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Hung RK, Yung PS, Ling SK, Samartzis D, Chan C, Hiller C, Cheung ET, Schoeb V, Surgenor B, Wong AY. Prevalence of dance-related injuries and associated risk factors among children and young Chinese dance practitioners. Medicine (Baltimore) 2023; 102:e36052. [PMID: 38013347 PMCID: PMC10681500 DOI: 10.1097/md.0000000000036052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 10/19/2023] [Indexed: 11/29/2023] Open
Abstract
While Chinese dance is a popular dance genre among Chinese teenagers and adults, little is known regarding the prevalence of dance-related injuries or factors associated with such injuries among Chinese dance practitioners. The current cross-sectional study aimed to determine the prevalence of dance-related injuries and their associated risk factors among young Chinese dance practitioners in Hong Kong. Online surveys were distributed to dancers through local dance associations, while paper-based surveys were distributed to young Chinese dance performers during the 54th School Dance Festival in Hong Kong. Self-reported hours of dancing, injuries in the last 12 months, injury sites, and related factors were collected. The injury rate, 12-month prevalence of dance-related injuries were determined. Risk factors for common dance injuries were analyzed using separate multivariate regression models. A total of 175 children (aged 10-14 years) and 118 young (aged 15-24 years) Chinese dance practitioners provided their dance injury information. Young dancers had a significantly higher injury rate (6.5 injuries vs 4.6 injuries/1000 dance hours) and 12-month prevalence (52.5% vs 19.4%) than their child counterparts. The most commonly injured sites were the knee (children:7.4%; young:15.3%), lower back (children: 4.6%; young: 9.5%), and ankles (children: 5.1%; young: 16.9%). Age was a significant independent risk factor for dance-related injuries to the upper back, lower back, and pelvis/buttock (odds ratios ranging from 1.2 to 1.3/additional years). Additionally, height was a significant independent risk factor for lower limb injury (odds ratios ranging from 1.0-1.1/additional centimeter). Collectively, young Chinese dance practitioners are more vulnerable to dance-related injuries than are child dancers. Older age increases the risk of trunk injuries, whereas taller dancers are more likely to sustain lower-limb injuries. Future research should determine the mechanisms underlying dance-related injuries among these dancers.
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Affiliation(s)
- Ryan K.H. Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Patrick S.H. Yung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Samuel K.K. Ling
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago
| | - Dino Samartzis
- Department of Health Sciences, Macquarie University, New South Wales, Australia
| | - Cliffton Chan
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Claire Hiller
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Esther T.C. Cheung
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Veronika Schoeb
- Victorian College of the Arts, The University of Melbourne, Victoria, Australia
| | - Brenton Surgenor
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Arnold Y.L. Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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2
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Stephens N, Nevill AM, Wyon MA. Injury Incidence and Severity in Musical Theatre Dance Students: 5-year Prospective Study. Int J Sports Med 2021; 42:1222-1227. [PMID: 34100276 DOI: 10.1055/a-1393-6151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Dance injury research has mainly focused on ballet and modern dance with little data on musical theatre dancers. The purpose was to assess the incidence and severity of injuries in a musical theatre dance college over a 5-year period; 198 pre-professional musical theatre dancers (3 cohorts on a 3-year training course) volunteered for the study; 21 students left the course over the study period. Injury aetiology data were collected by an in-house physiotherapy team. Differences between academic year and sex were analysed using a Poisson distribution model; significant difference was set at p≤0.05. In total, 913 injuries were recorded, and more injuries occurred in academic year 1 than year 2 and 3. Overall injury incidence was 1.46 injuries per 1000 hours (95% CI 1.34, 1.56); incidence significantly decreased between year 1, 2 and 3 (p<0.05). There was no significant sex difference for incidence or severity. Most injuries were classified as overuse (71% female, 67% male). Pre-professional musical theatre dancers report a high proportion of lower limb and overuse injuries comparable to other dance genres. Unlike other studies on pre-professional dancers, injury incidence and severity decreased with academic year, even though workload increased across the course.
