Injuries during transition periods across the year in pre-professional and professional ballet and contemporary dancers: A systematic review and meta-analysis

ObjectiveTo consider the association of injuries with transition periods in the dance year, i.e., when dancers return at the start of the year, and when they transition from rehearsal to performance periods.MethodsSix electronic databases were searched to November 2019. All English language peer-reviewed studies, of any study design investigating ballet and contemporary pre-professional and professional dance populations were included. Only those studies reporting on the timing of injury were included.ResultsFifteen cohort and two case-series studies were included. A meta-analysis of seven studies revealed the rate of injuries to be significantly higher for the second and third months (1.52; 95% confidence interval [CI]:1.11–2.08; 1.26; 95%CI:1.07–1.48 respectively) after the return to dance. Two further studies report more injuries up to Week 13 of the year. One study showed an increase in injured dancers at three and four weeks after transition from rehearsals to a performance season. Four studies show an increase in injuries at performance times.ConclusionsMeta-analyses of seven studies shows the second and third months after returning to dance have a significantly higher rate of injuries. More research is needed to quantify training loads in dance. Practitioners should be cognisant of the higher injury rates during periods of transition and consider modifying load, as it is a potential contributing factor.     

Injury epidemiology in pre-professional ballet dancers: A 5-year prospective cohort study

IntroductionPre-professional ballet dancers are at high-risk for injury, with injury rates ranging from 1.4 to 4.7 injuries/1000 dance-hours. In dance injury epidemiology, multi-year studies are limited, and findings are inconsistent. Thus, the extent to which injury estimates range from year to year in a pre-professional ballet program is currently unknown.ObjectiveThe aim of this study was to establish the extent and characteristics of injuries in pre-professional adolescent ballet dancers across five academic training years.Methods452 female and male pre-professional ballet dancers (median age, 15 years; range, 11–20 years) participated across five academic years at a vocational ballet school. Participants completed an online weekly injury questionnaire (OSTRC-Q) and self-reported dance hours questionnaire.ResultsQuestionnaire response was 91.4%. Depending on the definition of injury, yearly injury prevalence ranged from 32.1% (145/452; time-loss) to 67.4% (305/452; all-complaints) across the 5 years. Yearly injury rates ranged from 0.76 (95%CI: 0.66, 0.86; time-loss) to 2.54 (95%CI: 2.37, 2.73; all-complaints) per 1000 dance-hours. The ankle was the most reported injury location (range: 16–33%).ConclusionsInjury prevalence and injury rate estimates remained high across five academic years in a pre-professional ballet population. Injury estimates were highest when an all-complaints definition was employed.Level of evidenceTherapy/Prevention, Aetiology/Harm, level 2b.     

How does ballet training alter ankle tendinous morphology and hemodynamics in asymptomatic pre-professional dancers? An ultrasonographic study

Objectives

Among symptomatic dancers, sonographic abnormalities are common. Whether asymptomatic dancers have any abnormalities remains unknown. Some dancers became cyanosis over distal feet after ballet training. The hemodynamic changes at the feet in ballet are not clearly understood.

The association between menarche,intensity of training and passive joint ROM in young pre-professional female dancers: A longitudinal follow-up study

ObjectivesTo determine the association between the status of menarche (yes/no), the intensity of training and the potential to improve passive joint range of motion (ROM) over a 12-month period of dance training.DesignProspective cohort study.SettingDance studio.ParticipantsFifty-nine female dancers aged 12.8 ± 0.5.Main outcome measuresThe dancers were asked about their dance intensity and screened for anthropometric parameters and passive joint ROM in Grades 7 and 8.ResultsAlong the 12 months of dance training, we found significantly increased ankle-foot en-pointe, hip abduction, and hip external rotation (ER); significantly decreased hip internal rotation (IR); and significant increased hip ER:IR ratio. In Grade 7, 26 dancers (44.1%) reached menarche (Yes menarche); in Grade 8 an additional 23 dancers (39.0%) reached menarche (No/Yes menarche); and 10 dancers (16.9%) had not reached menarche (No menarche). MANOVA (mixed models) with repeated measures to compare joint ROM between the three menarche groups (Yes; No/Yes; No), with h/week dance practice as a co-variant, showed that hip ER, ankle-foot en-pointe, and ER:IR were significantly correlated with h/week in all three menarche groups.ConclusionsMost passive joint ROM can be improved over 12 months of dancing around the age onset of menarche. H/week of dance practice is a main factor contributing to improved hip ER, ankle-foot en-pointe and ER/IR ratio.     

