showed the same excursion patterns, but different joint moments, when compared to the dominant ankle in releve en pointe. The indication was that the two ankle joints may play different roles in controlling balance and movements throughout the entire period of the dance movements. Ankle bionmechanical patterns of the fiundamental ballet dance movement, releve en pointe, also were constructed in this study to help interpret and understand the bilateral ankle joint excursion pattern.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16389884 !1543-8627 (Print) Journal Article16389884TInstitute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan. 2~?XKoutedakis, Y. Sharp, N. C.2004jThigh-muscles strength training, dance exercise, dynamometry, and anthropometry in professional ballerinas714-8J Strength Cond Res184Adult Analysis of Variance Anthropometry Biomechanics Dancing/*physiology Female Humans Muscle, Skeletal/*physiology Physical Education and Training/*methods Thigh/*physiology TorqueNovpThe purpose of the present study was to assess the effects of 12 weeks of quadriceps and hamstring strength training on torque levels after a dance exercise and on selected anthropometric parameters. The sample consisted of 22 (ages, 25 +/- 1.3 years) full-time professional ballerinas who were randomly assigned into experimental (n = 12) and control (n = 10) groups. A dance routine designed to cause fatigue within 5 minutes, isokinetic dynamometry, and anthropometric assessments were conducted before and after strength training in both groups. Before strength training, the dance routine resulted in significant reductions of hamstring (p < 0.001) and quadriceps (p < 0.001) peak torques in both subject groups. However, after strength training, only control subjects demonstrated such torque decrements (p < 0.001) after the dance routine. Furthermore, the experimental group revealed greater knee extension (119 vs. 138 N.m; p < 0.001) and flexion (60 vs. 69 N.m; p < 0.001) torques, smaller sum of skinfolds (33.6 vs. 27.8 mm; p < 0.01), more fat-free mass (37.7 vs. 39.4 kg; p < 0.05), but unchanged body mass (p > 0.05) and thigh circumferences (p > 0.05). A negative relationship (p < 0.001) was found between initial strength levels and improvements measured at the end of the 12-week program. These results suggest that supplementary strength training for hamstring and quadriceps muscles is beneficial to professional ballerinas and their dancing; weaker individuals are more likely to benefit from such regimens than their stronger counterparts, whereas increases in thigh-muscle strength do not alter selected aesthetic components.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15574072 D1064-8011 Clinical Trial Journal Article Randomized Controlled Trial15574072~School of Sport, Performing Arts, and Leisure, University of Wolverhampton, West Midlands, United Kingdom. y.koutedakis@uth.gr &~?YSSteinberg, N. Hershkovitz, I. Peleg, S. Dar, G. Masharawi, Y. Heim, M. Siev-Ner, I.2006qRange of joint movement in female dancers and nondancers aged 8 to 16 years: anatomical and clinical implications814-23Am J Sports Med345MayBACKGROUND: Little data are available on changes that occur with age in joint range of motion in dancers and nondancers. HYPOTHESIS: In dancers, joint range of motion will increase with age, whereas it will decrease in nondancers, independent of the joint studied. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: The study population included 1320 female dancers, aged 8 to 16 years, who participated in different types of dancing classes (classical ballet, modern dance, jazz, etc) and 226 nondancers of similar age. Range of motion was measured for the hip, knee, ankle, foot, and spinal joints. RESULTS: The pattern of differences in range of motion with age varied in different joints and types of movement. (1) For combined ankle and foot plantar flexion (pointe), ankle plantar flexion, and hip external rotation, there was no change in range of motion in dancers, whereas range of motion diminished with age in the nondancers. (2) For ankle dorsiflexion, neither group showed any change with age, and range of motion was significantly greater in the nondancer group. (3) For knee flexion, hip flexion, and hip internal rotation, range of motion decreased with age in both groups. (4) For hip abduction, range of motion decreased with age in dancers and remained constant in the nondancers. (5) For hip extension, range of motion increased in both groups. (6) For lower back and hamstrings, range of motion increased among dancers with age and remained constant among nondancers. CONCLUSION: Dancers and teachers should realize that passive joint range of motion is unlikely to improve with age. Therefore, the major goal of a dancing program should focus on exercises that retain the natural flexibility of the dancers' joints rather than trying to improve them.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16382012 !0363-5465 (Print) Journal Article16382012Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel. knopp@wincol.ac.il?Z Thomas, K.S.2003`Functional eleve performance as it applies to heel-rises in performance-level collegiate dancers115-20#Journal of Dance Medicine & Science74In the evaluation of functional plantar flexor strength the ability to perform 25 single leg, standing heel-rises has been established as the clinical standard for a grade of "normal." Dancers, as a population, typically perform plantar flexion repeatedly in their training in an action known as eleve and releve. This increased use of plantar flexion formed the basic hypothesis that dancers may have an increased ability to perform repetitive heel-rises, and therefore need a higher standard in order to be considered "normal" and ready to return to daily dancing activity. Ninetyseven dancers from the performance companies at Brigham Young University performed maximal repetitions of standing heel-rises. A number of variables including dance genres, gender, regular menstrual cycle, cross-training in other genres, which leg went first, leg dominance, muscular fatigue location and previous injury to lower leg, ankle, or foot were included in the analysis. The mean value for maximal number of heel-rises performed by the 97 dancers was 33 (SE 0.83; range 17 to 100). When examined by genre, the values were as follows: ballet (mean 25, SE 3.72), ballroom (mean 25, SE 3.73), folk (mean 33, SE 3.64), modern (mean 26, SE 3.82), other (mean 31, SE 4.52). The data was also analyzed as repetitions per kilogram. Significant differences were found between the dance genres, cross-training in other genres, and regular menstrual cycles. Gender was only significant in the repetitions per leg and insignificant when the data was adjusted for body weight. Which leg went first, leg dominance, muscular fatigue location, and history of previous injury to the lower limb were found to be insignificant.GDance Medicine Training Facility, Brigham Young University, Provo, Utah?[ Welsh, T.M.2003'A primer on measuring dancer capacities5-9#Journal of Dance Medicine & Science71The reliable, valid, and sensitive measurement of dancer capacities is essential to dance medicine and science research, clinical practice, and dancer training. The unique nature of dance and the unusual demands it places on dancers present special challenges for measuring dancer capacities. The contributions in this and the next issue review measurement strategies for several capacities important to dancers. This article describes measurement characteristics common to the variety of disciplines encompassed by dance medicine and science. It concludes with a description of possible benefits for evolving standardized measures of important dancer capacities.xAssociate Professor of Dance, Dance Department, Florida State University, 201 Montgomery Gym, Tallahassee, FL 32306-2120?