Dear Medical Practitioner

Transcription

1 Dear Medical Practitiner The Western Australian Academy f Perfrming Arts (WAAPA) at Edith Cwan University (ECU) requires students applying fr certain curses t cnfirm their capacity t meet the physical requirements f the curse in which they have applied, prir t them starting the curse. As a part f ur duty f care, we ask that all students arrange fr a Medical Questinnaire and Assessment (belw) be cmpleted by an independent medical practitiner. This is t ensure we are aware f any cncerns befre the student starts the curse, and that we manage any cncerns thrughut the duratin f the student s time with WAAPA. Any queries regarding this dcument can be directed t the WAAPA Dance department n Thank yu fr yur time and cnsideratin in cmpleting this. Applicant Name: Address: Phne: DB: Gender:

2 TERTIARY DANCE COUNCIL: PHYSIOTHERAPIST EXAMINATION GENERAL POSTURE: Leg Length Difference Nrmal Right apprx mm lnger Nrmal Left apprx mm lnger Pstural Symmetry Iliac crest height Nrmal Right high Left high PSIS height Nrmal Right high Left high Scapular psitin Nrmal Right Left Head and Neck Psture Nrmal Pked Retracted Sclisis Nrmal Structural Pstural Lumbar Lrdsis Nrmal Hyper Hyp Pelvic Tilt Nrmal Anterir Psterir Ft Psture Right Nrmal Prnatin Supinatin Left Nrmal Prnatin Supinatin Metatarsal Frmula Right Left Hallux Valgus ( Bunin ) Nrmal Right Left LOWER LIMB: HIP Measurement Right Left Hip External Rtatin (Hip Neutral) Active Passive Optimal Requirement Passive Hip Internal Rtatin (Hip Neutral) >20 Ilipsas Flexibility 10 Straight Leg Raise Ft Relaxed (Hamstring) Ft Drsiflexed (Neural) F = 120 M = 90 F = 110 M = 90 1

3 KNEE Patella (Kneecap) Mbility Right Nrmal Hypermbile Hypmbile Left Nrmal Hypermbile Hypmbile Knee Hyperextensin Right: cms Left:: cms ANKLES AND FEET Measurement Right Left 1st MTP Jint (Big Te) Extensin 90 Optimal Requirement Pinte cm Gastrcnemius Flexibity (Calf) > 15 TRUNK/SPINE Lumbar Spine (Lw Back) Extensin Range f mvement Nrmal Hypermbile Hypmbile Cntrl f mvement Gd Fair Pr Abdminal Stability Test UPPER LIMB Measurement Right Left Optimal Requirement Shulder Flexin (elevatin) 180 Wrist Extensin 90 2

4 GENERAL COMMENTS: DISCLAIMER: I understand that the results f this screening can be discussed by the undersigned physitherapist with the staff undertaking the auditins I will be attending. DANCER'S SIGNATURE: PARENT'S/GUARDIAN'S SIGNATURE: (Required nly if the applying dancer is under the age f 18 years) DATE: / / DATE OF ASSESSMENT: / / PHYSIOTHERAPIST: ADDRESS: PHONE: PHYSIOTHERAPIST'S SIGNATURE: 3

5 1. GUIDELINES FOR PHYSIOTHERAPY EXAMINATIONS This assessment shuld be cmpleted by a nminated dance health prfessinal (details belw), signed and dated. It shuld take apprximately minutes t cmplete. The dancer shuld ensure that: This physitherapy assessment is cmpleted by a physitherapist with dance knwledge r experience wherever pssible; Apprpriate clthing is wrn. The spine and limb measurements need t be viewed and therefre need t be visible. Accrdingly, the dancer shuld be prepared t underg the assessment in underwear r similar clthing (e.g. bike shrts and sprts bra); He r she des nt warm-up fr the assessment ; He r she cmpletes the questinnaire sectin f the assessment prir t presenting fr the physitherapy assessment ; A cpy f this assessment is kept fr their individual recrds. The health prfessinal shuld ensure that: The dancer is nt warmed up prir t the assessment; All methds f measurement are clsely adhered t; A gnimeter and nn-elastic measuring tape are used where necessary; The cmpleted questinnaire is reviewed and cmmented upn where necessary. This assessment shuld be cmpleted by ne f the dance physitherapists frm the Physitherapy Assciatin (Australia wide) where pssible. 2. TESTING PROTOCOLS The reliability f examinatin results can be influenced by: Between tester variability; Individual variability in the dancer being tested; Inherent errrs in the testing prcedures. In rder t minimise the level f variability between results, the testing prcedures undertaken shuld be standardised. Fr this examinatin, the fllwing prtcls shuld be fllwed. GENERAL POSTURE A visual bservatin is undertaken frm the frnt, side and behind the standing dancer. Special bservatins are made f: 1. Leg Length Difference With the dancer in crk lying, he r she is asked t raise their hips ff the grund and drp them back t the start psitin. The therapist then straightens the dancer s legs by grasping their ankles and cmpares the relative height f the medial malleli. 2. Metatarsal Frmula Feel the length f the metatarsals by palpating the base f the metatarsal shafts in the relaxed nn- weight bearing ft. Relative lengths f the metatarsals shuld be nted frm the lngest t the shrtest. Fr example, in a ft which the secnd metatarsal is lnger than the first, third, furth and fifth respectively, the measurements is nted as If the first is lnger r equal t the secnd the frmula is Hallux Valgus If the line f the first metatarsal shaft and first phalanx f the big tes deviates twards the little te by a measurement f greater than 10 degrees it is nted as hallux valgus + presence f thickened tissue ver the jint line (bunin). 4

