Injury Rates and Characteristics Associated with Participation in Organized Dance Education:A Systematic Review

Introduction: Several studies and recent systematic reviews have investigated injury in dance settings and have largely focused on specific concert dance genres (i.e., ballet, contemporary) and elite levels (i.e., pre-professional, professional) of dance. Less is known about the health of those who participate in dance education settings, namely teachers and students from private dance studios. Given that these individuals constitute a large proportion of the dance community, greater clarity of risks in the dance training environment could benefit an underserved majority by informing the development of effective injury prevention strategies.Objective: The primary objective was to describe injury rates and characteristics associated with participation in organized dance education settings.Methods: Six electronic databases were searched to April 2021 (Medline, EMBASE, SportDiscus, CINAHL, SCOPUS, Cochrane). Selected studies met a priori inclusion criteria that required original data from dance teacher and student samples within formal dance education settings. All genres of dance were eligible. Studies were excluded if no injury outcomes or estimates of dance exposure were reported, if injuries occurred during rehearsal and performance, or if dance was used as a therapeutic intervention or exercise. Two reviewers independently assessed each paper for inclusion at abstract and full text screening stages. The quality of included studies was assessed using the Joanna Briggs Institute Level of Evidence tool.Results: The initial database search identified 1,424 potentially relevant records, 26 were included and scored. Most studies (n = 22) focused on dance students only, three included only dance teachers, and one study included both. Among both dance students and teachers, the majority of injuries reported were overuse or chronic and involved the lower limb. For studies that reported injury rates (n = 14), estimates ranged from 0.8 to 4.7 injuries per 1,000 dance hours, 4.86 per 1,000 dancer-days, and 0.21 to 0.34 per 1,000 dance exposures.Conclusions: Based on the current research, dance students and teachers experience a similar rate of injury to concert and professional dancers, and their injuries are most commonly overuse injuries involving the lower extremity. There have been few high-quality investigations of injury specific to the dance training environment. Therefore, consensus around the burden of injury in the dance education settings remains difficult. Future dance epidemiological investigations that examine the burden of injury among dance teachers and students, include operational injury and exposure definitions, and utilize prospective designs are warranted.<br/

Pre-season Screening and Injury Surveillance of Pre-Professional Dancers: A Longitudinal Study

Few dance epidemiology studies have utilized evidence-based pre-season screening measures, prospective injury surveillance, and biostatistical modelling to investigate potential risk factors for dance-related injury across multiple years. Post-injury there is currently no return-to-dance protocol to guide injury rehabilitation. A dance-specific jump test to detect lower-limb asymmetries and normative values for common pre-season screening assessments may prove useful for onsite clinicians who are responsible for dancer populations. Therefore, the aims of this doctoral research were to assess the prevalence, incidence, and risk factors for dance-related injury in pre-professional ballet dancers, to evaluate the test-retest reliability of a dance specific jump test using wearable technology, and to establish normative values for common pre-season screening assessments. In Chapter three, it was found that injury prevalence, injury rate, severity, and location remain consistent across five years of training, further justifying the growing body of research that demonstrates pre-professional ballet dancers are at high risk for injury. In an examination of potential risk factors in Chapter four, a significant association between lumbopelvic control and dynamic balance, when adjusted for psychological coping skills and years of previous dance training, with side-to-side differences was found. In Chapter five, findings demonstrated that using accelerometers during a dance-specific jump test did not produce reliable measures of lower limb landing asymmetries. However, test-retest reliability was demonstrated for performance measures (i.e., flight time and jump height). This means that inertial measurement units placed on the lower limb could be used to quantify jump loads and measure jump height performance during injury rehabilitation. Finally, in chapter six, normative values and percentiles were determined for ankle and hip range of motion, lumbopelvic control, and dynamic balance for healthy, adolescent ballet dancers training at the pre-professional level. In conclusion, the use of a comprehensive injury surveillance program across multiple years has established consistent risks and a risk profile for dance-related injury in pre-professional dancers. Baseline and normative values of jump performance and common pre-season screenings may be a more appropriate reference for injury than lower-limb asymmetry metrics

LONGITUDINAL ASSESSMENTS OF BALANCE AND JUMP-LANDING PERFORMANCE IN COLLEGIATE ATHLETES PRE AND POST ACL INJURIES

The purpose was to quantify the effect of anterior cruciate ligament (ACL) injuries on performance in a lower extremity reaching test and a jump-landing test in collegiate athletes. Eight Division I athletes performed these two tests prior to their ACL injuries. They also performed the reaching test 3 and 6 months after their ACL reconstruction surgeries and the jump-landing test 6 months after their surgeries. Participants demonstrated decreased reaching distances for the injured leg and increased reaching distance asymmetries at 3-month and 6-month post-surgery compared pre-injury (p