When do injuries occur in dance? A systematic review and discussion of training load

Sports medicine research suggests that overuse injuries may result from inappropriate training load1-2. In dance research, overuse is estimated to be a factor in 75% of allinjuries3. Training loads for dancers typically involve high repetition of extreme movement. Volume of training ranges from six to eight hours per day during rehearsalperiods and up to ten hours during performance seasons4. Holiday periods, however, can last up to three months5-6. This systematic review identifies studies in ballet andcontemporary dance that have investigated the relationship between injuries and their annual timing (AT) (for example, across a performance season, a semester, or a training or working year). Six electronic databases were searched up to June 3, 2016: PubMed, Embase, CINAHL, SPORTdiscus, Scopus, and the Performing Arts Database. Medical subject headings used in PubMed were “wounds and injuries”,“musculoskeleletal diseases” and “dancing”. Keywords used were injur*, sprain, strain*, “muscul* dis*”, danc* and ballet. Only original data, and cohort studies in balletand/or contemporary dance that report a relationship of injury to AT were included. 1196 abstracts were searched. Reference lists of identified studies were also searched. Two reviewers independently assessed each identified study for risk of bias using the Newcastle-Ottawa Scale (NOS) for Observational Studies7. An analysis of the identified studies was conducted on the relationship of injury and AT across potentially inflective changes in load, such as returning to dance after holiday periods, or transitioning from rehearsal periods to performance seasons, when working hours and cardiovascular demands may increase8-9. In the discussion of training load, findings in sports medicine of a relationship between change in training load and injury, and delay in injury presentation after acute spikes in training load10-11 are highlighted as potentially relevant to dance, particularly as a guide to management oftraining loads. A useful metric, for example, may be to quantify training load as the product of the duration and intensity of training1, which, to the authors’ knowledge hasnot been investigated in relation to injury in dance

Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study

IntroductionThe ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure.MethodsInternational experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance.ResultsSixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control—Performance Monitoring; (3) Arousal and Regulatory Systems—Arousal; (4) Cognitive Control—Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control—Response Selection and Inhibition/Suppression; (6) Working memory—Flexible Updating; (7) Working memory—Active Maintenance; (8) Perception and Understanding of Self—Self-knowledge; (9) Working memory—Interference Control, and (10) Expert-suggested—Shifting.DiscussionOur results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization

Psychological predictors of injury in elite athletes

The nature of injuries within sport and the psychological factors impacting upon injury rehabilitation are well documented (Brewer, 2003; Johnson, 1997; Van Mechelen, Hlobil, & Kemper, 1992; Weiss, 2003), however existing scientific knowledge that addresses the psychological predictors of injury in elite sport is somewhat contradictory and less comprehensive. Given the cost of injuries, both in terms of time out of sport, the expense of rehabilitation, and adverse social and economic effects (Van Mechelen et al., 1992), further examination of the psychological predictors of injury in elite athletes may prove beneficial for the sports medicine community. In light of this, the purpose of the present study was to examine the relationship between injuries, specific medical factors (e.g., asthma, back pain) and psychological risk factors including life stress, mood, previous psychological diagnoses and disordered eating behaviour in an elite athlete population - scholarship athletes at the Queensland Academy of Sport (QAS). This investigation was undertaken with a primary focus upon applied research that addresses 'real life' challenges facing athletes and sports medicine staff, versus examination of theoretical issues within the area of psychological risk factors and sports injuries. Research was conducted via examination of data obtained through processes and measures already established by the QAS as part of their medical screening policy. Based upon the results of this investigation, recommendations can be made with regards to implications for practical application within specific elite sporting environments (e.g., QAS), in addition to the sports medicine community at large. Furthermore, through the summary of injury characteristics and the development of population-specific tables of normative data for the mood and life stress measurement scales, an applied contribution to the existing body of knowledge can be made that provides a baseline for future research into screening protocols and interventions aimed at reducing the risk of injury in sport

When do injuries occur in dance? A systematic review and\ud discussion of training load