\#Shah, S. Luftman, J. Vigil, D.V.2005GStress injury of the talar dome and body in a ballerina: a case report.91-5#Journal of Dance Medicine & Science93-4Talar stress injury was diagnosed in a 16-year-old ballerina who frequently danced en pointe, a position in which the subtalar joint is locked with the heel and forefoot in varus position. After completing a 6-week non-weightbearing period as prescribed, the patient wore a removable walker boot for 2 weeks. During this period, she underwent nonweightbearing exercise and symptoms resolved. She avoided prohibited movements for 2 weeks; during the next 6 months, she gradually returned to full dance activity. When last seen at follow-up 4 months later, the patient remained pain-free. During en point dancing, the force of full weightbearing is probably transmitted through the talus and thus predisposes it to stress fracture from repetitive loading. ~?]De Marco, R. J.2006How bees tune their dancing according to their colony's nectar influx: re-examining the role of the food-receivers' ;eagerness'421-32 J Exp Biol209Pt 3Feb 1Apis mellifera bees perform dances to communicate the presence of desirable nectar sources. The regulation of these dances does not depend exclusively on properties of the nectar sources, but also upon certain stimuli derived from the foraging status of the colony as a whole; i.e. bees exploiting a source of constant profitability are more likely to dance when the colony's nectar intake rate is low. Based on these stimuli, individual bees tune their dances according to their colony's nectar influx without visiting alternative nectar sources. Division of labour, in addition, is a common feature in honeybees. Upon returning to the nest, successful foragers transfer the content of their crops to food-receivers by means of a common behaviour in social insects called trophallaxis, i.e. the transfer of liquid food by mouth. Martin Lindauer stated that a returned forager may sense the foraging status of its colony on the basis of the food transfer process by computing how quickly and eagerly the food-receivers unload its crop. This study focuses on the forager's experience during the food transfer process, its variability based on the colony's nectar influx, and the separate effects that the ;ease' and the ;eagerness' of the food-unloading have on the tuning of recruitment dances. Results indicate that foragers can rapidly sense variations in the colony's nectar influx, even when they experience no variation in the time interval between their return to the hive and the beginning of the food transfer. To accomplish this task they appear to use stimuli derived from the number of food-receivers, which enable them, in turn, to set their dance thresholds in relation to the nectar influx of their colony. The relevance of these findings is discussed in the context of communication and successful foraging.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16424092 !0022-0949 (Print) Journal Article16424092Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Pb. II, Ciudad Universitaria, C1428EHA, Buenos Aires, Argentina.~?^Cooper, M. E. Wolin, P. M.1999aOs trigonum syndrome with flexor hallucis longus tenosynovitis in a professional football refereeS493-6Med Sci Sports Exerc317 SupplAdult Ankle Injuries/*diagnosis/etiology/*therapy Diagnosis, Differential Humans Male Occupational Diseases/*diagnosis/etiology/*therapy Pain/etiology Syndrome *Talus Tenosynovitis/*diagnosis/etiology/*therapyJulTThe presentation of posterior ankle pain in any patient poses a diagnostic dilemma. The os trigonum syndrome and flexor hallucis longus stenosing tenosynovitis have been reported to occur in professional and amateur ballet dancers. It is important to consider these diagnoses in a patient who is not a dancer, as is shown in the case presented here. The patient in this case is a professional referee who injured his ankle while working on artificial turf. The treatment for os trigonum syndrome and flexor hallucis longus tenosynovitis is initially conservative, but in refractory cases, surgical removal of the os and release of the flexor hallucis longus tendon can be successfully performed. This is the first reported case of os trigonum syndrome and flexor hallucis longus tenosynovitis presenting simultaneously in a patient who is not a dancer.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10416550 .0195-9131 (Print) Case Reports Journal Article10416550`Department of Orthopaedic Surgery, The University of Illinois at Chicago, USA. mracooper@aol.com?_2Femino, J.E. Trepman, E. Chisholm, K. Razzano, L.2000bThe role of the flexor hallucis longus and peroneus longus in the stabilization of the ballet foot86-89%Journal of Dance and Medicine Science436The importance of the flexor hallicis longus (FHL) and peroneus longus tendons in the stabilization of the subtalar joint and the longitudinal arch of the foot was demonstrated in 8 fresh-frozen human cadaver foot and ankle specimens. Dissection of the foot was done to transect stabilizing structures including joint capsule and periarticular ligaments of the medial side of the subtalar, talonavicular, navicular-first cueiform, and first metatarsalcuneiform joints; the subtalar ligaments in the sinus tarsi and the lateral sapsule of the middle subtalar facet were also transected. The FHL and peroneus longus tendons were isolated and the specimen fixed to a frame. Without any tenson on the FHL and peroneus longus tendons, the foot was supple and unstable. With tension applied to the FHL tendon alone, the boney arch of the foot became rigid, with inversion of the subtalar joint, rising of the longitudinal arch, plantarflexion of the forefoot, and slight adduction of the forefoot. With tension applied to the peroneus longus tendon alone, the boney arch of the foot became rigid, with eversion of the subtalar joint, rising of the longitudinal arch, plantarflexion of the forefoot, and abduction of the forefoot. With tension applied to both the FHL and peroneus longus tendons synchronously, the boney arch rose and became rigid, with plantar flexion and neutral abduction-adduction position of the forefoot. When additional tension was applied to the peroneus longus, the rigid foot assumed a locked position in mild hindfoot eversion and forefoot abduction. These qualitative observations are consistent with the hypothesis that the FHL and peroneus longus are important stabilizers of the foot in dance (demi-pointe and pointe) and soccer (kick) and may provide an explanation for injury of these tendons with these activities.~?`.Hamilton, W. G. Geppert, M. J. Thompson, F. M.1996dPain in the posterior aspect of the ankle in dancers. Differential diagnosis and operative treatment1491-500J Bone Joint Surg Am7810]Adolescent Adult Ankle Joint/*surgery Cumulative Trauma Disorders/diagnosis/*surgery *Dancing Diagnosis, Differential Employment Follow-Up Studies Humans Joint Diseases/diagnosis/surgery Pain/etiology Patient Satisfaction Postoperative Care Postoperative Complications Retrospective Studies Tenosynovitis/diagnosis/etiology/surgery Treatment OutcomeOctA retrospective review was performed of the results of operative treatment of stenosing tenosynovitis of the flexor hallucis longus tendon or posterior impingement syndrome, or both, in thirty-seven dancers (forty-one operations). The average duration of follow-up was seven years (range, two to thirteen years). The results were assessed with use of a questionnaire for all patients, and a clinical evaluation was performed for twenty-one patients (twenty-two ankles). Twenty-six operations were performed for tendinitis and posterior impingement; nine, for isolated tendinitis; and six, for isolated posterior impingement syndrome. A medial incision was used in thirty-three procedures; a lateral incision, in six; an anterior and a medial incision, in one; and a lateral and a medial incision, in one. Thirty ankles had a good or excellent result; six, a fair result; and four, a poor result. (The result of the second procedure on an ankle that was operated on twice was not included.) The result was good or excellent for twenty-eight of the thirty-four ankles in professional dancers, compared with only two of the six ankles in amateur dancers.