Bone mineral density in pre-professional female ballet dancers: A systematic review and meta-analysis

Objectives

To quantitatively compare bone mineral density (BMD) outcomes between pre-professional female adolescent ballet dancers and control populations.

Injuries associated with equestrian sports: Epidemiology and mechanism

Equestrian-related injuries—including fatalities—are more common than is generally appreciated, and, since most participants are young, the years of lost productive life are significant. Most injuries can be classified as one of four major mechanisms: falls, crush injuries, kicks, and bites. We present current epidemiologic data and a gamut of injuries illustrating these mechanisms. It is our intent that awareness of the scope of injuries and means of prevention will aid us in the care and education of our patients.     

Preventive effect of tailored exercises on patellar tendinopathy in elite youth athletes: A cohort study

ObjectiveTo investigate the effects of an intervention with tailored exercises on the incidence of patellar tendinopathy (PT) in elite youth jumping athletes.DesignProspective crossover cohort.SettingOne sport club facility.Participants271 elite youth basketball and volleyball player were followed in the first year of the study (Observation year) and 270 athletes were followed in the second year (intervention year).Main outcome measureIncidence rates of PT per 1,000h of exposure. Cox survival analysis was used to verify the effects of the intervention (exercises implemented according to the findings of a preseason assessment) on PT incidence.ResultsThe exercise prevention program significantly reduced the number of cases of PT, with athletes submitted to the intervention showing 51% less risk of developing PT. The overall PT incidence in the Observation year (5.9 per 1,000h of exposure) was significantly higher than that in the intervention year (2.8 per 1,000h of exposure) (P = .037). Twenty-six athletes developed PT in the observation year, whereas 13 athletes developed PT in the intervention year.ConclusionsA tailored preventive program may be able to reduce the incidence of patellar tendinopathy, especially in male youth volleyball athletes. Randomized controlled trials are encouraged to confirm these findings.     

Injuries and allegations of oral rape: A retrospective review of patients presenting to a London sexual assault referral centre

A retrospective review was carried out of patients seen at the Haven sexual assault referral centre in South East London between January 2009 and September 2010 to determine the frequency and nature of oral injuries found in people reporting oral rape. Ninety five eligible patients were identified and relevant information was extracted from standardised Haven forms completed during forensic medical examination. The main outcome measures were prevalence, type and location of oral injury. Eighteen (19%) were found to have sustained an oral injury. The most common injury was abrasions, followed by bruising and petechiae. The lips were the most common site of injury followed by the soft palate and the inside of the cheeks. It was concluded that injuries in the mouth were not common after an allegation of oral rape. Injuries were minor and did not require treatment.     

Effects of a functional training program in patients with fibromyalgia: A 9-year prospective longitudinal cohort study

There are evidences that physical exercise is an effective instrument for improving physical fitness, health, and quality of life and causes beneficial effects on the symptoms of patients with fibromyalgia. The purpose of this study was to analyze effects of a functional training program on pain, fitness, and quality of life in patients with fibromyalgia in a 9-year prospective longitudinal cohort study. Forty women with fibromyalgia participated in this study; 24 received an exercise program and were called the active group; and 16 were the control group. Tender points, visual analogical scale (VAS) of pain, physical fitness, Fibromyalgia Impact Questionnaire (FIQ), and Short-Form Health Survey 36 (SF-36) were analyzed. The active group experienced significant improvements in FIQ, TP, and VAS (P < .001), whereas the control group showed significant worsening in the FIQ scale (P = .004). Moreover, the active group experienced significant improvements in leg strength (P < .001), balance (P = .033), cardiorespiratory fitness (P < .001), emotional role (P = .024), and mental health (P = .025); whereas the control group significantly worsened on handgrip strength (P = .017), balance (P = .043), cardiorespiratory fitness (P = .020), and in general health (P < .001). A Pearson correlation analysis revealed a significant relationship between the improvement in physical fitness variables and the improvements in FIQ, TP, and VAS. In conclusion, a regular practice of moderate-intensity physical activity shows a positive effect long-term on fitness, pain, the impact of the disease, and the quality of life in women with fibromyalgia.     

