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81. Developmental rheumatology in children. Scenario: Out-toeing

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

82. Developmental rheumatology in children. Scenario: Clumsy child

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

83. Developmental rheumatology in children. Scenario: Bow legs in children

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

84. Developmental rheumatology in children. Scenario: Tip-toe walking

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

85. Developmental rheumatology in children. Scenario: Curly toes in children

is not suspected; back problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community (...) and strains, acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

86. Developmental rheumatology in children. Scenario: Flat feet in children

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

87. Developmental rheumatology in children. Scenario: Growing pains

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

88. Developmental rheumatology in children

(for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral of children (...) is a diagnosis of exclusion. The list of more serious conditions that need to be considered which can present similarly to growing pains is extensive and includes [ ; ]: Autoimmune and inflammatory conditions (for example juvenile dermatomyositis, juvenile idiopathic arthritis); infectious conditions (for example osteomyelitis, septic arthritis, cellulitis). Malignancy (for example leukaemia, Ewing sarcoma, metastatic lesions). Trauma (for example sprains and strains, acute or stress fracture, nerve injury

2019 NICE Clinical Knowledge Summaries

89. Developmental rheumatology in children. Scenario: Knock knees in children

is not suspected; back problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community (...) and strains, acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

90. Developmental rheumatology in children. Scenario: Hypermobility in children

is not suspected; back problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community (...) and strains, acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

91. Developmental rheumatology in children. Scenario: Delayed walking in children

is not suspected; back problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community (...) and strains, acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

92. Developmental rheumatology in children. Scenario: In-toeing gait in children

is not suspected; back problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community (...) and strains, acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

93. Developmental rheumatology in children. Scenario: Heel pain in children

problems (for example pain, scoliosis, neurological symptoms, systemic illness) — orthopaedics. Suspected neurological problem; possible cancer; milestone delay or regression; suspected non-accidental injury; bladder or bowel problems — paediatrics. Other features may also be present for which specialist assessment is necessary, but with less urgency. Have I got the right topic? Have I got the right topic? From birth to 16 years. This CKS topic covers when to consider community management or referral (...) , acute or stress fracture, nerve injury). Structural conditions (for example slipped capital femoral epiphysis, joint hypermobility syndrome, patellofemoral syndrome). Metabolic conditions (for example vitamin D deficiency). Non-inflammatory pain syndromes (for example fibromyalgia and restless leg syndrome). In contrast with these conditions, the physical examination in a child with growing pains is usually normal [ ]. Heel pain Heel pain Heel pain is commonly reported in young children

2019 NICE Clinical Knowledge Summaries

94. Twisting Somersaults, Triple Axels, Tours en l’air, The Firework, Silks

McKinven is chartered physiotherapist with a special interest in dance medicine and performance science. He is the program chair for IADMS, is the dance representative for the ACPSEM and has been told looks great in a kilt. References Kenny SJ, Whittaker JL, Emery CA. Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review (2016) British Journal of Sports Medicine 50:997-1003. Shirer I, Hallé M. (2011) Psychological predictors of injuries in circus artists (...) Principles and Injuries Current Sports Medicine Reports 16,5:351–356 Molnar, M & Karin J (2017) The Complexities of Dancers’ Pain Journal of Dance Medicine and Science 21,1:3-4(2) McNeil, W & Jones S (2018) The Pilates client on the hypermobility spectrum 22,1:209-216 DiFiori JP, Benjamin HJ, Brenner JS , et al (2014) Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine British Journal of Sports Medicine 48:287-288. Soligard T

2019 British Journal of Sports Medicine Blog

95. Artistry on Ice: the physical and athletic demands of figure skating and the vital role physiotherapists play

sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. Br J Sports Med. 2013;47:1012-1022. Han, J. S., Geminiani, E. T., & Micheli, L. J. Epidemiology of Figure Skating Injuries: A Review of the Literature. Sports Health , 2018. 10(6), 532–537. Weber, A. E., Bedi, A., Tibor, L. M., et al. The Hyperflexible Hip: Managing Hip Pain in the Dancer and Gymnast. Sports Health . 2015. 7 (...) (4), 346–358. Campanelli, V., Piscitelli, F., Verardi, L., et al. Lower Extremity Overuse Conditions Affecting Figure Skaters During Daily Training. Orthopaedic Journal of Sports Medicine . 2015. Porter, E.B. Common Injuries and Medical Problems in Singles Figure Skaters. Current Sports Medicine Reports . September/October 2013 – Volume 12 – Issue 5 – p 318–320. d’Hemecourt, P.A., Luke, A. Sport-specific biomechanics of spinal injuries in aesthetic athletes (dancers, gymnasts, and figure skaters