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8876576 !0021-9355 (Print) Journal Article88765762St. Luke's-Roosevelt Hospital, New York City, USA. ~?a9Jaffee, N. W. Gilula, L. A. Wissman, R. D. Johnson, J. E.2001GDiagnostic and therapeutic ankle tenography: outcomes and complications365-71AJR Am J Roentgenol1762Ankle Joint/*radiography Follow-Up Studies Humans Questionnaires Tendons, Para-Articular/*radiography Tenosynovitis/*radiography/therapyFebOBJECTIVE: The purpose of our study was to evaluate tenography complications and outcomes in a large series. MATERIALS AND METHODS: Of 144 tenograms obtained consecutively from May 5, 1995, to March 17, 1997, 111 were located for at least a 6-month follow-up; 65 were posterior tibial, 39 peroneal, two anterior tibial, three flexor digitorum longus, and two flexor hallucis longus tenograms. Tenography was performed fluoroscopically with contrast material and anesthetic followed by steroid placement into tendon sheaths. RESULTS: Of 65 patients undergoing posterior tibial tenography, 31 (48%) had complete or near-complete symptom resolution; 17 (26%) had no relief. Seventeen patients (26%) had initial relief with the subsequent return of pain to the pretenography level. Of 39 patients undergoing peroneal tenography, 18 (46%) had complete or near-complete symptom resolution; 10 (26%) had no and 11 (28%) had initial relief with subsequent pretenography pain return. Of three patients undergoing flexor digitorum longus tenography, one had complete, one had no, and one had initial relief with complete pretenography pain return. One of two patients who underwent flexor hallucis longus tenography had no relief; the other had initial relief with complete pain return. Two patients who underwent anterior tibial tenography had complete pain relief. We found no correlation between degree of tenosynovitis shown radiographically and therapeutic improvement with anesthetic and steroid injection. Tenography complications included one posterior tibial tendon rupture (0.89%) and 14 patients with skin discoloration at the tendon sheath injection site. CONCLUSION: Forty-seven percent of surgical candidates whose condition was refractory to conservative therapy had complete or near-complete prolonged symptom relief after tenography. In appropriate patients, tenography is excellent therapy for tenosynovitis. Certain precautions make complications rare.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11159075 !0361-803X (Print) Journal Article11159075USouthwest Radiology Associates, 1200 Postoak Blvd., Ste. 426, Houston, TX 77056, USA. ~?b+Kolettis, G. J. Micheli, L. J. Klein, J. D.1996>Release of the flexor hallucis longus tendon in ballet dancers1386-90J Bone Joint Surg Am789Adolescent Adult Ankle/physiopathology/*surgery Comparative Study Constriction, Pathologic/etiology/physiopathology/rehabilitation/surgery *Dancing/injuries Female Follow-Up Studies Foot/*surgery Humans Methods Pain/physiopathology Physical Therapy Modalities Postoperative Care Retrospective Studies Subtalar Joint/physiopathology Tendons/physiopathology/*surgery Tenosynovitis/etiology/physiopathology/rehabilitation/*surgery Treatment Outcome Weight-BearingSepThirteen female ballet dancers had an operative release of the flexor hallucis longus tendon because of isolated stenosing tenosynovitis, and the results were reviewed after a mean duration of follow-up of six years and six months (range, two to ten years). All of the patients danced at the advanced or professional level, and all had failed to respond to non-operative management. The mean age of the patients at the time of the operation was twenty years (range, thirteen to twenty-six years). Symptoms, which included pain and tenderness over the medial aspect of the subtalar joint, had been present for a mean of six months (range, two to twelve months) preoperatively and were exacerbated by jumping and by attempts to perform en pointe work. Crepitus was present in six patients, and triggering was present in three. No patient had evidence of a symptomatic os trigonum. Postoperatively, all patients participated in a formal physical-therapy program for a mean of nine weeks (range, four to thirteen weeks). All patients returned to dancing, within a mean of five months (range, two to nine months), and eleven reached a level of full participation in dancing without restriction. At the time of the most recent follow-up, all patients noted improvement compared with the pre-operative condition. Eight patients were professional ballet dancers, four were students at advanced ballet schools, and one had stopped performing ballet for reasons unrelated to the tenosynovitis of the flexor hallucis longus. In addition, two of the students had decided not to pursue careers in dancing because of persistent, but greatly diminished, symptoms. No complications were noted in this series. We concluded that an operative release of the flexor hallucis longus is effective for the treatment of isolated stenosing tenosynovitis in female ballet dancers who place high demands on the foot and ankle and for whom non-operative treatment has failed.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8816655 !0021-9355 (Print) Journal Article88166556Children's hospital, Boston, Massachusetts 02115, USA. ~?c5Na, J. B. Bergman, A. G. Oloff, L. M. Beaulieu, C. F.2005oThe flexor hallucis longus: tenographic technique and correlation of imaging findings with surgery in 39 ankles974-82 Radiology2363Adolescent Adult Aged Ankle Joint/*radiography/surgery Female Humans Male Middle Aged Pain/etiology Retrospective Studies Tendons, Para-Articular/*radiography/surgery Tenosynovitis/*radiography/surgerySep`PURPOSE: To examine the use of tenography for evaluation of the flexor hallucis longus (FHL) sheath. MATERIALS AND METHODS: Institutional review board approval was waived, patient consent was obtained, and the study was HIPAA compliant. Retrospective review of 192 FHL tenograms and associated surgical records identified 39 ankles in 37 patients (17 male, 20 female; mean age +/- standard deviation, 38 years +/- 13.8; range, 14-68 years) in which both tenography and surgery had been performed. Two radiologists reviewed tenographic findings, including contrast agent extravasation, synovial irregularity, stenosis, fibrous bands, sheath outpouching, extent of opacification, and communications with adjacent structures. Alterations in pain after anesthesia of the tendon sheath were also recorded. Surgical reports were reviewed. RESULTS: Thirty-four of 39 tenograms were diagnostic. Some extravasation occurred in nine (45%) of 20 injections with an initial injection method and in two (11%) of 19 with a new injection technique. Synovial irregularity was present in all 34 studies (15 mild, 16 moderate, three severe). Stenoses were identified in 23 (68%) of 34 ankles, fibrous bands were seen in 16 (47%) of 34 ankles, and outpouching of the sheath above a stenosis was present in 13 (38%) of 34 ankles. Communication of the FHL sheath with the ankle, flexor digitorum longus, or subtalar joint occurred in half the cases. Most patients with pain reported relief; relief was complete (100% reduction from preprocedural pain) in eight of 27, moderate (50%-90% reduction) in nine of 27, and mild (<50% reduction) in eight of 27 patients. CONCLUSION: Tenography of the FHL sheath produced diagnostic images in almost all patients and effectively demonstrated abnormalities of the tendon sheath. Pain relief with anesthetic injection helped confirm the FHL sheath as the pain generator.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16118172 !0033-8419 (Print) Journal Article16118172rDepartment of Radiology, Stanford University Medical Center, 300 Pasteur Dr, S-056, Stanford, CA, 94305-5105, USA.C?dFNachazel, Kathleen M.J.2002_Mechanism and treatment of tendinitis of the flexor hallucis longus in classical ballet dancers13-15Athletic Therapy Today72Human Kinetics0dancer's tendinitis crepitus clicking triggering March 2002Faulty technique, poor trunk alignment, and repetitive stress can predispose dancers to FHL-tendon injuries. Classic symptoms include crepitus and pain along the line of the FHL as far as the medial longitudinal arch. Testing for the FHL includes having the dancer plantar flex the ankle and flex and extend the great toe with the ankle in a neutral position. For a positive test, there will be triggering, or clicking, in the great toe and crepitus in the FHL posterior to the medial malleolus.