Sports medicine research suggests that overuse injuries may result from inappropriate training load1-2. In dance research, overuse is estimated to be a factor in 75% of all\ud injuries3. Training loads for dancers typically involve high repetition of extreme movement. Volume of training ranges from six to eight hours per day during rehearsal\ud periods and up to ten hours during performance seasons4. Holiday periods, however, can last up to three months5-6. This systematic review identifies studies in ballet and\ud contemporary dance that have investigated the relationship between injuries and their annual timing (AT) (for example, across a performance season, a semester, or a training or working year). Six electronic databases were searched up to June 3, 2016: PubMed, Embase, CINAHL, SPORTdiscus, Scopus, and the Performing Arts Database. Medical subject headings used in PubMed were “wounds and injuries”,\ud “musculoskeleletal diseases” and “dancing”. Keywords used were injur*, sprain, strain*, “muscul* dis*”, danc* and ballet. Only original data, and cohort studies in ballet\ud and/or contemporary dance that report a relationship of injury to AT were included. 1196 abstracts were searched. Reference lists of identified studies were also searched. Two reviewers independently assessed each identified study for risk of bias using the Newcastle-Ottawa Scale (NOS) for Observational Studies7. An analysis of the identified studies was conducted on the relationship of injury and AT across potentially inflective changes in load, such as returning to dance after holiday periods, or transitioning from rehearsal periods to performance seasons, when working hours and cardiovascular demands may increase8-9. In the discussion of training load, findings in sports medicine of a relationship between change in training load and injury, and delay in injury presentation after acute spikes in training load10-11 are highlighted as potentially relevant to dance, particularly as a guide to management of\ud training loads. A useful metric, for example, may be to quantify training load as the product of the duration and intensity of training1, which, to the authors’ knowledge has\ud not been investigated in relation to injury in dance

Artistic and Health Professionals' Perceptions of Training Load Practices in Pre-Professional and Professional Ballet and Contemporary Dance : A Cross-Sectional Survey

This study aimed to investigate the perceptions of training load practices of dance artistic and health professionals. Artistic staff and health professionals with experience in dance were invited to participate in a cross-sectional survey study relating to training load practices in pre-professional and professional, ballet and contemporary dance. The survey was developed from previous investigations in soccer and consisted of multiple-choice, Likert scale, and free-text responses. Responses to closed questions were reported by percentage and 95% confidence intervals (95% CI). Thematic analysis was performed by two independent assessors of free-text responses. There were six artistic staff and 18 health professional participants. Artistic staff were perceived to be "mostly/completely responsible" for planning training (artistic staff: 100%, 95% CI: 61%, 100%; health professionals: 94%, 95% CI: 76%, 100%), with health professionals "mostly/completely responsible" at times of injury (artistic staff: 83%, 95% CI: 41%, 99%; health professionals: 95% CI: 61%, 96%). Both groups reported using individual modification to manage training loads and recognized the benefits of rest. Artistic staff recognized the need to modify training when injured, in line with experience levels, workload, age, and general health. Both groups "agree/strongly agree" that monitoring would be or is useful (artistic staff: 83%, 95% CI: 41%, 99%; health professionals: 95% CI: 61%, 96%). This investigation provides insight into the perceptions of artistic staff and health professionals with experience in dance toward training practices. Artistic staff and health professionals need to work together and adapt monitoring practices to their context to support artistic staff in planning training. The findings guide the implementation of these interventions by understanding potential barriers to their effectiveness that may potentially reduce injury.</p

Artistic and Health Professionals' Perceptions of Training Load Practices in Pre-Professional and Professional Ballet and Contemporary Dance: A Cross-Sectional Survey