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Affiliation(s)
- Nicola Stephens
- Department of Performers Physiotherapy, Performers College, Stanford-Le-Hope, United Kingdom of Great Britain and Northern Ireland
| | - Alan M Nevill
- Institute of Human Sciences, University of Wolverhampton, Walsall, United Kingdom of Great Britain and Northern Ireland
| | - Matthew Alexander Wyon
- Institute of Human Sciences, University of Wolverhampton, Walsall, United Kingdom of Great Britain and Northern Ireland.,Department of Research, National Institute of Dance Medicine and Science, Birmingham, United Kingdom of Great Britain and Northern Ireland
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3
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Russell JA, McIntyre L, Stewart L, Wang T. Concussions in Dancers and Other Performing Artists. Phys Med Rehabil Clin N Am 2020; 32:155-168. [PMID: 33198893 DOI: 10.1016/j.pmr.2020.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dancers and other performing artists are subject to head impacts that result in concussion-like symptoms. In spite of this, performing arts do not have access to the continual, focused emphasis on the diagnosis, management, and prevention of concussions that is commonplace in sports. Performing arts present a unique environment in which concussions occur and must be managed. This article outlines what is known about performing arts concussions, describes mechanisms of head impacts sustained by participants in dance and the related artforms of theater, circus, and film and television stunts, and offers concussion management guidelines for these artistic fields.
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Affiliation(s)
- Jeffrey A Russell
- Ohio University, College of Health Sciences and Professions, School of Applied Health Sciences and Wellness, Grover Center E182, Athens, OH 45701, USA.
| | - Lauren McIntyre
- Harkness Center for Dance Injuries at NYU Langone Health, 614 2nd Avenue, Floor 2, Suite G, New York, NY 10016, USA
| | - Lori Stewart
- Union of British Columbia Performers/ACTRA, 300 - 380 West 2nd Avenue, Vancouver, British Columbia V5Y 1C8, Canada
| | - Tina Wang
- Loma Linda School of Medicine, Loma Linda VA Hospital, 429 N Central Ave, Upland, CA 91786, USA
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4
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Currey J, Sheng D, Neph Speciale A, Cinquini C, Cuza J, Waite BL. Performing Arts Medicine. Phys Med Rehabil Clin N Am 2020; 31:609-632. [PMID: 32981582 DOI: 10.1016/j.pmr.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Performing artists are a unique subset of athletes. With the highly repetitive nature of performance training, emphasis on proper technique, ergonomics, and preventive cross-training is vital, as many injuries are due to overuse or poor technique. There are novel medical concerns in performers, including ENT problems, mental health concerns and substance use risks. While music is central to performances, it is also a treatment modality to address cognitive, sensory, and motor dysfunctions in certain neurological conditions. Due to this wide array of issues, it is imperative to understand the specific needs and risks of performers to provide optimal medical care.
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Affiliation(s)
- Jovauna Currey
- Department of Sports and Physical Medicine, Kaiser Permanente, The Permanente Medical Group, 3975 Old Redwood Highway, MOB 5, Suite 152, Santa Rosa, CA 95403, USA. https://twitter.com/jcurreymd
| | - Dana Sheng
- Department of Physical Medicine and Rehabilitation, UC Davis, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
| | - Alyssa Neph Speciale
- Department of Physical Medicine and Rehabilitation, UC Davis, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
| | - Camilla Cinquini
- Kaiser Permanente Rehabilitation, The Permanente Medical Group, 3975 Old Redwood Highway, MOB 5, Suite 154, Santa Rosa, CA 95403, USA
| | - Jorge Cuza
- Department of Physical Medicine and Rehabilitation, UC Davis, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
| | - Brandee L Waite
- Department of Physical Medicine and Rehabilitation, UC Davis School of Medicine, UC Davis Sports Medicine, 3301 C Street, Suite 1600, Sacramento, CA 95816, USA.
