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Farooqi A, Talwar D, Tata R, Harwood K, Maguire K. Comparison of pediatric performance athlete injuries presenting to emergency departments. PHYSICIAN SPORTSMED 2023; 51:64-72. [PMID: 34696657 DOI: 10.1080/00913847.2021.1996863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Pediatric injuries in performance sports represent a significant healthcare burden and account for over 50,000 annual Emergency Department (ED) visits in the United States. The objective of this study was to characterize and compare pediatric injury presentation across the most common performance sports. METHODS The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed for pediatric injuries (3-18 years) related to gymnastics, dance, or cheerleading from 2015-2019. Cases were categorized as children (˂11 years) or adolescent (≥11 years). Injuries were categorized as orthopedic (fractures, dislocations, sprain, strains), non-orthopedic (contusion, internal injury, laceration), concussion, or other/unknown. Case narratives were used to categorize mechanism of injury as contact or non-contact. Appropriate sample NEISS weights estimation was applied for statistical analysis and Confidence Intervals (CI). RESULTS A total of 393,110 injuries were observed over the five-year study period, with a mean of 78,622 annual injuries. Gymnastics, dance, and cheerleading accounted for 136,422 injuries, 96,416 injuries, and 160,272 injuries, respectively. Most cases were adolescent (71%; 95% CI: 68-74%) and occurred in a sports-related setting (65%, 95% CI: 57-72%). Gymnastics had the highest proportion of injuries among children (50%) as compared to dancers (25%) or cheerleaders (12%) (p < 0.01). Non-contact injuries most affected the lower extremity (43-68%) and resulted in an orthopedic diagnosis (63-71%), and contact injuries had a higher proportion of injuries affecting the head, neck, and face (29-51%) and non-orthopedic diagnoses (29-38%). Gymnastics had the most upper extremity non-contact injuries (42%) and dance the most lower extremity non-contact injuries (68%) (p < 0.01). Cheerleading had the highest incidence of overall concussions (8%), contact injuries (47%), and concussions due to contact injury (15%). CONCLUSION Pediatric gymnasts, cheerleaders, and dancers have important similarities and differences in injury pattern which may lead to the development of sport-specific injury prevention programs for pediatric performance athletes.
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Affiliation(s)
- Ali Farooqi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States
| | - Divya Talwar
- Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
| | - Ravi Tata
- Drexel School of Medicine, Philadelphia, Unites States
| | - Kathleen Harwood
- Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
| | - Kathleen Maguire
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States.,Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
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Mailuhu AKE, van Rijn RM, Stubbe JH, Bierma-Zeinstra SMA, van Middelkoop M. Incidence and prediction of ankle injury risk: a prospective cohort study on 91 contemporary preprofessional dancers. BMJ Open Sport Exerc Med 2021; 7:e001060. [PMID: 34178374 PMCID: PMC8190045 DOI: 10.1136/bmjsem-2021-001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/03/2022] Open
Abstract
Objectives This study examines the incidence of ankle injuries and identifies ankle injury risk among contemporary preprofessional dancers. Methods A total of 91 first-year contemporary preprofessional dancers were prospectively followed during one academic year. Self-reported ankle injuries, assessed with the Oslo Sports Trauma Research Centre questionnaire, were categorised as all complaint ankle injuries, substantial ankle injuries or time-loss ankle injuries. In addition, ankle injuries leading to medical attention were included. Regression analyses were used to determine the association between potential risk factors (dancer characteristics, history of ankle injury in the previous year, ankle range of motion and dorsiflexion) and ankle injuries. Results The 1-year ankle injury incidence proportion was 18.7% (n=17), 8.8% (n=8), 15.4% (n=14) and 7.7% (n=7), respectively, for all complaint ankle injuries, ankle injuries requiring medical attention, time-loss injuries and substantial injuries. Being male (OR=0.27; 95% CI 0.09 to 0.75) and being a student of the Bachelors in Dance and Education (OR=0.27; 95% CI 0.08 to 0.97) were univariately associated with a lower risk of an ankle injury. Conclusion Almost 20% of first-year preprofessional dancers reported an ankle injury, with more than 80% of the dancers reporting that their injury leads to dance time loss. Males and students of the bachelors in dance and education were at lower risk of ankle injuries. As ankle injuries are common among dancers, studies with larger sample sizes, a more heterogeneous population (eg, different dance styles) and longer follow-up periods are necessary to evaluate the impact of ankle injuries in further detail.