~?eOloff, L. M. Schulhofer, S. D.1998"Flexor hallucis longus dysfunction101-9J Foot Ankle Surg3727Adolescent Adult Aged Child Constriction, Pathologic Diagnosis, Differential Female *Foot Foot Diseases/diagnosis/etiology/physiopathology/surgery Humans Male Middle Aged Postoperative Complications Retrospective Studies *Tendons/physiopathology/surgery *Tenosynovitis/diagnosis/etiology/physiopathology/surgeryMar-AprNineteen consecutive cases of flexor hallucis longus stenosing tenosynovitis that underwent operative tenolysis from September 1994 to December 1996 were retrospectively reviewed. This is classically a disorder of ballet dancers, and to a much lesser extent, running athletes. The patients were primarily nonathletic, male, and middle-aged. The mean symptom duration was 20 months, multiple physicians had been encountered, and misdiagnosis was common. Patients presented with overlapping signs and symptoms of flexor hallucis longus tendinitis, plantar fasciitis, and tarsal tunnel syndrome. A cross-reference of patients with posteromedial ankle pain, medial arch pain, and/or a positive Tinel's sign revealed that 14 (74%) and 6 (32%) feet had two of three, or all three signs, respectively. Magnetic resonance imaging and tenography proved valuable in establishing the correct primary diagnosis. Nonoperative protocols were unsuccessful. Flexor hallucis longus tenolysis was successful in each case with a mean return to regular activity at 9 weeks. Flexor hallucis longus stenosing tenosynovitis may be more prevalent than reported and should be a diagnosis of inclusion among all patient populations who present with posterior ankle, medial arch, and/or tarsal tunnel symptoms.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9571456 (1067-2516 (Print) Journal Article Review9571456_Sports Orthopedic and Athletic Rehabilitation Medicine Group (SOAR), Menlo Park, CA 94025, USA..~?f,Petersen, W. Pufe, T. Zantop, T. Paulsen, F.2003Blood supply of the flexor hallucis longus tendon with regard to dancer's tendinitis: injection and immunohistochemical studies of cadaver tendons591-6Foot Ankle Int248Adult Aged Aged, 80 and over Cadaver Dancing/*injuries Female Humans Immunohistochemistry Injections Ink Laminin/analysis Male Middle Aged Tendinopathy/etiology/*physiopathology Tendons/*blood supply/chemistryAugOThe flexor hallucis longus is the most common site of lower extremity tendon disorders in ballet dancers. Reduced vascularity is an important factor contributing to tendon degeneration and rupture under strain. A study was conducted on the vascular pattern of the human flexor hallucis longus tendon with injection techniques and immunohistochemically by using antibodies against laminin. Blood supply arose from the posterior tibial and the medial plantar artery. Peritendinous blood vessels penetrated the tendon and anastomosed with a longitudinally oriented intratendinous network. Injection specimens and immunohistochemistry revealed one avascular zone in which the tendon passed behind the talus and a second in which the tendon wrapped around the first metatarsal head. These are the most typical areas for tendon degeneration and rupture.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12956563 !1071-1007 (Print) Journal Article12956563oDepartment of Orthopaedic Surgery, Christian-Albrechts-University Kiel, Kiel, Germany. wolfpetersen@hotmail.com`~?gSanhudo, J. A.2002QStenosing tenosynovitis of the flexor hallucis longus tendon at the sesamoid area801-3Foot Ankle Int239Constriction, Pathologic *Hallux/injuries Humans Male Middle Aged Sesamoid Bones Tendon Injuries/diagnosis/*surgery Tendons/*surgery Tenosynovitis/*surgerySep5The author presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon at the sesamoid area of the great toe following injury of the hallux. Although stenosing tenosynovitis of the flexor hallucis longus tendon is not rare, occurring frequently in ballet dancers, its entrapment at the sesamoid area was rarely described in the literature. Early recognition of this condition is very important for successful treatment. This patient did not respond to nonoperative treatment and surgical tenolysis was very successful for relief of the symptoms.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12356176 .1071-1007 (Print) Case Reports Journal Article12356176CMae de Deus Hospital, Porto Alegre, RS, Brazil. jsanhudo@uol.com.br~?hSchulhofer, S. D. Oloff, L. M.2002/Flexor hallucis longus dysfunction: an overview 411-8, viClin Podiatr Med Surg193Ankle Foot *Foot Diseases/diagnosis/physiopathology Humans *Muscular Diseases/diagnosis/physiopathology Tendons/physiopathology/surgeryJulWhereas acute and chronic injuries of the tibialis posterior, peroneal and Achilles tendon are frequently encountered, disorders of the flexor hallucis longus tendon are often overlooked, which may contribute to chronic pain and disability. Patients with stenosing tenosynovitis of the flexor hallucis longus tendon frequently present with overlapping signs and symptoms of flexor hallucis longus tendinitis, plantar fasciitis and tarsal tunnel syndrome, which the authors collectively refer to as "flexor hallucis longus dysfunction." A keen awareness of the presenting signs and symptoms and use of ancillary MR imaging and FHL tenography will assist the practitioner in recognizing this commonly misdiagnosed condition.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12379974 (0891-8422 (Print) Journal Article Review12379974schully@nets.com?iShybut, G. Miller, C.2005! "Trigger toe" in a ballet dancer99-102&Medical Problems of Performing Artists202^ Adult *Ballet *Diagnosis, Differential Female *Occupational-Related Injuries/di [Diagnosis] *Occupational-Related Injuries/th [Therapy] *Performing Artists Tendon Injuries/su [Surgery] *Tendon Injuries/di [Diagnosis] *Tendon Injuries/th [Therapy] *Toe Injuries/di [Diagnosis] *Toe Injuries/th [Therapy]ALM is a 36-year-old, white, female ballet teacher who presented with pain and swelling in the right ankle and with flexor weakness in the right great toe. She reports that she has been unable to demonstrate an en pointe position to her class for the past 6 months. She has had pain, weakness, and catching with flexion of the right great toe for the past year. Initially, she attributed the symptoms to new shoes, but even with shoe modifications her symptoms persisted. She reports that her discomfort improves with periods of rest, but with any attempt to return to her normal activities, she develops a large swollen mass behind her medial malleolus and pain with plantar flexion of the toe. In the past, she was able to flex her toe, but it would "stick" which would require her to passively manipulate it in order for it to move again. Now she is unable to actively flex the toe beyond 30 deg. When she initially noted the symptom! s, she sought treatment from her message therapist and for a short time had relief from her pain; but as she returned to dancing, her symptoms recurred. She added herbal supplements, "Pilates" exercises, and contrast therapy without improvement. Over the counter nonsteroidal drugs improved her pain and swelling but not her function. %~?jATamburrini, O. Porpiglia, H. Barresi, D. Bertucci, B. Console, D.1999M[The role of magnetic resonance in the diagnosis of the os trigonum syndrome]462-7Radiol Med (Torino)986Adolescent Adult English Abstract Female Foot Diseases/*diagnosis Humans Hypertrophy/diagnosis *Magnetic Resonance Imaging/methods Male Pain/diagnosis Syndrome Talus/*pathology/radiography Tenosynovitis/diagnosisDec#PURPOSE: We investigated the yield of Magnetic Resonance Imaging (MRI) in hindfoot conditions, particularly the os trigonum syndrome, which are very difficult to diagnose clinically. MATERIAL AND METHODS: We examined 7 consecutive patients complaining of hindfoot pain for more than 4 months (male:female = 1:6; age range 16-22 years, average 18.6). Three patients practiced competitive sports and 4 ballet. We performed conventional radiography (orthogonal projections) and then MRI with a 0.5 T superconductive unit with surface coils; MR images were acquired with T1-weighted spin-echo (SE), T2-weighted gradient-echo (GRE), and fast inversion recovery (FIR) fat-suppressed sequences with 4 mm thickness and 0 mm gap. RESULTS: In 2 cases the os trigonum had irregular margins with subchondral sclerosis and widened synchondrosis. In 3 patients we found flexor hallucis longus tenosynovitis, likely caused by tendon compression and displacement within its sheath; there were neither os trigonum marrow edema nor synchondrosis widening. One patient had os trigonum hypertrophy, mild synchondrosis widening and marrow edema, in the os trigonum and the posterior aspect of talus. One patient had the os trigonum, but no signs referable to the os trigonum syndrome. CONCLUSIONS: In the posterior impingement syndrome, our objective is to show inflammatory changes in the posterior capsule of the ankle joint, adjacent ligaments, tendons and chondrosynovial surface. In these cases, the yield of conventional radiography and CT is rather poor, while MRI provides important information on soft tissues involvement, synovial reaction, chondral and subchondral bone injuries and the association of flexor hallucis longus synovitis, if present. MRI also yields detailed information for correct therapeutic approach. In conclusion, for the (differential) diagnosis of hindfoot pain in clinically suspected os trigonum syndrome, MRI appears to be the technique of choice, after conventional radiography, thanks to its noninvasiveness, multiplanarity, and high spatial and contrast resolution.