Epidemiology of injury in English Professional Football players: A cohort study

ObjectiveTo estimate the current incidence and location of injury in English professional football.DesignProspective cohort study conducted over one competitive season (2015/16).SettingProfessional football players competing in the English Football League and National Conference.Participants243 players from 10 squads (24.3 ± 4.21 per squad).Main outcome measureInjury incidence, training and match exposure were collected in accordance with the international consensus statement on football injury epidemiology.Results473 injuries were reported. The estimated incidence of injury was, 9.11 injuries/1000 h of football related activity. There was a higher incidence of injury during match play (24.29/1000 h) compared to training (6.84/1000 h). The thigh was the most common site of injury (31.7%), muscle strains accounted for 41.2% of all injuries. The hamstrings were the most frequently strained muscle group, accounting for 39.5% of all muscle strains and 16.3% of all injuries. Moderate severity injuries (8–28 days) were the most common (44.2%).ConclusionsIncidence of injury has increased over the last 16 years with muscle strains remaining the most prevalent injury. The hamstrings remain the most commonly injured muscle group.     

子痫前期与新生儿死亡相互关系的回顾性队列研究

目的：分析子痫前期与新生儿死亡之间的相互关系。方法：从1995～2006年间选入孕产妇9138例，其中子痫前期患者共1005例。按回顾性队列研究原则，采用多变量Logistic回归模型调整混杂因素后评估子痫前期对新生儿死亡率的影响。统计新生儿的早期（0～7d）及晚期（8—42d）死亡率。结果：子痫前期组的早产儿死亡率均较低（OR：0．60，95％CI：0．53—0．63及OR：0．82，95％CI．0．71-0．89），而足月新生儿的死亡率较高（OR：1．04，95％CI：1．01—1．13）。结论：子痫前期是早产儿死亡的低风险因素，但对足月新生儿具有高风险。     

Injuries in Dutch elite field hockey players: A prospective cohort study

This study describes the prevalence, incidence density, severity, and nature of injuries in elite field hockey players over the Dutch 2015–2016 season. Eighty players answered a baseline questionnaire and were subsequently followed up every 2 weeks to report the hours spent on training/competition and experienced injuries, which were registered using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Of the 74 players included in the analysis, 52 (70%) reported 112 injuries. Eighty‐seven injuries (78%) received medical attention, and 56 (50%) led to training/competition time‐loss. Thirty‐four injuries (30%) hampered players’ availability to train and compete. Most of the injuries (74%) were not caused by any contact. The mean prevalence of injury was 29% (95% confidence interval [CI] 3–55) for all, 9% (95% CI 0–20) for acute, and 14% (95% CI 0–36) for overuse injuries. Players sustained 3.5 (95% CI 2.5–4.5) new acute injuries per 1000 hours of training and 12.3 (95% CI 7.6–17.0) per 1000 hours of competition. The median of the severity score was 28 from 100 (25%–75% interquartile range [IQR] 16–42) for all, 35 (IQR 23–53) for acute, and 21 (IQR 16–31) for overuse injuries. On average, 1 in 4 elite field hockey players experiences an injury within a 2‐week period during the season. Although acute injuries are common, overuse injuries pose a comparable problem in elite field hockey. As injuries are a burden on players’ health and may hamper performance and availability to train and compete, prevention is of great importance.     

Injuries in Norwegian female elite soccer: a prospective one-season cohort study

Female soccer has become increasingly popular during the last two decades. According to the International Football Association (FIFA) there are approximately 40 million registered female soccer players in the world. Three studies in elite soccer have shown an injury incidence during games ranging from 12.6 to 23.3 injuries per 1,000 h. A very high incidence of ACL-injuries ranging from 0.31 to 2.2 per 1,000 game hours has also been shown. We followed the Norwegian female elite series during the 2001 season to estimate the incidence and characteristics of injuries. A total of 181 female soccer players on ten teams were followed during the 2001 elite season in Norway. We recorded baseline data, match and training exposure and injury data as type of injury, location and severity of injury. The mean age of the players was 23 years (range 17–34). A total of 189 injuries were recorded and 19 (10%) of these were overuse injuries; 89 (47%) occurred during games and 100 (53%) during training sessions. The incidence of acute injuries was 23.6 per 1,000 game hours and 3.1 per 1,000 training hours. The majority of the injuries occurred in the lower extremities (81%), but there were also a significant number of head injuries (6.3%). The most common injury type was ankle sprain (17.2%). Half of the injuries were minor, with training or game absence of less than 7 days. Midfielders sustained the most injuries (32.6%) with an incidence of 42.4 per 1,000 game hours. We recorded two ACL-injuries and two PCL-injuries during the season. They all occurred during games, and the incidence was therefore calculated to 0.6 per 1,000 game hours for both injury types. The incidences of injuries reported for female soccer varies considerably, with the highest numbers reported from Germany and the present study. These studies have also the highest incidence of minor injuries registered. The location of the injuries is quite similar compared to other reports, but the number of ankle sprains seems to be higher in our study, whereas the number of knee and thigh injuries is lower. There has been much attention to ACL injuries in team handball and hamstring injuries in soccer in Norway, and this could have influenced the team’s pre-season training, resulting in a reduction in the incidence of these injury types. The high number of ankle injuries has to be addressed to see whether this is a result of inadequate rehabilitation routines leading to re-injuries, or other factors. The high number of ACL-injuries in these reports is alarming and needs special attention in the future.     