2019 British Journal of Sports Medicine Blog

96. Investigation of Risk Factors and Characteristics of Dance Injuries. (PubMed)

Investigation of Risk Factors and Characteristics of Dance Injuries. The aim of the present study was to identify risk factors for the occurrence of sport injuries in dancers related to anthropometric variables, training, and specific dance characteristics.One-year, retrospective, cross-sectional study.26th Dance Festival of Joinville (Brazil), 2008.Five hundred dancers (409 women and 91 men) with a mean age of 18.26 ± 4.55 years.Dancers participating in the 26th Dance Festival of Joinville (...) (Brazil) were interviewed using the Reported Condition Inquiry, which was previously validated and modified for dance. This questionnaire contains questions addressing the anthropometric data of the volunteers and characteristics of injuries that occurred in the past 12 months.The data were collected through interviews addressing the occurrence of injuries and respective characteristics. Injury was considered any pain or musculoskeletal condition resulting from training and competition sufficient

2011 Clinical Journal of Sport Medicine

97. Stress fractures of the base of the metatarsal bones in young trainee ballet dancers (PubMed)

Stress fractures of the base of the metatarsal bones in young trainee ballet dancers Classical ballet is an art form requiring extraordinary physical activity, characterised by rigorous training. These can lead to many overuse injuries arising from repetitive minor trauma. The purpose of this paper is to report our experience in the diagnosis and treatment of stress fractures at the base of the second and third metatarsal bones in young ballet dancers. We considered 150 trainee ballet dancers (...) from the Ballet Schools of "Teatro Alla Scala" of Milan from 2005 to 2007. Nineteen of them presented with stress fractures of the base of the metatarsal bones. We treated 18 dancers with external shockwave therapy (ESWT) and one with pulsed electromagnetic fields (EMF) and low-intensity ultrasound (US); all patients were recommended rest. In all cases good results were obtained. The best approach to metatarsal stress fractures is to diagnose them early through clinical examination and then through

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2009 International orthopaedics

98. Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon (PubMed)

Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence-based practice, we describe (...) the chiropractic care of a professional ballet dancer following surgical calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon. The care provided involves an array of modalities from exercise and rehabilitation to spinal manipulative therapy.

Full Text available with Trip Pro

2009 The Journal of the Canadian Chiropractic Association

99. Patellofemoral Pain

, soleus, lateral reti- naculum, or iliotibial band. EXAMINATION – OUTCOME MEASURES: ACTIVITY LIMITATIONS/SELF-REPORT MEASURES A Clinicians should use the Anterior Knee Pain Scale (AKPS), the patellofemoral pain and osteoarthritis sub- scale of the Knee injury and Osteoarthritis Outcome Score (KOOS-PF), or the visual analog scale (VAS) for activity or Eng and Pierrynowski Questionnaire (EPQ) to measure pain and func- tion in patients with PFP . In addition, clinicians should use the VAS for worst pain (...) Subjective Knee Evaluation Form ITBS: iliotibial band syndrome JOSPT: Journal of Orthopaedic & Sports Physical Therapy KOOS: Knee injury and Osteoarthritis Outcome Score KOOS-PF: patellofemoral pain and osteoarthritis subscale of the Knee injury and Osteoarthritis Outcome Score KOS-ADLS: Knee Outcome Survey-Activities of Daily Living Scale KOS-SAS: Knee Outcome Survey-Sports Activity Scale KQoL-26: Knee Quality of Life 26-item questionnaire LEFS: Lower Extremity Functional Scale –LR: negative likelihood

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

100. Amenorrhoea

guidance to CKS topic structure. The evidence base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence. There are no major changes to the recommendations. March 2009 — minor update to include hypopituitarism following traumatic brain injury as a cause of amenorrhoea. Issued in April 2009. July to September 2006 — reviewed. Validated in December 2006 and issued in January 2007. October 2005 — minor technical update. Issued (...) occurring less frequently than every 35 days [ ]. Prevalence How common is it? Primary amenorrhoea is rare and has a prevalence of about 0.3% [ ]. Secondary amenorrhoea is more common, with a reported prevalence of about 3–4% in women of reproductive age [ ; ], 5–60% in competitive endurance athletes, and 19–44% in ballet dancers [ ]. Causes What causes it? Causes of primary amenorrhoea What are the causes of primary amenorrhoea? Causes of primary amenorrhoea in those with normal secondary sexual

2018 NICE Clinical Knowledge Summaries

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