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10755005 !0033-8362 (Print) Journal Article10755005RIl ruolo della Risonanza Magnetica nella diagnosi della sindrome dell'os trigonum.eDipartimento di Medicina Sperimentale e Clinica, Universita degli Studi Magna Graecia, Catanzaro, CZ.1~?k1Trepman, E. Kadel, N. J. Chisholm, K. Razzano, L.1999GEffect of foot and ankle position on tarsal tunnel compartment pressure721-6Foot Ankle Int2011Adult Ankle/*physiology Biomechanics Cadaver Foot/*physiology Human Models, Biological Pressure Tarsal Tunnel Syndrome/*physiopathology/therapyNovTarsal tunnel intracompartment pressures were determined in 10 fresh-frozen normal human adult cadaver specimens. With the foot and ankle held in mild plantarflexion and neutral eversion-inversion, mean tarsal tunnel pressure was minimal (2 +/- 1 mmHg). However, when the foot and ankle were positioned in full eversion, mean tarsal tunnel pressure increased to 32 +/- 5 mmHg (P < or = 0.005); in full inversion, mean pressure increased to 17 +/- 5 mmHg (P < or = 0.05). There was no significant difference in mean tarsal tunnel pressure between the everted and inverted positions. These results support the hypothesis that increased pressure within the tarsal tunnel when the foot is moved into the everted or inverted position may aggravate posterior tibial nerve entrapment. These findings may also provide an explanation for clinically observed aggravation of symptoms in these positions, night pain, and improvement of symptoms with neutral immobilization in some patients with tarsal tunnel syndrome.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=105828481071-1007 Journal Article10582848cDepartment of Orthopaedic Surgery, New York University, Hospital for Joint Diseases, New York, USA.~?l)van Dijk, C. N. Scholten, P. E. Krips, R.2000WA 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology871-6 Arthroscopy168Adult Ankle/pathology/*surgery Ankle Injuries/diagnosis/surgery Ankle Joint/pathology/surgery Arthroscopy/methods Endoscopy/*methods Female Humans Joint Diseases/diagnosis/surgery Talus/pathology/surgery Tendinopathy/diagnosisNovWe describe a 2-portal endoscopic approach of the hindfoot with the patient in the prone position. By means of this approach, it is possible to visualize and treat a variety of posterior ankle problems. Not only can pathology of the posterior ankle joint and subtalar joint be visualized and treated, but also periarticular pathology, such as calcifications or scar tissue, can be diagnosed and treated. We describe a professional ballet dancer with chronic flexor hallucis longus tendinitis and a posterior ankle impingement syndrome caused by an os trigonum of both ankles. The patient was successfully treated by removing the os trigonum and releasing the flexor hallucis longus tendon. She resumed her professional activities within 2 months after endoscopic treatment.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11078550 31526-3231 (Electronic) Case Reports Journal Article11078550nAcademic Medical Center, Department of Orthopaedic Surgery, Amsterdam, The Netherlands. C.N.vanDijk@amc.uva.nl ~?m7Golomer, E. Guillou, E. Testa, M. Lecoq, C. Ohlmann, T.2005~Contribution of neck proprioception to subjective vertical perception among experts in physical activities and untrained women31-5 Neurosci Lett3811-2Adult Dancing/*physiology Female Head/innervation/physiology Humans Martial Arts/*physiology Neck/innervation/*physiology Physical Fitness/*physiology Posture/*physiology Proprioception/*physiology Visual Fields/*physiology Visual Perception/*physiology Jun 10-17The purpose of this study was to investigate the influence of physical training on subjective vertical perception with the different head positions in order to explore the involving of the neck proprioception. Visual field dependence was assessed using a rod and frame test on women practising judo or dance (international level) or no specific physical activity. Tests were performed with head upright or tilted head to disturb the Z-axis egocentric reference frame. A cluster analysis determined the distribution of visual field independent (VFI) and visual field dependent (VFD) participants. The first result showed no head position effect for the group of judoists (6 degrees +/-5 degrees ; 7 degrees +/-5 degrees ) and dancers (4 degrees +/-2 degrees ; 5 degrees +/-3 degrees ) but a significant effect for untrained participants (5 degrees +/-2 degrees ; 7 degrees +/-3 degrees ): their visual vertical perception was more disturbed with tilted head than with head upright. A variability exists among experts and would necessitate further analysis. The second result showed no influence of the head position for all VFD participants, whereas for VFI participants significant difference between upright and tilted head appeared both for experts (3 degrees +/-1 degrees ; 4 degrees +/-2 degrees ) and untrained participants (3 degrees +/-1 degrees ; 5 degrees +/-2 degrees ). In this research, whatever physical activity level, the VFI participants would mainly use the Z-axis reference frame and rely on proprioceptive information. VFD among experts and VFI among untrained participants suggest that proprioceptive reference frame of neck may not provide alone according the groups an appropriate postural control.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15882785 B0304-3940 Clinical Trial Controlled Clinical Trial Journal Article15882785Laboratoire Cognition et Motricite, UPRES JE 2378, UFR STAPS Paris V, Universite Rene Descartes, 1 rue Lacretelle, 75015 Paris, France. golomer@ccr.jussieu.frM~?n,Golomer, E. Keller, J. Fery, Y. A. Testa, M.2004OUnipodal performance and leg muscle mass in jumping skills among ballet dancers415-8Percept Mot Skills982Absorptiometry, Photon Adolescent *Art Body Mass Index Female Humans Lower Extremity/*physiology Muscle, Skeletal/*physiology Psychomotor Performance/*physiologyAprWe examined the vertical jump performance of each leg among 10 right-footed female ballet dancers with 1 yr. of international professional experience (quadrilles: Opera ballerinas). Their mean age was 17.5 yr. (SD=0.3). The maximal height of the unilateral jump was recorded, and muscle mass was evaluated by biphotonic absorptiometry method. Muscle mass and maximal jump height were similar for the two legs. A strong inverse relation was found between the muscle mass of the right leg (67%) and maximal jump height (r=-.81, p<.01) but not for the left leg. These results highlight a functional asymmetry and the effect of motor laterality in dance.