OBJECTIVE:To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers.
...DESIGN:Prospective cohort study.
SETTING:Codarts University of the Arts.
PATIENTS:Forty-five first-year students of Bachelor Dance and Bachelor Dance Teacher.
ASSESSMENT OF RISK FACTORS:At the beginning of the academic year, the injury history (only lower-extremity) and student characteristics (age, sex, educational program) were assessed using a questionnaire. Besides, lower-extremity kinematics single-leg squat (SLS), strength (countermovement jump) and height and weight (body mass index) were measured during a physical performance test.
MAIN OUTCOME MEASURES:Substantial lower-extremity injuries during the academic year were defined as any problems leading to moderate or severe reductions in training volume or in performance, or complete inability to participate in dance at least once during follow-up as measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems. Injuries were recorded on a monthly basis using a questionnaire. Analyses on leg-level were performed using generalized estimating equations to test the associations between substantial lower-extremity injuries and potential risk factors.
RESULTS:The 1-year incidence of lower-extremity injuries was 82.2%. Of these, 51.4% was a substantial lower-extremity injury. Multivariate analyses identified that ankle dorsiflexion during the SLS (OR 1.25; 95% confidence interval, 1.03-1.52) was a risk factor for a substantial lower-extremity injury.
CONCLUSIONS:The findings indicate that contemporary dance students are at high risk for lower-extremity injuries. Therefore, the identified risk factor (ankle dorsiflexion) should be considered for prevention purposes.
Purpose
Hip and groin injuries in football are problematic due to their high incidence and risk of chronicity and recurrence. The use of only time-loss injury definitions may underestimate the burden ...of hip and groin injuries. Little is known about hip and groin injury epidemiology in female football. The first aim of this study was to examine the within-season (2014–2015) prevalence of total injury with and without time-loss in female amateur football players. The second aim was to study the within-season and preseason (2015–2016) prevalence of hip/groin injuries with and without time-loss. The third aim was to study the association between the duration of hip and groin injury in the 2014–2015 season and the severity of hip/groin problems during the 2015–2016 preseason.
Methods
During the preseason, 434 Dutch female amateur football players completed an online questionnaire based on the previous season and current preseason. The hip and groin outcome score (HAGOS) was used to assess the severity of hip and groin injuries.
Results
The hip/groin (17%), knee (14%), and ankle (12%) were the most frequent non-time-loss injury locations. The ankle (22%), knee (18%), hamstring (11%), thigh (10%), and hip/groin (9%) were the most common time-loss injury locations. The previous season prevalence of total injury was 93%, of which non-time-loss injury was 63% and time-loss injury was 37%. The prevalence of hip/groin injury was 40%, non-time-loss hip/groin injury was 36% and time-loss hip/groin injury was 11%. The preseason prevalence of hip/groin injury was 27%, non-time-loss hip/groin injury was 25%, and time-loss hip/groin injury was 4%. Players with longstanding hip/groin injury (> 28 days) in the previous season had lower HAGOS scores at the next preseason than players with short-term (1–7 days) or no hip/groin injury (
p
< 0.001). From all players with hip/groin injury from the previous season, 52% also sustained hip/groin injury in the following preseason, of which 73% were recurrent and 27% were chronic hip/groin injuries.
Conclusion
Injury risk, and especially non-time-loss hip and groin injury risk, is high in female amateur football. Three-quarters of the players with longstanding hip and groin injuries in the previous season have residual problems at the start of the following season.
Level of evidence
II.
To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers.
Prospective ...cohort study.
Codarts University of the Arts.
Forty-five first-year students of Bachelor Dance and Bachelor Dance Teacher.
At the beginning of the academic year, the injury history (only lower-extremity) and student characteristics (age, sex, educational program) were assessed using a questionnaire. Besides, lower-extremity kinematics single-leg squat (SLS), strength (countermovement jump) and height and weight (body mass index) were measured during a physical performance test.
Substantial lower-extremity injuries during the academic year were defined as any problems leading to moderate or severe reductions in training volume or in performance, or complete inability to participate in dance at least once during follow-up as measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems. Injuries were recorded on a monthly basis using a questionnaire. Analyses on leg-level were performed using generalized estimating equations to test the associations between substantial lower-extremity injuries and potential risk factors.
The 1-year incidence of lower-extremity injuries was 82.2%. Of these, 51.4% was a substantial lower-extremity injury. Multivariate analyses identified that ankle dorsiflexion during the SLS (OR 1.25; 95% confidence interval, 1.03-1.52) was a risk factor for a substantial lower-extremity injury.