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5
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STANHOPE J, WEINSTEIN P. Why do we need to investigate non-classical musicians to reduce the burden of musicians' musculoskeletal symptoms? INDUSTRIAL HEALTH 2020; 58:212-223. [PMID: 31588069 PMCID: PMC7286715 DOI: 10.2486/indhealth.2019-0094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/26/2019] [Indexed: 06/10/2023]
Abstract
Musculoskeletal symptoms (MSSs) are common among professional musicians; however, most of the research has focused on orchestral/classical musicians. In some countries orchestral and classical musicians are in the minority; hence targeting research towards these specific sub-groups of musicians is unlikely to address the overall burden of musicians' MSSs, unless the research is generalizable to other types of musicians. This multidisciplinary narrative review seeks to answer the question: "why do we need to examine the MSSs of non-classical groups of performing musicians in order to reduce the burden of musicians' MSSs?". There are differences in the education, posture, tasks (e.g. military training for military band musicians, dancing for those in musical theatre), venues and management of MSSs for different types of musicians. Future research should compare classical and non-classical musicians in order to determine which specific sub-groups (e.g. military band musicians) have the greatest MSS burden, such that further research into the risk factors of and interventions for MSSs can be targeted towards the sub-groups of musicians with the greatest MSS burden. In doing so, we maximise the likelihood of being able to introduce interventions, policies and practice that reduce the burden of musicians' MSSs.
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Affiliation(s)
| | - Philip WEINSTEIN
- School of Biological Sciences, The University of Adelaide,
Australia
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6
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Pacheco C, Behlau M. Immediate Impact of Vocal Demand on Musical Theater Singers in Brazil. J Voice 2019; 33:804.e13-804.e22. [DOI: 10.1016/j.jvoice.2018.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/20/2018] [Indexed: 10/14/2022]
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7
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Vassallo AJ, Trevor BL, Mota L, Pappas E, Hiller CE. Injury rates and characteristics in recreational, elite student and professional dancers: A systematic review. J Sports Sci 2018; 37:1113-1122. [DOI: 10.1080/02640414.2018.1544538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Amy Jo Vassallo
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Bronwyn L Trevor
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Liana Mota
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Evangelos Pappas
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Claire E Hiller
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
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8
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Barker L, Burnstein B, Mercer J. Acceleration profile of an acrobatic act during training and shows using wearable technology. Sports Biomech 2018; 19:201-211. [PMID: 29792560 DOI: 10.1080/14763141.2018.1460394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The purpose of this study was to describe the mechanical characteristics of a trampoline circus act and its individual tracks performed in training and shows using a tri-axial accelerometer. A track is an artist's specific role within a choreographed act. Seven male acrobats performed their trampoline act during training and shows while wearing a triaxial accelerometer and reported ratings of perceived exertion (RPE) after each trial. Average acceleration (AVG), root mean square (RMS), root mean to the fourth (RM4), time spent in specific acceleration ranges and RPE were measured/recorded from training and show acts. Paired t-tests compared dependent variables between training and show. Acceleration AVG, RMS and RM4 were significantly higher (p < 0.05) in training than show. RPE was significantly higher (p < 0.05) in show than training. No significant differences existed in time spent in any of the acceleration ranges between training and show. GPS devices have been used to manage workloads in field sports but are inoperable in theatres. But, inertial measurements may be an effective alternative to describe mechanical demands in theatre or arena environments. Wearable technology may be useful to coaches to improve understanding of track demands to manage artist workloads.