This study aimed to investigate the perceptions of training load practices of dance artistic and health professionals. Artistic staff and health professionals with experience in dance were invited to participate in a cross-sectional survey study relating to training load practices in pre-professional and professional, ballet and contemporary dance. The survey was developed from previous investigations in soccer and consisted of multiple-choice, Likert scale, and free-text responses. Responses to closed questions were reported by percentage and 95% confidence intervals (95% CI). Thematic analysis was performed by two independent assessors of free-text responses. There were six artistic staff and 18 health professional participants. Artistic staff were perceived to be "mostly/completely responsible" for planning training (artistic staff: 100%, 95% CI: 61%, 100%; health professionals: 94%, 95% CI: 76%, 100%), with health professionals "mostly/completely responsible" at times of injury (artistic staff: 83%, 95% CI: 41%, 99%; health professionals: 95% CI: 61%, 96%). Both groups reported using individual modification to manage training loads and recognized the benefits of rest. Artistic staff recognized the need to modify training when injured, in line with experience levels, workload, age, and general health. Both groups "agree/strongly agree" that monitoring would be or is useful (artistic staff: 83%, 95% CI: 41%, 99%; health professionals: 95% CI: 61%, 96%). This investigation provides insight into the perceptions of artistic staff and health professionals with experience in dance toward training practices. Artistic staff and health professionals need to work together and adapt monitoring practices to their context to support artistic staff in planning training. The findings guide the implementation of these interventions by understanding potential barriers to their effectiveness that may potentially reduce injury

Ballet and contemporary dance injuries when transitioning to full-time training or professional level dance: a systematic review

This systematic review examines the relationship between injury and two stages of a dancer's career development: when transitioning to full-time training and to a professional dance company. The findings are discussed in relation to managing transitioning loads with regard to injury prevention. Six electronic databases (PubMed, Embase, CINAHL, SPORTDiscus, Scopus, and Performing Arts Periodicals Database) were searched from inception to July 2018, inclusive of English language peer reviewed studies investigating injury in pre-professional and professional ballet and contemporary dancers. Seventeen studies met the inclusion criteria. "Limited" evidence revealed that dancers transitioning to professional ballet had a significantly higher rate of time-loss injuries per exposure hour relative to established professionals, whereas transitioning professional contemporary dancers had a significantly lower rate of both medical-attention and time-loss injuries. "Limited" evidence also showed a decreased rate and trend toward lower prevalence rates for time-loss injuries per exposure hour for transitioning ballet students and an increased rate of medical-attention injury in a combined cohort of transitioning ballet and contemporary dance students. Thus, this review provides some evidence that injuries tend to occur as dancers are transitioning to full-time ballet or contemporary dance training or to professional careers

Ballet and Contemporary Dance Injuries When Transitioning to Full-Time Training or Professional Level Dance: A Systematic Review

This systematic review examines the relationship between injury and two stages of a dancer's career development: when transitioning to full-time training and to a professional dance company. The findings are discussed in relation to managing transitioning loads with regard to injury prevention. Six electronic databases (PubMed, Embase, CINAHL, SPORTDiscus, Scopus, and Performing Arts Periodicals Database) were searched from inception to July 2018, inclusive of English language peer reviewed studies investigating injury in pre-professional and professional ballet and contemporary dancers. Seventeen studies met the inclusion criteria. "Limited" evidence revealed that dancers transitioning to professional ballet had a significantly higher rate of time-loss injuries per exposure hour relative to established professionals, whereas transitioning professional contemporary dancers had a significantly lower rate of both medical-attention and time-loss injuries. "Limited" evidence also showed a decreased rate and trend toward lower prevalence rates for time-loss injuries per exposure hour for transitioning ballet students and an increased rate of medical-attention injury in a combined cohort of transitioning ballet and contemporary dance students. Thus, this review provides some evidence that injuries tend to occur as dancers are transitioning to full-time ballet or contemporary dance training or to professional careers.</p

The relationship between mindfulness, sport anxiety, pessimistic attributions and flow in competitive cyclists

This research investigated a model of connecting greater mindfulness to more occurrences of flow and less sport-specific anxiety and pessimistic sport attributions in competitive cyclists. The research examined direct and indirect paths from mindfulness to the subjective state of being in flow. Indirect paths examined were through pessimistic sports attributions, sport-specific anxiety and flow conditions. Key findings were that higher levels of mindfulness were associated with more experience of flow, fewer sports-related pessimistic cognitions, and less sport-specific anxiety. Lower levels of sport-specific pessimistic attributions and sport-specific anxiety were associated with a higher frequency of experienced flow conditions. A higher frequency of flow conditions was associated with more occurrence of the subjective state of being in flow. The results support a model connecting mindfulness to flow experience through the meeting of flow conditions and through less experience of pessimism and anxiety. The results have implications for possible interventions focused upon increasing mindfulness to enhance the occurrence of flow