Differences in kinetic asymmetry between injured and noninjured novice runners: A prospective cohort study

PurposeThe purpose of this prospective study was to describe natural levels of asymmetry in running, compare levels of asymmetry between injured and noninjured novice runners and compare kinetic variables between the injured and noninjured lower limb within the novice runners with an injury.MethodsAt baseline vertical ground reaction forces and symmetry angles (SA) were assessed with an instrumented treadmill equipped with three force measuring transducers. Female participants ran at 8 and 9 km h^?1 and male runners ran at 9 and 10 km h^?1. Participants were novice female and male recreational runners and were followed during a 9-week running program.ResultsTwo hundred and ten novice runners enrolled this study, 133 (63.3%) female and 77 (36.7%) male runners. Thirty-four runners reported an RRI. At baseline SA values varied widely for all spatio-temporal and kinetic variables. The inter-individual differences in SA were also high. No significant differences in SA were found between female and male runners running at 9 km h^?1. In injured runners the SA of the impact peak was significantly lower compared to noninjured runners.ConclusionsNatural levels of asymmetry in running were high. The SA of impact peak in injured runners was lower compared to noninjured runners and no differences were seen between the injured and noninjured lower limbs.     

Incidence of injuries among professional football players in Spain during three consecutive seasons: A longitudinal,retrospective study

ObjectivesThe aim of the study was to determine risk factors that maybe be associated with a higher incidence of injuries in elite football players in the Spanish league during a three-year follow-up. Injury was defined as a musculoskeletal complaint (pain and/or discomfort) reported by players to the medical staff and receiving medical attention.DesignA longitudinal retrospective study.Settingand participants: Seventy-one players from Malaga Football Club, who were in the first squad team for three consecutive seasons.Main outcome measuresIncidence, location, severity of injuries were reported according to the Injury Consensus Group for football injuries.ResultsThree hundred and fifty six injuries were found, with the highest proportion (44%) being located in the thigh. We found 6.9 (SD 5.87) injuries per 1000 h of match time and 0.23 (SD 0.22) per 1000 h of training. Forwards presented the highest rates in both incidence and severity of injury. Exposure to training was inversely related to the total number of injuries, which means that the greater the exposure to training the lesser the number of injuries.ConclusionsThis information can assist clinicians in the identification of risk factors and, thus, the elaboration of prevention programmes that reduce football injuries.     

The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

BackgroundA recent study demonstrated joint hypermobility increased the incidence of injury in an elite football team utilising a univariate statistical model.ObjectivesTo compare injury incidence between hypermobile and non-hypermobile elite football players incorporating a multi-site design and multivariate inferential statistics.Methods80 players comprising 3 English Championship football teams were followed prospectively during the 2012–2013 season. Joint hypermobility was assessed according to the 9-point Beighton Criteria at the start of the study period. A cut-off score of ≥4 categorised a participant as hypermobile. Player exposure and time-loss injuries were recorded throughout.ResultsMean ± standard deviation incidence of injuries was 9.2 ± 10.8 injuries/1000 h. The prevalence of hypermobility was 8.8%. Hypermobiles had a tendency for higher injury incidence (mean [95% confidence interval] difference, 5.2 [0.9–2.7] injuries/1000 h; p = 0.06). Cox regression analyses found training exposure to be highly significant in terms of injury risk (p < 0.001) for all participants. Non-hypermobiles had a lower injury risk (p = 0.11), according to the Cox model, which is suggestive but not conclusive that hypermobility predisposes injury risk.ConclusionsHypermobility showed a trend towards increased risk of injury. Training exposure is a significant injury risk factor in elite football.     

Incidence,costs, and temporal trends of sports injury-related hospitalisations in Australian children over a 10-year period: A nationwide population-based cohort study

Objectives

To quantify and describe the incidence, cost, and temporal trends of sports injury-related hospitalisations in Australian children over a 10-year period.