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Affiliation(s)
- Leland Barker
- Department of Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, NV, USA.,Coaching & Performance Department, Cirque Du Soleil, Las Vegas, NV, USA
| | - Bryan Burnstein
- Coaching & Performance Department, Cirque Du Soleil, Las Vegas, NV, USA
| | - John Mercer
- Department of Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
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9
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Vassallo AJ, Pappas E, Stamatakis E, Hiller CE. Differences in the occurrence and characteristics of injuries between full-time and part-time dancers. BMJ Open Sport Exerc Med 2018; 4:e000324. [PMID: 29629183 PMCID: PMC5884381 DOI: 10.1136/bmjsem-2017-000324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 11/05/2022] Open
Abstract
Background Professional dancers are at significant risk of injury due to the physical demands of their career. Despite their high numbers, the experience of injury in freelance or part-time dancers is not well understood. Therefore, the aim of this study was to examine the occurrence and characteristics of injury in part-time compared with full-time Australian professional dancers. Methods Data were collected using a cross-sectional survey distributed to employees of small and large dance companies and freelance dancers in Australia. Statistical comparisons between full-time and part-time dancer demographics, dance training, injury prevalence and characteristics were made using χ2, two-tailed Fisher’s exact tests, independent t-tests and Mann-Whitney U tests. Results A total of 89 full-time and 57 part-time dancers were included for analysis. A higher proportion of full-time dancers (79.8%) than part-time dancers (63.2%) experienced an injury that impacted on their ability to dance in the past 12 months (p=0.035). Injuries characteristics were similar between groups with fatigue being the most cited contributing factor. Part-time dancers took longer to seek treatment while a higher proportion of full-time dancers were unable to dance in any capacity following their injury. Conclusion More full-time dancers sustained an injury in the past 12 months, and were unable to dance in any capacity following their injury. However injuries still commonly occurred in part-time dancers without necessarily a large volume of dance activity. Part-time dancers often access general community clinicians for treatment, who may need additional education to practically advise on appropriate return to dance.
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Affiliation(s)
- Amy Jo Vassallo
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Claire E Hiller
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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10
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11
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Abstract
CONTEXT Injury data on hip and groin injuries vary, and these injuries are often misrepresented or overlooked for more commonly seen injuries, such as those to the foot and ankle. OBJECTIVE To provide a systematic review of the injury rates of hip and groin pathology in dancers and look to establish a better understanding of the occurrence of hip and groin injuries in the dancer population. DATA SOURCES A literature search was performed using PubMed and CINAHL databases for articles published between 2000 and 2016. STUDY SELECTION Inclusion criteria consisted of (1) documentation of the number of hip and/or groin injuries, (2) study population consisting of dancers whose training included some level of ballet, and (3) studies of levels 1 through 3 evidence. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Level 3. DATA EXTRACTION A single reviewer identified studies that met the inclusion criteria. The number of overall injuries, hip/groin injuries, study participants, injured participants, training hours per week, mean age of study group, injury definition, injury reporting method, and study time frame were extracted. RESULTS Thirteen unique studies were included in the descriptive analysis. Of the 2001 dancers included in this study, 3527 musculoskeletal injuries were seen in 1553 dancers. Of these, 345 injuries were localized to the hip and groin region (overall rate, 17.2%). An incidence rate of 0.09 hip and groin injuries per 1000 dance-hours was seen in the selected cohort studies. Of 462 professional dancers, 128 hip/groin injuries were recorded, for an injury rate of 27.7%. Of the 1539 student dancers, 217 hip/groin injuries were recorded, for an injury rate of 14.1% ( P < 0.01). CONCLUSION Data on hip and groin injuries have many limitations. However, these injuries represent an important health issue for dancers of all skill levels, encompassing 17.2% of musculoskeletal injuries seen in dancers. An increasing rate of hip/groin injuries is seen in professional dancers compared with students.
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Affiliation(s)
- Natasha Trentacosta
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Lyle J Micheli
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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12
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Abstract
OBJECTIVE Workplace hazards in the performing arts cause injuries, disabilities, and deaths every year. Occupational health professionals are familiar with most of these hazards and are particularly qualified to contribute to efforts to reduce them. This article reviews current health issues in the performing arts and highlights opportunities for occupational health contributions. METHODS Recognized experts in performing arts medicine were consulted and articles illustrating performing arts health issues were reviewed. Literature sources included medical databases, unindexed art-health publications, and popular press articles. RESULTS Resources discussing hazards and health issues in theater, dance, voice, and instrumental musicians were located and reviewed. CONCLUSIONS Treatment providers have a history of involvement with segments of the performing arts. The occupational health approach to workplace health issues can effectively complement these efforts. Sources of further information on performing arts health concerns are available.