6 LOWER LIMB 1. Hip Rtatin (Hip Neutral) The dancer lies in supine with knees bent ver the end f the plinth. The resting leg is lifted t place the ft flat n the end f the plinth (knee bent t ceiling). The fllwing measurements are undertaken: a) The dancer is asked t actively externally rtate the test hip. The pelvis and thigh must remain flat n the plinth. The angle between the tibia and vertical is measured. b) This test is repeated with the examiner ver-pressing external rtatin and measuring the angle between the tibia and vertical. The pelvis and thigh must remain flat n the plinth. c) The examiner verpressures internal rtatin and measures the angle between the tibia and vertical. The pelvis and thigh must remain flat n the plinth. 2. Ilipsas Flexibility (Mdified Thmas Test) The dancer perches n the end f the testing plinth and rlls back t lying whilst hlding bth knees t the chest. The dancer is asked t keep hld f the cntralateral limb in maximal flexin f the hip as the tested thigh is lwered twards hrizntal (knee is relaxed int flexin). The dancer shuld relax the hip and thigh muscles. The angle f hip flexin is measured with a gnimeter between the hrizntal and the lng axis f the femur (between the greater trchanter and the lateral tibial cndyle). The hip angle is recrded as psitive r negative frm the 0 axis (hrizntal). Fr example, -7 dentes a hip flexed abve hrizntal, 12 represents a thigh that lies belw the hrizntal. 3. Straight Leg Raise With the dancer lying in supine, the leg is raised and ver-pressured with minimal pelvic tilting. Slight hip adductin shuld be maintained and hip external rtatin prevented. a) the ft is held in a relaxed psitin in rder t measure the length f the hamstrings b) the measure is retested with the ankle drsiflexed in rder t measure the length f the neural structures. 4. Patella Mbility With the dancer in lng sitting and quadriceps relaxed, palpatin f each patella is undertaken and the relative mbility laterally is nted. 5. Knee Hyperextensin With the dancer in lng sitting n a plinth, he r she is asked t actively drsiflex the ankle and straighten the knee fully. The distance between the heel and the tp f the plinth is then measured in centimetres 6. 1st Metatarsphalangeal Jint Extensin With the dancer in lng sitting, the first MTP jint is ver-pressed (passively) int extensin. The angle measured is between the line f the shaft f the first metatarsal and the prximal phalanx. 7. Pinte With the dancer in lng sitting, the ft is pinted (active plantarflexin). The angle between the line f the fibula and the 5th metatarsal is measured. The talcrural jint is the fulcrum. If the measure is ver 180 degrees the larger ankle is the measure. 8. Sleus Flexibility (Plié) With the dancer standing in frnt f a wall, he r she perfrms a demi plié in parallel n ne leg t tuch the bending knee t the wall (heel stays in cntact with the grund, knee bends ver the secnd te). The distance frm the wall t the big te is measured and nted. 9. Gastrcnemius Flexibility With the dancer standing with the ball f their ft n the edge f a step, measure the angle between the fibula and the fifth metatarsal as the heel is drpped ver the edge (the leg is kept straight, ankle is the fulcrum). 5

7 10. Lumbar Spine Extensin With the dancer in standing, lumbar spine extensin is bserved with particular attentin paid t: a) range f mvement available b) cntrl f the mvement affrded by the lwer abdminals (transversus abdminus) - especially as the dancer returns t the upright psitin 11. Abdminal Stability Test The main purpse f this test is t assess the stabilising functin f the abdminals. The dancer is instructed t hllw the abdminals, maintain a neutral spine psitin and keep the trunk and pelvis level. The tester palpates the abdmen fr cntinued cntractin thrughut the test. One hand can be placed under the dancer s lw back t encurage and facilitate the dancer t maintain the psitin. Failure t cmplete the test ccurs when the back arches r tensin is lst frm the palpatin. The 5 tests are perfrmed in crk lying (dancer lying n their back with the knees bent and feet n the flr) Grade 1: the dancer is able t maintain the spine and pelvis psitin while lifting ne bent leg t a hip angle f 90 degrees flexin and returning it t the bed Grade 2: the dancer maintains the spine and pelvic psitin, while the first leg is lifted ff the bed and lifting the secnd leg ff the bed t the same psitin as 1 and dwn Grade 3: the dancer keeps ne leg ff the bed at 90 degrees hip flexin and maintains neutral spine and pelvic psitin while extending the ther leg sliding it ut and returning t the start psitin Grade 4: the dancer is able t maintain neutral spine and pelvic psitin while extending bth legs frm the raised crk lying psitin ut tgether with heels tuching plinth and return t raised crk lying Grade 5: the dancer is able t maintain neutral spine and pelvic psitin while extending bth legs frm the raised crk lying psitin ut tgether withut heels tuching the plinth (5cm abve plinth) and return t raised crk lying. Examiner places hands under heels t catch if dancer cannt maintain abdminal cntrl 12. Shulder Flexin In standing and with the thumbs facing frwards, the dancer raises bth arms frward and abve the head as far as pssible. The angle between the lng axis f the humerus (between the superir tip f the lecrann prcess and the midpint f the lateral brder f the acrmin prcess) and the vertical (using the lateral midline f the iliac crest as a guide) is measured. 13. Wrist Extensin The dancer s wrist is ver-pressured int extensin and the angle between the line f the 5th metacarpal and the shaft f the ulna is measured. 6