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Affiliation(s)
- Adinda K E Mailuhu
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Rogier M van Rijn
- Codarts Rotterdam, University of the Arts, Rotterdam, the Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, the Netherlands
| | - Janine H Stubbe
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Codarts Rotterdam, University of the Arts, Rotterdam, the Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, the Netherlands.,Rotterdam Arts and Sciences Lab (RASL), Rotterdam, the Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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L Biernacki J, Stracciolini A, Fraser J, J Micheli L, Sugimoto D. Risk Factors for Lower-Extremity Injuries in Female Ballet Dancers: A Systematic Review. Clin J Sport Med 2021; 31:e64-e79. [PMID: 30589745 DOI: 10.1097/jsm.0000000000000707] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ballet dancers have a high prevalence of injuries to the lower extremity. Many studies have investigated the relationship between dance injury and risk factors. However, risk factors for lower-extremity injury comparing recreational- and elite-level ballet dancers are scarce. OBJECTIVE To systematically review available original studies to assess risk factors for lower-extremity injury in female ballet dancers between recreational and elite ballet dancers. DATA SOURCES Five online databases [Web of Science, PubMed, OVID (Medline), EBSCO, and ProQuest] were searched systematically. STUDY SELECTION Included studies had an analytic study design published in the past 11 years and investigated an association between potential risk factors and lower-extremity injury in female ballet dancers. STUDY APPRAISAL Assessed independently by 2 reviewers using the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine. RESULTS Seventeen studies were included. Alignment was a risk factor for lower-extremity injury in both recreational and elite ballet dancers. In elite ballet dancers, poor lumbopelvic movement control, inappropriate transversus abdominis contraction, decreased lower-extremity strength, and poor aerobic fitness were risk factors for lower-extremity injury. In recreational ballet dancers, hypermobility of the hip and ankle and longer training hours were risk factors for lower-extremity injury. Mean DB score was 15.94 (SD 1.57). The majority of studies were retrospective cohort studies or had poor follow-up, with 7 level 2b studies, 6 level 3b studies (cross-sectional), and 4 level 1b studies (prospective cohort with good follow-up). CONCLUSIONS Alignment was identified as a common risk factor for recreational and elite ballet dancers. Other risk factors differed between recreational ballet dancers and elite ballet dancers. Future studies are warranted to use a prospective study design, identify dance level-specific risk factors, and implement evidence-based prevention strategies.
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Affiliation(s)
- Jessica L Biernacki
- Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Andrea Stracciolini
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts; and
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Joana Fraser
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts; and
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Lyle J Micheli
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts; and
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts; and
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
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Abstract
BACKGROUND Dance is a physical pursuit that involves loading the spine through repetitive dynamic movements and lifting tasks. As such, low back pain (LBP) and low back injury (LBI) have been identified as common health problems in contemporary and classical ballet dancers. However, clarity regarding the experience of LBP and LBI in dance is lacking. OBJECTIVES To systematically review and synthesize the epidemiology of LBP and LBI in dance populations. METHODS A comprehensive search of 6 electronic databases, back catalogs of dance science-specific journals, and reference lists of relevant articles and a forward citation search were performed. RESULTS Fifty full-text articles were included in the final systematic review. There was considerable methodological heterogeneity among the included studies. The median (range) point, yearly, and lifetime prevalence of LBP was 27% (17%-39%), 73% (41%-82%), and 50% (17%-88%), respectively. The lower back contributed to 11% (4%-22%) of time loss and 11% (5%-23%) of medical-attention injuries. CONCLUSION Dancers are vulnerable to LBP and LBI. The use of definitions that are sensitive to the complexity of LBP and LBI would facilitate improved understanding of the problem within dance, inform health care strategies, and allow for monitoring LBP-specific intervention outcomes. J Orthop Sports Phys Ther 2019;49(4):239-252. Epub 18 Jan 2019. doi:10.2519/jospt.2019.8609.