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13
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Cahalan R, O'Sullivan P, Purtill H, Bargary N, Ni Bhriain O, O'Sullivan K. Inability to perform because of pain/injury in elite adult Irish dance: A prospective investigation of contributing factors. Scand J Med Sci Sports 2015; 26:694-702. [PMID: 26040202 DOI: 10.1111/sms.12492] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 12/26/2022]
Affiliation(s)
- R. Cahalan
- Department of Clinical Therapies; University of Limerick; Limerick Ireland
| | - P. O'Sullivan
- School of Physiotherapy; Curtin University of Technology; Perth Western Australia Australia
| | - H. Purtill
- Department of Mathematics & Statistics; University of Limerick; Limerick Ireland
| | - N. Bargary
- Department of Mathematics & Statistics; University of Limerick; Limerick Ireland
| | - O. Ni Bhriain
- Irish World Academy of Music and Dance; University of Limerick; Limerick Ireland
| | - K. O'Sullivan
- Department of Clinical Therapies; University of Limerick; Limerick Ireland
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14
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Donahue EN, LeBorgne WD, Brehm SB, Weinrich BD. Reported Vocal Habits of First-Year Undergraduate Musical Theater Majors in a Preprofessional Training Program: A 10-Year Retrospective Study. J Voice 2014; 28:316-23. [DOI: 10.1016/j.jvoice.2013.11.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 11/27/2013] [Indexed: 11/25/2022]
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15
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Sport-Specific Biomechanics of Spinal Injuries in Aesthetic Athletes (Dancers, Gymnasts, and Figure Skaters). Clin Sports Med 2012; 31:397-408. [DOI: 10.1016/j.csm.2012.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care.
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Affiliation(s)
| | - Amy Silva-Smith
- Beth-El College of Nursing and Health Sciences at the University of Colorado Springs,
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Shrier I, Meeuwisse WH, Matheson GO, Wingfield K, Steele RJ, Prince F, Hanley J, Montanaro M. Injury patterns and injury rates in the circus arts: an analysis of 5 years of data from Cirque du Soleil. Am J Sports Med 2009; 37:1143-9. [PMID: 19286913 DOI: 10.1177/0363546508331138] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Human circus arts are gaining increasing popularity as a physical activity with more than 500 companies and 200 schools. The only injury data that currently exist are a few case reports and 1 survey. HYPOTHESIS To describe injury patterns and injury rates among Cirque du Soleil artists between 2002 and 2006. STUDY DESIGN Descriptive epidemiology study. METHODS The authors defined an injury as any work-related condition recorded in an electronic injury database that required a visit to the show therapist. Analyses for treatments, missed performances, and injury rates (per 1000 artist performances) were based on a subset of data that contained appropriate denominator (exposure) information (began in 2004). RESULTS There were 1376 artists who sustained a total of the 18 336 show- or training-related injuries. The pattern of injuries was generally similar across sex and performance versus training. Most injuries were minor. Of the 6701 injuries with exposure data, 80% required < or =7 treatments and resulted in < or =1 completely missed performance. The overall show injury rate was 9.7 (95% confidence interval, 9.4-10.0; for context, published National Collegiate Athletic Association women's gymnastics rate was 15.2 injuries per 1000 athlete-exposures). The rate for injuries resulting in more than 15 missed performances for acrobats (highest risk group) was 0.74 (95% confidence interval, 0.65-0.83), which is much lower than the corresponding estimated National Collegiate Athletic Association women's gymnastics rate. CONCLUSION Most injuries in circus performers are minor, and rates of more serious injuries are lower than for many National Collegiate Athletic Association sports.
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Affiliation(s)
- Ian Shrier
- McGill University, Montreal, Quebec, Canada.