The findings indicate that contemporary dance students are at high risk for lower-extremity injuries. Therefore, the identified risk factor (ankle dorsiflexion) should be considered for prevention purposes.
Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries.
To investigate the incidence and ...characteristics of injuries in the Dutch premier soccer league.
Cohort study.
The Dutch premier soccer league.
During the 2009-2010 soccer season, a total of 217 professional soccer players from 8 teams were prospectively followed.
The medical staff recorded time-loss injuries, including information on injuries (ie, type, body part, duration) and exposure data for training sessions and matches.
A total of 286 injuries were recorded, affecting 62.7% of the players. The overall injury incidence was 6.2 injuries per 1000 player-hours, 2.8 in training sessions and 32.8 in matches. Most of the recorded injuries were acute (68.5%). Eight percent of the injuries were classified as recurrent. Injuries were most likely to be located in the lower extremities (82.9%). Injury time loss ranged from 1 to 752 days, with a median of 8 days. Knee injuries had the greatest consequences in terms of days of absence from soccer play (on average, 45 days). The most common diagnosis was muscle/tendon injury of the lower extremities (32.9%).
Injury risk in the Dutch premier soccer league is high, especially during matches. Preventive measures should focus on the most common diagnoses, namely, muscle/tendon injuries of the lower extremities.
Physical and mental health problems in music students are usually identified using self-reported data. The use of an Electronic Health Record database can avoid biases to give an overview of the ...extent of health problems in this population. Therefore, the aim of this study is to gain insight into both physical and mental health related issues in classical music students using this type of data collection. An Electronic Health Record database including five years of data from a Performing Arts Health Centre (PAHC) of a university or the arts, was used to analyze the number and characteristics of health consultations in music students. The total number of students, health consultations and the average number of visits per health consultation were calculated over five years. Furthermore, numbers and percentages of both physical and mental health consultations were registered. Also, the number and percentage of health consultations per instrument group were compared to the proportion of each instrument group within the specific sample. Over a period of five years, 230 students visited the PAHC and 417 health consultations were reported. 43.5% of the students who visited a health professional indicated at least one physical health consultation, 29.1% at least one mental health consultation and 27.4% at least one in both categories. An injury was the most frequently registered physical health consultation (40.2%), followed by performance improvement (9.8%) and stress (9.6%). Voice students registered relatively most health consultations. As far as we know, this is the first cross-sectional study using Electronic Health Record data from a PAHC to gain insight into both physical and mental health related issues in a population of classical music students. Looking at the variety of health consultations registered in the database, a multidisciplinary team and multidisciplinary approach are necessary to meet the needs of the students in terms of physical and mental health support and performance improvement.
The aim of this study was to investigate the effect of COVID-19 preventive measures on the mental health of performing arts students. In a prospective cohort study, performing arts students (
N
= ...213) from Codarts Rotterdam, University of the Arts, were invited to monitor their health during one academic year (September 2019–May 2020). Every month, students completed items on mental health complaints, stress, and sleep quality. Chi-square tests and repeated-measures ANOVA with deviation contrasts were performed to investigate whether COVID-19 preventive measures were associated with changes in mental health complaints, stress scores, and sleep quality. During the COVID-19 lockdown, subjective mental health, Mental Health Inventory-5 (MHI-5), and items on loneliness were additionally completed by the respondents. A total of 98 students (46.0%) were included in the analyses. The 3-month prevalence of mental health complaints was significantly higher during the COVID-19 lockdown compared to the two pre-COVID-19 periods (
p
< 0.001). Mean stress scores were significantly lower for February (35.20) and March (36.41) when compared to the overall mean (40.38). Sleep quality scores (mean) were significantly higher for April (6.90), and May (6.89) when compared to overall mean (6.58). Furthermore, at least 75.5% of the participants dealt with moderate to very severe loneliness in all 3 months during the COVID-19 lockdown. During lockdown, performing arts students perceived less stress and their sleep quality increased. However, the prevalence of mental health complaints increased. Besides, 3 out 4 students dealt with moderate to very severe loneliness.
The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the ...association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (
N
= 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0–100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as “all injuries” (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and “substantial injuries” (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann–Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March,
p
< 0.05), and in 5 months for substantial injuries (September, October, November, December, April,
p
< 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries
F
(1.87,216.49) = 3.10,
p
= 0.051 and substantial injuries
F
(2,138) = 4.16,
p
= 0.018. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.