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15141905 !0031-5125 (Print) Journal Article15141905Laboratoire Cognition et Motricite, Unite Fonctionnelle de Recherche en Sciences et Technique des Activites Physiques et Sportives, Universite Pans Rene Descartes, France. golomer@ccr.jussieu.fr?o_Hamilton, D. Aronsen, P. Loken, J.H. Berg, I.M. Skotheim, R. Hopper, D. Clarke, A. Briffa, N.K.2006fDance training intensity at 11-14 years is associated with femoral torsion in classical ballet dancers299-303"British Journal of Sports Medicine40?pLHirsch, N.M. Eisenmann, J.C. Moore, S.J. Winnail, S.D. Stalder, M.A.2003KEnergy balance and physical activity patterns in university ballet dancers.73-9#Journal of Dance Medicine & Science737This study estimates daily energy expenditure (DEE) and the amount and relative intensity of daily activity energy expenditure (AEE) and compares DEE with selfreported daily energy intake (DEI) among university ballet dancers. Three male and eleven female university-level ballet dancers, ranging from 19 to 24 years of age, participated in the study. Daily energy expenditure and physical activity intensity were assessed by minute-to-minute heart rate monitoring during two weekdays and one weekend day. Prior to the assessment of energy expenditure, heart rate-oxygen consumption measurements during sedentary activity and submaximal and maximal exercise were established for each individual. Estimated DEE in male and female dancers was 4,617 +/- 1,244 and 2,945 +/- 823 kilocalories per day (kcals x day[-1]), respectively. Male dancers accumulated 450 +/- 62 min x day[-1] and female dancers accumulated 296 +/- 198 min x day[-1] in moderate-to-very hard physical activity (greater than 50% maximal heart rate). Reported DEI was 1,949 kcals x day[-1] and 938 kcal x day[-1] less than DEE in male and female dancers, respectively (p < 0.05). This information provides a guide to the energy demands of ballet dancers that nutritionists and instructors can use to optimize performance without compromising the health of the dancer.aArapahoe Community College, University Center at Chaparral, 15633 Brookstone Dr, Parker, CO 80134~?q2Peace, K. A. Hillier, J. C. Hulme, A. Healy, J. C.2004\MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases1025-33 Clin Radiol5911Adolescent Adult Ankle Joint/*pathology Bone Marrow Diseases/diagnosis Constriction, Pathologic/diagnosis *Dancing Edema Humans Joint Diseases/*diagnosis Magnetic Resonance Imaging Pain/*etiology Retrospective Studies Syndrome Synovitis/diagnosisNovAIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n = 25). Thickening of the posterior capsule (n = 13) and tenosynovitis of flexor hallucis longus (n = 17) were also common. An os trigonum was an infrequent finding (n = 7). Bone marrow oedema, commonly in the posterior talus (n = 10) or in a patchy distribution (n = 10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15488852 0009-9260 Journal Article15488852dDepartment of Clinical Radiology, Chelsea and Westminster Hospital, London, UK. kalpeace@hotmail.com m~?rMichelson, J. Dunn, L.2005kTenosynovitis of the flexor hallucis longus: a clinical study of the spectrum of presentation and treatment291-303Foot Ankle Int264Adolescent Adult Aged Aged, 80 and over Exercise Therapy Female *Foot Hallux Rigidus/etiology/therapy Humans Male Middle Aged Pain/etiology/therapy Prospective Studies Tendons/*surgery Tenosynovitis/*surgery/therapyAprBACKGROUND: Symptoms associated with flexor hallucis longus (FHL) pathology can manifest themselves anywhere along its length from the posterior leg to the plantar foot and the hallux. This study describes the spectrum of clinical presentations seen with FHL pathology, illustrates the relevant physical examination findings, and outlines a treatment approach. MATERIALS: Computerized medical data was prospectively collected on 81 patients treated between January, 1997 and March, 2002. The 55 females and 26 males had an average age of 38.3 years, with a mean follow-up of 21.3 months. Forty-five of 81 had previous therapy that failed, usually for "plantar fasciitis." Twenty-seven were active athletically and 24 related the onset of symptoms to a specific traumatic episode. Pain was located at the posteromedial ankle in 40, plantar heel in 23, plantar midfoot in 22, and multiple locations in 16. All patients had tenderness of the FHL. Restriction of FHL excursion was demonstrated in 30 patients by limited hallux metatarsophalangeal joint dorsiflexion when the ankle was dorsiflexed ("FHL stretch test"). Thirty-four patients had magnetic resonance imaging of the FHL, 28 (82%) of which were positive for synovitis of the FHL. Treatment included an FHL stretching program, short-term immobilization, and operative decompression and synovectomy in patients for whom nonoperative treatment failed. RESULTS: Of the 58 patients treated nonoperatively, 37 (64%) had successful results. Twenty-three patients had surgery, 20 at the posterior ankle fibro-osseous tunnel, and three in the sesamoid region. All patients treated operatively had successful outcomes. A subset of 10 patients had hallux rigidus symptoms without significant osteophyte formation. All 10 obtained successful results with treatment directed at restoring normal FHL excursion (nine nonoperatively, one by FHL release). This suggests that limited FHL excursion may be an etiology for the development of hallux rigidus. CONCLUSIONS: Clinical syndromes related to the FHL are more frequent than previously reported. The close relationship of the FHL to commonly injured structures (such as the plantar fascia) contributes to significant delays in effective treatment.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15829213 !1071-1007 (Print) Journal Article15829213qDepartment of Orthopaedics, University of Vermont, Stafford 428B, Burlington, VT 05405, USA. OrthoPod@comcast.net\~?sAToledo, S. D. Akuthota, V. Drake, D. F. Nadler, S. F. Chou, L. H.2004BSports and performing arts medicine. 6. Issues relating to dancersS75-8Arch Phys Med Rehabil85 3 Suppl 1Biomechanics Dancing/*injuries/physiology Humans Lower Extremity/*physiopathology Occupational Diseases/diagnosis/etiology/*physiopathology/therapyMarThis self-directed study module highlights biomechanics unique to dance that predispose to common injuries of the lower extremity and discusses preventative strategies. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVE: To summarize lower-limb and back injuries commonly seen in dancers.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15034860 10003-9993 Journal Article Review Review, Tutorial15034860Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, IL 60611, USA. stoledo@rehabchicago.orgP?t5Britton, N.F. Franks, N.R. Pratt, S. C. Seeley, T.D. 2002/Deciding on a new home: how do honeybees agree? 1383-1388 Proceedings: Biological Sciences2692691498 W~?u(Brown, S. Martinez, M. J. Parsons, L. M.2006The neural basis of human dance1157-67 Cereb Cortex168-Adult Biological Clocks/*physiology Brain/*physiology Brain Mapping Dancing/*physiology Female Humans Leg/*physiology Male Motor Cortex/physiology Movement/physiology *Music Proprioception/*physiology Psychomotor Performance/*physiology Research Support, Non-U.S. Gov't Somatosensory Cortex/physiologyAugHuman dance was investigated with positron emission tomography to identify its systems-level organization. Three core aspects of dance were examined: entrainment, meter and patterned movement. Amateur dancers performed small-scale, cyclically repeated tango steps on an inclined surface to the beat of tango music, without visual guidance. Entrainment of dance steps to music, compared to self-pacing of movement, was supported by anterior cerebellar vermis. Movement to a regular, metric rhythm, compared to movement to an irregular rhythm, implicated the right putamen in the voluntary control of metric motion. Spatial navigation of leg movement during dance, when controlling for muscle contraction, activated the medial superior parietal lobule, reflecting proprioceptive and somatosensory contributions to spatial cognition in dance. Finally, additional cortical, subcortical and cerebellar regions were active at the systems level. Consistent with recent work on simpler, rhythmic, motor-sensory behaviors, these data reveal the interacting network of brain areas active during spatially patterned, bipedal, rhythmic movements that are integrated in dance.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16221923 01047-3211 (Print) Clinical Trial Journal Article16221923hResearch Imaging Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.