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18
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O'Loughlin PF, Hodgkins CW, Kennedy JG. Ankle Sprains and Instability in Dancers. Clin Sports Med 2008; 27:247-62. [DOI: 10.1016/j.csm.2007.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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19
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Injury patterns in elite preprofessional ballet dancers and the utility of screening programs to identify risk characteristics. J Orthop Sports Phys Ther 2008; 38:126-36. [PMID: 18383646 DOI: 10.2519/jospt.2008.2390] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Retrospective descriptive cohort study. OBJECTIVES To describe the distribution and rate of injuries in elite adolescent ballet dancers, and to examine the utility of screening data to distinguish between injured and noninjured dancers. BACKGROUND Adolescent dancers account for most ballet injuries. Limited information exists, however, regarding the distribution of, rate of, and risk factors for, adolescent dance injuries. METHODS AND MEASURES Two hundred four dancers (age, 9-20 years) were screened over 5 years. Screening data were collected at the beginning and injury data were collected at the end of each training year. Descriptive statistics were used to characterize distribution and rate of injuries. Inference statistics were used to examine differences between injured and noninjured dancers. RESULTS Fifty-three percent of injuries occurred in the foot/ankle, 21.6% in the hip, 16.1% in the knee, and 9.4% in the back. Thirty-two to fifty-one percent of the dancers were injured each year, and, over the 5 years, there were 1.09 injuries per 1000 athletic exposures, and 0.77 injuries per 1000 hours of dance. Significant differences between injured and noninjured dancers were limited to current disability scores (P = .007), history of low back pain (P = .017), right foot pronation (P = .005), insufficient right-ankle plantar flexion (P = .037), and lower extremity strength (P = .045). CONCLUSION Distribution of injuries was similar to that of other studies. Injury rates were lower than most reported rates, except when expressed per 1000 hours of dance. Few differences were found between injured and noninjured dancers. These findings should be considered when designing and implementing screening programs.
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20
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Abstract
BACKGROUND Misdiagnosed o sesamoid bone pathology in dancers may result in prolonged pain, disability, and career limitation. A thorough understanding of sesamoid disorders and appropriate treatment facilitates timely recovery. The potential loss of hallux plantar flexion strength consequent to sesamoidectomy is a major consideration for dancers. CASE DESCRIPTION An 18-year-old dance student sustained a delayed-union fracture of her lateral (fibular) sesamoid. Treatment included an inductive coupling external bone stimulator with pulsed electromagnetic field, activity, and weight-bearing restrictions, protective padding, strengthening, functional retraining, and progressive return to dance. OUTCOME Following use of an external bone stimulator for 12 months, the dancer successfully returned to her previous level of dancing. Repeated SF-36 and Dance Functional Outcome System scores confirmed this improvement. DISCUSSION Loss of hallux plantar flexion strength with sesamoid resection can be devastating to a dancer who requires push-off strength for multiple turns and jumps. Treatment with bone stimulation was therefore selected over more invasive measures. The dancer was compliant with systematic functional progression. Improvement, as seen on radiographs and outcome scores, accompanied her full functional recovery.
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21
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Abstract
Although dancers develop overuse injuries common in other athletes, they are also susceptible to unique injuries. This article reviews common foot and ankle problems seen in dancers and provides some basic diagnosis and treatment strategies.
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Affiliation(s)
- Nancy J Kadel
- Department of Orthopaedics and Sports Medicine, University of Washington, Box 356500, 1959 Northeast Pacific Street, Seattle, WA 98195, USA.
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22
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Abstract
Although dance medicine has derived extensive knowledge from sports medicine, some aspects covered in the practice of dance medicine are unique to this field. Acute and overuse injuries must be analyzed within the scope of associated mechanisms of injury, mainly related to the practice of specific dance techniques. Even though most available medical literature concerning dance medicine is specific to ballet-related conditions, many of the concepts covered here and in other articles can be helpful in the treatment and diagnosis of participants in other dance disciplines. Continued research is expanding the knowledge on injury patterns of different dance disciplines. It is the experience of dance practitioners that dancers are quite in touch with their bodies; thus, when their ailments are systematically analyzed, and underlying cause can usually be identified. In this sense, it is evident that the principles of dance medicine and rehabilitation allow the practitioner to arrive at a diagnosis and treat the underlying causes to prevent reinjury, ameliorate sequelae from injury, and minimize residual deficits after injury.
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Affiliation(s)
- Keryl Motta-Valencia
- Physical Medicine and Rehabilitation Department, VA Caribbean Healthcare System, San Juan, Puerto Rico 00921-3201.