Musculoskeletal complaints are common in pre-professional and professional classical violinists and these complaints can affect violinists' performance. Therefore, it is important to identify the ...factors that contribute to healthy performance in this population. Qualitative studies with a variety of stakeholders are able to provide insights from different perspectives into factors influencing healthy performance for the pre-professional and professional classical violinist. In the current small-scale, exploratory study, semi-structured interviews were conducted with various stakeholders; two classical violin students, one classical violin teacher, a physiotherapist, a professional classical violinist, who is also a performance coach, and a health specialist who also graduated as a professional classical violist. Thematic analysis was conducted using Atlas.ti 9. We identified six themes that were indicated as important by the participants in terms of ensuring healthy performance for the pre-professional and professional classical violinist. The themes were: (1) physical aspects (involved in playing the violin); (2) practice routine and techniques; (3) interaction between physical and mental aspects; (4) culture; (5) role of the main subject teacher; and (6) preventive measures. Furthermore, when asked specifically about the development of a physical screening tool, the participants indicated that such a tool should include multiple factors covering various regions of the body, the inclusion of a questionnaire on risk-factors, and follow-up measurements. Also, collaborations between health professionals and main subject teachers were recommended as part of the screening tool to increase commitment of participating students. The results of the current study are based on the opinions, attitudes, and ideas of a small, selected group of participants only and cannot be generalized to a wider group of violinists. More research is needed regarding factors influencing healthy performance, before conservatoires and professional orchestras can develop programs for a healthy playing environment for pre-professional and professional violinists.
Background
Several studies have investigated injuries of (pre-)professional ballet dancers, however most used a medical-attention and/or time-loss definition and did not analyse the prevalence of all ...health problems. The aim was to analyse the frequency and characteristics of all self-reported physical and mental health complaints (i.e. injuries, illnesses and mental health problems) of professional ballet dancers during one season.
Methods
Three professional ballet companies were prospectively monitored weekly during one season with the Performing artist and Athlete Health Monitor (PAHM). Numerical rating scales (ranging 0–10) were used for severity of musculoskeletal pain, all health problems and impairment of the ability to dance at full potential in the previous seven days. If dancers rated the severity of their health problems or their impairment greater than 0, they were asked to answer specific questions on the characteristics of each health problem.
Results
Over a period of 44 weeks, 57 dancers (57.9% female) filled in 1627 weekly reports (response rate of 64.9%), in which 1020 (62.7%) health problem were registered. The dancers reported musculoskeletal pain in 82.2% of the weeks. They felt that their ability to dance at their full potential was affected due to a health problem in about every second week (52.6%) or on at least 29.1% of the days documented in the weekly reports. Almost all dancers (96.5%) reported at least one injury, almost two thirds (64.9%) an illness and more than a quarter (28.1%) a mental health problem. On average, every dancer reported 5.6 health problems during the season. Most of the 320 health problems were injuries (73.1%), 16.9% illnesses and 10.0% mental health problems. Injuries affected mainly ankle, thigh, foot, and lower back and were mostly incurred during rehearsal (41.6%) or training (26.1%). The most frequent subjective reasons of injury were “too much workload” (35.3%), “tiredness/exhaustion” (
n
= 22.4%) and “stress/overload/insufficient regeneration” (
n
= 21.6%).
Conclusion
Preventive interventions are urgently required to reduce the prevalence of health problems and especially injuries of professional dancers. Injury prevention measures should regard the balance of the load capacity of professional dancers and the workload in training, rehearsals and performances.
Key Points
The prevalence of health problems is high: Almost all professional ballet dancers (97%) reported at least one injury, 65% an illness and 28% a mental health problem during one season.
Health problems have substantial impact: On at least 29% of the days documented in the weekly reports, the dancers were not able to dance at full potential due to a health problem.
Many injuries seem to be preventable: Half of the injuries occur during training (26%) or rehearsal run-through (23%) and the most frequent reasons were “too much workload” (35%), “tiredness / exhaustion” (n=22%) and “stress / overload / insufficient regeneration” (22%).
This study investigated potential risk factors (coping, perfectionism, and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality ...studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program, and history of injury) and psychological constructs (coping, perfectionism, and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e., student characteristics and psychological constructs) and substantial injuries. Ninety-nine students were included in the analyses. During the academic year 2016/2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84-0.98), age (OR: 0.67; 95% CI: 0.46-0.98), and BMI (OR: 1.38; 95% CI: 1.05-1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger sample sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career.
PDF