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Moita JP, Gomes A, Xarez L, Coelho C. The role of prediagnostic data in injury epidemiology in preprofessional dancers. Scand J Med Sci Sports 2019; 29:606-614. [PMID: 30634200 DOI: 10.1111/sms.13382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/31/2018] [Accepted: 12/31/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION preprofessional dance training starts at very early ages, on a highly demanding environment placing students at significant risk for injury. Injury management and prevention are a matter of concern. Given the constant interchangeability of risk factors, identifying injury patterns may prove to be equally as important. Data looking back from the time of injury through context-specific approaches are missing. OBJECTIVES To identify activity-related injury patterns based on prediagnostic data. METHODS Prospective, non-randomized, observational study, over a 3 years period on a full-time preprofessional dance school featuring both gender students aged 9-21 years old. Non-parametric statistics were used. RESULTS A total of 625 dance injury records from 209 students, n = 68 males and n = 141 females, were analyzed. Season injury risk probability was identified, proving different for each skill level (SkL). Multiple individual injuries revealed a trend toward prevalence rates in advanced level, while index injuries incidence becomes more noticeable in entry level students. Overall incidence rates had no significant differences within SkL. Anatomical location was in line with previous research, although differences were found between gender and SkL. Most injuries occurred in classes, with jumps standing out as the main motor action associated with injury symptoms of gradual onset mechanism. CONCLUSION Dance injuries happen because of dance practice. Knowing the context of injury history from the injured dancer perspective is determinant for management and prevention. prediagnostic data are an umbrella term encompassing several aspects of injury background and represents fertile ground for research. Context-specific methodological approaches are recommended.
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Affiliation(s)
- João Paulo Moita
- Escola Superior de Saúde Atlântica, Barcarena, Portugal.,Escola de Dança do Conservatório Nacional, Lisboa, Portugal
| | - António Gomes
- Departamento de Cirurgia, Hospital Prof. Dr. Fernando Fonseca, Amadora, Portugal
| | - Luís Xarez
- Faculdade de Motricidade Humana, Laboratório do Comportamento Motor, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Constança Coelho
- Universidade de Lisboa, Faculdade de Medicina de Lisboa, Laboratório de Genética, Instituto de Saúde Ambiental, Lisboa, Portugal
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Siev-Ner I, Stern MD, Tenenbaum S, Blankstein A, Zeev A, Steinberg N. Ultrasonography findings and physical examination outcomes in dancers with and without patellofemoral pain. PHYSICIAN SPORTSMED 2018; 46:48-55. [PMID: 28994332 DOI: 10.1080/00913847.2018.1391048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To identify whether a physical examination for patello-femoral pain (PFP) is related to ultrasonography findings at the knee, and to identify possible factors related to PFP in young dancers. METHODS Sixty-seven young female dancers (7th grade, aged 12.8 ± 0.5) from three schools with identical special dance programs were included in the study. All the dancers were interviewed for demographic details, dance background, and training intensity; were evaluated for anthropometric measurements; underwent physical examination of both knees for PFP and for knee range of motion (ROM); and, had ultrasonography assessment for pathologies and of anatomical parts of their knees. RESULTS PFP was found in 54.5% of the 134 knees physically examined. In ultrasonography assessment, infra-articular effusion was found in 46.2% of the knees examined. H/week of dance practice was significantly higher among dancers with PFP (in both knees) compared with dancers with no PFP (p < .05). Knees with PFP had a significantly higher prevalence of intra articular effusion (p = .018) and higher prevalence of genu-recurvatum (p = .042). Knees with PFP had significantly greater growth plate width-anterior tibial tuberosity (p = .022) and a greater bony trochlear groove angle (p = .048). CONCLUSION This study describes the relationship between physical examination for PFP and the sonographic findings, and the factors related to knee injuries. The results showed a high prevalence of PFP and intra articular knee effusion among young dancers at the age of 12-13 years; and, that the number of hours of practice and anatomical structure are related to PFP. Our results should alert physicians, physiotherapists, athletic trainers and dance teachers to the need for devising modifications of training and injury prevention strategies from a young age (<12 years old).
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Affiliation(s)
- Itzhak Siev-Ner
- a Orthopedic Rehabilitation Department , Sheba Medical Center , Tel-Hashomer , Israel
| | - Myriam D Stern
- b Department of Radiology , Sheba Medical Center, Sackler School of Medicine , Tel Aviv University , Israel
| | - Shay Tenenbaum
- c Department of Orthopedic Surgery , Chaim Sheba Medical Center, Sackler Faculty of Medicine , Tel Aviv University , Israel
| | - Alexander Blankstein
- c Department of Orthopedic Surgery , Chaim Sheba Medical Center, Sackler Faculty of Medicine , Tel Aviv University , Israel
| | - Aviva Zeev
- d The Wingate College of Physical Education and Sports Sciences at the Wingate Institute , Netanya , Israel
| | - Nili Steinberg
- d The Wingate College of Physical Education and Sports Sciences at the Wingate Institute , Netanya , Israel
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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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