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Toledo SD, Akuthota V, Drake DF, Nadler SF, Chou LH. Sports and performing arts medicine. 6. Issues relating to dancers. Arch Phys Med Rehabil 2004; 85:S75-8. [PMID: 15034860 DOI: 10.1053/j.apmr.2003.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED This 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.
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Affiliation(s)
- Santiago D Toledo
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, IL 60611, USA.
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Byhring S, Bø K. Musculoskeletal injuries in the Norwegian National Ballet: a prospective cohort study. Scand J Med Sci Sports 2002; 12:365-70. [PMID: 12453164 DOI: 10.1034/j.1600-0838.2002.01262.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of the present study was to determine the incidence of musculoskeletal injuries among professional ballet dancers in the Norwegian National Ballet. A 19 weeks prospective study with registration and clinical assessment of dancers with injuries was conducted. Medical staff working for the National Ballet registered incidence of injuries. In addition the dancers filled out a questionnaire about previous injuries, their work situation, and factors they believed increased the risk of injuries. Of the 41 dancers (80% response rate), 31 dancers experienced one injury or more. The majority of injuries involved foot and ankle. Twenty-two per cent of the injuries were acute injuries. Seventy-five per cent of the injuries were soft tissue injuries. Most injuries were of mild to moderate severity. Sixteen per cent of the injuries resulted in absence from work. Factors, the dancers believed were associated with risk of injuries were related to training, organizational factors and environmental factors. Seventy-eight per cent of the dancers experienced "negative" stress at work. Sixty-four per cent experienced that they had little influence on their work conditions. This study showed, however, no significant association between these psychological factors and musculoskeletal injuries. It is concluded that there is a high incidence of musculoskeletal injuries in the Norwegian National Ballet.
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Affiliation(s)
- S Byhring
- Oslo University College, Pilestredet 52, 0167, Oslo, Norway
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Abstract
OBJECTIVES To obtain more information about injuries of West End performers. METHODS A retrospective survey of 269 performers appearing in 20 West End productions (12 dramas and eight musicals). RESULTS In current productions, 46% of all performers sustained at least one injury for an average of 0.87 injuries per performer. Lower extremity injuries were the most common for dancers (52.2% of injuries) and actors (43.2%) with neck and back injuries the second most common. Sprains and strains were the most common diagnoses. 61% of performers thought that their injuries were preventable. Most performers consulted nonphysician healthcare providers. Factors significantly influencing the risk of injuries for performers include female sex, a history of previous injuries, missed performances due to previous injuries, more physically demanding roles, and performing on raked (angled) stages. CONCLUSION West End performers commonly sustain injuries. Although primary prevention of most theatrical injuries is not possible, modification of raked stages may reduce the incidence. This study may be helpful to the growing number of healthcare providers who practice performing arts medicine and may stimulate additional concern and research in the medical and theatrical communities about the performance injuries of professionals, amateurs, and theatrical students worldwide.
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Affiliation(s)
- R W Evans
- Department of Neurology, University of Texas, Houston Medical School, USA
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Bronner S, Brownstein B. Profile of dance injuries in a Broadway show: a discussion of issues in dance medicine epidemiology. J Orthop Sports Phys Ther 1997; 26:87-94. [PMID: 9243407 DOI: 10.2519/jospt.1997.26.2.87] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A description of dance injuries in a Broadway show using ballet technique is reported for the first time. Presentation of this material is used as a vehicle to discuss issues in dance epidemiology and etiology. As interest and research in dance medicine increases, standardization of reporting methods and definitions becomes critical in discussions of epidemiology and etiology. Borrowing from sports medicine classifications, which define sports injury as "time lost from play," we suggest dance injury be defined as "time lost from performing". The overall injury rate was 40.0%, which was low compared with those of classical ballet companies. The majority of injuries involved the foot and ankle, similar to previous reports of classical ballet companies. Reasons for the low injury rates and types of injuries are discussed. The information necessary to facilitate comparison of data with other studies is outlined. We hope this article will contribute to further discussion regarding adoption of universal language and details necessary for reporting injury. Additional areas of research are suggested.
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Affiliation(s)
- S Bronner
- Healthsouth Manhattan II, New York, NY 10022, USA
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