~?vCSacco, K. Cauda, F. Cerliani, L. Mate, D. Duca, S. Geminiani, G. C.2006dMotor imagery of walking following training in locomotor attention. The effect of "the tango lesson"1441-9 Neuroimage323vAdult Attention/*physiology Awareness Brain Mapping Dancing/*physiology Data Interpretation, Statistical Efferent Pathways/physiology Female Foot/physiology Functional Laterality/physiology Humans Image Processing, Computer-Assisted Imagination/*physiology Leg/physiology Locomotion/*physiology Male Motor Cortex/physiology Neuronal Plasticity/physiology Walking/*physiologySepThe hypothesis of this study is that focusing attention on walking motor schemes could modify sensorimotor activation of the brain. Indeed, gait is a learned automated process, mostly regulated by subcortical and spinal structures. We examined the functional changes in the activity of the cerebral areas involved in locomotor imagery tasks, before and after one week of training consisting of physical and mental practice. The aim of the training was to focus the subject's conscious attention on the movements involved in walking. In our training, subjects were asked to perform basic tango steps, which require specific ways of walking; each tango lesson ended with motor imagery training of the performed steps. The results show that training determines an expansion of active bilateral motor areas during locomotor imagery. This finding, together with a reduction of visuospatial activation in the posterior right brain, suggests a decreased role of visual imagery processes in the post-training period in favor of motor-kinesthetic ones.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16861008 Q1053-8119 (Print) Clinical Trial Journal Article Research Support, Non-U.S. Gov't16861008Center for Cognitive Science and Department of Psychology, University of Turin, via Po 12, 10123 Turin, Italy. sacco@psych.unito.it I~?wICastelo-Branco, C. Reina, F. Montivero, A. D. Colodron, M. Vanrell, J. A.2006~Influence of high-intensity training and of dietetic and anthropometric factors on menstrual cycle disorders in ballet dancers31-5Gynecol Endocrinol221BAdolescent Age Factors Amenorrhea/*etiology/physiopathology Anthropometry/methods Body Mass Index Case-Control Studies Comparative Study Dancing/*physiology *Diet Dysmenorrhea/etiology/physiopathology Exercise/*physiology Female Humans Menarche/physiology Oligomenorrhea/*etiology/physiopathology Statistics, NonparametricJanBackground. Intensity of exercise and low energy consumption, specific type and amount of training, early age at initiation, previous menstrual dysfunctions, low body mass index (BMI) or percentage body fat, pathological feeding habits and psychological stress have been suggested as potential factors accountable for menstrual irregularities in female athletes.Aim. To evaluate the influence of intensive training and of dietetic and anthropometric factors on menstrual cycles in female ballet dancers.Method. A case-control study, in which a structured interview and physical examination were carried out in two groups of teenagers aged between 12 and 18 years. The study included a total of 115 adolescent girls distributed in two groups: dancers (group B, n = 38) and girls of the same age not engaged in any sports activity (group C, n = 77).Results. Early starting high-intensity training delayed the onset of menarche ( p < 0.001). Dancers had a higher prevalence of oligomenorrhea and amenorrhea than control girls ( p = 0.004). Additionally, the dancers had lower scores in anthropometric variables: breast circumference 80 cm vs. 86.6 cm for controls ( p = 0.0001), low weight in 18% of dancers vs. 2.6% of controls ( p = 0.0001), and low height in 18% of dancers vs. 9% of controls ( p = 0.016). In addition, in dancers, low BMI was observed in 21% compared with 13% of controls ( p = 0.0001). Finally, 32% of the dancers were on a weight-control diet while this percentage decreased to 12% for the girls in control group (odds ratio = 3.49, 95% confidence interval = 1.31-9.25).Conclusions. In ballet dancers, high-intensity training was associated with late onset of menarche, menstrual disorders, lower weight and height development, and abnormal feeding behaviors.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16522531 !0951-3590 (Print) Journal Article16522531iHospital Clinic, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain. castelo@medicina.ub.es?xChartrand, D. Chatfield, S.J.2005MA critical review of the prevalence of secondary amenorrhea in ballet dancers74-80#Journal of Dance Medicine & Science93-49The literature was evaluated in an effort to explain the apparently high prevalence and wide range of secondary amenorrhea reported for ballet dancers. In the general population the prevalence of secondary amenorrhea is between 2% to 5%. In the ballet community the prevalence of amenorrhea is 6% to 73%. Seven of the 22 articles assessed present a prevalence of secondary amenorrhea greater than 30% for ballet dancers. Due to lack of reported information within these studies, a better understanding of the data cannot be gained. Existing reports were found deficient in the following areas: activity level, caloric intake, menstrual log, specific subject information (rank, expertise, and individual and group data), standard definition of secondary amenorrhea, methods of data collection, lack of prospective studies, and recordings of hormonal contraceptives. To enable an evaluation and explanation of the prevalence of secondary amenorrhea in ballet dancers, new research should be undertaken to include all these variables in order to provide a more complete understanding.<7y;Guidetti, L. Emerenziani, G. P. Gallotta, M. C. Baldari, C.2007NEffect of warm up on energy cost and energy sources of a ballet dance exercise275-81Eur J Appl Physiol993Adolescent Anaerobic Threshold *Dancing *Energy Metabolism Exercise Tolerance/*physiology Female Humans Lactic Acid/blood Models, Biological Muscle, Skeletal/*metabolism *Oxygen Consumption Time FactorsFebTo evaluate the effect of warm up on energy cost and energy sources of a ballet dance exercise, 12 adolescent talented female dancers performed a ballet exercise (30 s of tours piques en dedans on pointe) without and following a warm up. Warm up consisted in a light running followed by a period of stretching and two ballet exercises. The overall energy requirement of dance exercise (VO(2eq)) was obtained by adding the amount of VO(2) during exercise above resting (aerobic source or VO(2ex)) to the VO(2) up to the fast component of recovery (anaerobic alactic source or VO(2al)) and to the energy equivalent of peak blood lactate accumulation (anaerobic lactic source or (VO2lA) of recovery. VO(2eq) of exercise preceded by warm up amounted to 37 +/- 3 ml kg(-1). VO(2al) represented the higher fraction (50 +/- 6%) of VO(2eq), the remaining fractions were: 39 +/- 5% for VO(2ex) and 11 +/- 3% for VO2lA . VO(2eq) of exercise without warm up amounted to 38 +/- 3 ml kg(-1). This value was made up of: 26 +/- 6% by VO(2ex), 56 +/- 6% by VO(2al) and 18 +/- 3% by VO2lA. Between exercise conditions, significant differences were found in VO(2ex) (P < 0.01), VO2lA (P < 0.01), and VO(2al) (P < 0.05). The metabolic power requirement, 1.6 times higher than subject's VO2max indicates a very demanding exercise. The anaerobic alactic source was the most utilized. It can be concluded that, when dance exercise was preceded by warm up, the anaerobic sources contribution decreased whereas the aerobic energy source increased.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17165061 TJournal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Germany1439-6319 (Print)&European journal of applied physiology17165061NIstituto Universitario di Scienze Motorie, Piazza Lauro De Bosis, Rome, Italy.engx~?zfMatthews, B. L. Bennell, K. L. McKay, H. A. Khan, K. M. Baxter-Jones, A. D. Mirwald, R. L. Wark, J. D.2006eThe influence of dance training on growth and maturation of young females: a mixed longitudinal study342-56 Ann Hum Biol333May-Jun4BACKGROUND: The effects of systematic sports training during childhood and adolescence on subsequent growth and sexual maturation remains in dispute. AIM: The study aimed to determine whether moderate-high volumes of dance training adversely influence linear growth and sexual maturation of young girls progressing through puberty. SUBJECTS AND METHODS: This 3-year mixed longitudinal study comprised 82 novice dancers and 61 controls, aged 8-11 years at baseline, who were assessed bi-annually for 3 consecutive years. A biological maturational age was determined by estimating attainment of age at peak height velocity (PHV). Body dimensions were measured by anthropometry, and exercise levels, nutritional intake and age at menarche by questionnaires. RESULTS: Controls had significantly greater unadjusted height velocity than dancers 1 year before PHV, however there was no difference between groups in age of attainment of PHV. When controlling for maturation, lean mass, fat mass and extracurricular sport (excluding dancing), there were no group differences in absolute growth or velocity of growth in height, sitting height or leg length. Within the dancers there were no effects of years of dancing (>6.5 years) or weekly dance hours (>7 h per week) on growth velocities. No association was found between age at menarche and years or hours of dance training. CONCLUSION: Results suggest that moderate-high levels of dance training do not affect linear growth and maturation. Thus, girls should not be discouraged from dance participation on the basis of potential growth delays.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17092871 B0301-4460 (Print) Journal Article Research Support, Non-U.S. Gov't17092871wCentre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Victoria, Australia.)~?{!Nihal, A. Rose, D. J. Trepman, E.2005HArthroscopic treatment of anterior ankle impingement syndrome in dancers908-12Foot Ankle Int2611NovBACKGROUND: The purpose of this study was to evaluate the results of arthroscopic treatment of anterior bony and soft-tissue impingement of the ankle in elite dancers. METHODS: The study is a case series retrospectively reviewed. In the period between 1990 and 1999, 11 elite dancers (12 ankles) had ankle arthroscopy after a diagnosis of anterior ankle impingement that markedly interfered with their dancing. Initial nonoperative treatment failed in all subjects. Previous ankle trauma was noted in all subjects. There were seven women and four men (average age 28 years). Tibiotalar exostoses were radiographically noted in six ankles. Standard anteromedial and anterolateral arthroscopic portals and instrumentation were used for resection of bone spurs and debridement of impinging soft tissues. Patients were nonweightbearing for 5 days after surgery and had postoperative physiotherapy. RESULTS: Nine dancers returned to full dance activity at an average of 7 weeks after surgery. One patient did not return to dance performance because of concurrent unrelated orthopaedic problems, but he resumed work as a dance teacher; he developed a recurrent anterior tibial spur that was successfully resected at a second arthroscopy 9 years later. Another dancer developed postoperative scar-tissue impingement and stiffness; she had a repeat arthroscopy 4 months after the initial procedure and subsequently returned to dance performance. All patients eventually had marked postoperative improvement in pain relief and dance performance. CONCLUSIONS: Arthroscopic debridement is an effective method for the treatment of bony and soft-tissue anterior ankle impingement syndrome in dancers and has minimal morbidity.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16309602 !1071-1007 (Print) Journal Article16309602/Hull Royal Infirmary, Hull, East Yorkshire, UK.|7|Brockmann, A. Robinson, G. E.2007YCentral Projections of Sensory Systems Involved in Honey Bee Dance Language Communication125-136Brain Behav Evol702May 185Honey bee dance language is a unique and complex form of animal communication used to inform nest mates in the colony about the specific location of food sources or new nest sites. Five different sensory systems have been implicated in acquiring and communicating the information necessary for dance language communication. We present results from neuronal tracer studies identifying the central projections from four of the five. Sensory neurons of the dorsal rim area of the compound eyes, involved in acquiring sun-compass based information, project to the dorsal-most part of the medulla. Sensory neurons of the neck hair plates, required to transpose sun-compass based information to gravity-based information in the dark hive, project to the dorsal labial neuromere of the subesophageal ganglion. Sensory neurons from the antennal joint hair sensilla and the Johnston's organ, which perceive information on dance direction and distance from mechanostimuli generated by abdomen waggling and wing vibration, project to the deutocerebral dorsal lobe and the subesophageal ganglion, and the posterior protocerebrum, respectively. We found no 'dance-specific' projections relative to those previously described for drone and queen honey bees and other insect species that do not exhibit dance communication. We suggest that the evolution of dance language communication was likely based on the modification of central neural pathways associated with path integration, the capability to calculate distance, and directional information during flight. Copyright (c) 2007 S. Karger AG, Basel.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17519525 Journal article1421-9743 (Electronic)17519525rDepartment of Entomology, and Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Ill., USA.Eng~?}Menzel, R. Greggers, U. Smith, A. Berger, S. Brandt, R. Brunke, S. Bundrock, G. Hulse, S. Plumpe, T. Schaupp, F. Schuttler, E. Stach, S. Stindt, J. Stollhoff, N. Watzl, S.2005:Honey bees navigate according to a map-like spatial memory3040-5Proc Natl Acad Sci U S A1028{Animals Bees/*physiology *Behavior, Animal *Homing Behavior Maps *Memory Research Support, Non-U.S. Gov't *Spatial BehaviorFeb 22By using harmonic radar, we report the complete flight paths of displaced bees. Test bees forage at a feeder or are recruited by a waggle dance indicating the feeder. The flights are recorded after the bees are captured when leaving the hive or the feeder and are released at an unexpected release site. A sequence of behavioral routines become apparent: (i) initial straight flights in which they fly the course that they were on when captured (foraging bees) or that they learned during dance communication (recruited bees); (ii) slow search flights with frequent changes of direction in which they attempt to "get their bearings"; and (iii) straight and rapid flights directed either to the hive or first to the feeding station and then to the hive. These straight homing flights start at locations all around the hive and at distances far out of the visual catchment area around the hive or the feeding station. Two essential criteria of a map-like spatial memory are met by these results: bees can set course at any arbitrary location in their familiar area, and they can choose between at least two goals. This finding suggests a rich, map-like organization of spatial memory in navigating honey bees.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15710880 0027-8424 Journal Article15710880Institut fur Biologie, Neurobiologie, Freie Universitat Berlin, Konigin-Luise-Strasse 28/30, 14195 Berlin, Germany. menzel@neurobiologie.fu-berlin.dePK7I/**refs.FRM 0B< !// !HPRIMARYyearIndex 6ByP/) idreference_type text_stylesauthoryear title pages secondary_title volume numbernumber_of_volumessecondary_authorplace_published publishersubsidiary_authoredition keywords type_of_workdate2)  abstractlabelurltertiary_titletertiary_author notes isbn custom_1 custom_2 custom_3 custom_4alternate_titleaccession_number call_number short_title custom_5 custom_6sectionoriginal_publicationH) reprint_editionreviewed_itemauthor_addressimagecaption custom_7 electronic_resource_number link_to_pdf translated_author translated_titlename_of_databasedatabase_providerresearch_notes language access_datelast_modified_date !! H!H!H! (H! 3H! >H! IH! TH!_H!jH!uH! H!H!H! H! H!H! H!H!H!H!H! H! H! H! H! %H! 0H!;H!FH! QH! \H! gH! rH!}H!H!H!H!H!H!H! H! H! H! H! H!H! H!H! "H! -H!8H!idreference_typetext_stylesauthoryeartitlepagessecondary_titlevolumenumbernumber_of_volumessecondary_authorplace_publishedpublishersubsidiary_authoreditionkeywordstype_of_workdateabstractlabelurltertiary_titletertiary_authornotesisbncustom_1custom_2custom_3custom_4alternate_titleaccession_numbercall_numbershort_titlecustom_5custom_6sectionoriginal_publicationreprint_editionreviewed_itemauthor_addressimagecaptioncustom_7electronic_resource_numberlink_to_pdftranslated_authortranslated_titlename_of_databasedatabase_providerresearch_noteslanguageaccess_datelast_modified_datePK7{ftbtbrefs.MYDPK7I/**brefs.FRMPKl