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Monfort-Torres G, García-Massó X, Skýpala J, Blaschová D, Estevan I. Coordination and coordination variability during single-leg drop jump landing in children. Hum Mov Sci 2024; 96:103251. [PMID: 39032450 DOI: 10.1016/j.humov.2024.103251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/02/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Coordinative patterns require experience and learning to be acquired, producing movements that offer efficient solutions to various situations and involving certain degree of variability. This coordination variability implies functionality in movement, but it can be impacted by the type of sport practice from early years. The purpose of this work is to analyze the coordination variability and coordination patterns in a specific action such as single-leg landing in children practicing gymnastics, volleyball and non-sporting children. Thirty children (15 girls) performed 10 successful trials of single-leg landing from a height of 25 cm. A motion capture system (9 cameras) was used to capture 3D thigh and shank kinematics. To identify the significant effect of children's groups on coordination and coordination variability during single-leg landing, one-dimensional Statistical Parametric Mapping (SPM) was used. Regarding the coordination patterns, in the frontal plane, during the attenuation phase of single-leg landing, the control group exhibited a higher frequency of Anti-Phase with proximal dominancy compared to the sport groups (i.e., gymnastics, and volleyball). In addition, in the sagittal plane during the second peak phase, volleyball players exhibited a higher coordination variability than the gymnastics. The children in the control group showed a greater frequency of antiphasic movements, which indicates the influence of training at an early age, being a determining factor in the increase or not of variability.
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Affiliation(s)
- Gonzalo Monfort-Torres
- Education & Sport Unit, Florida Universitaria, Carrer del Rei En Jaume I, 2, 46470 Catarroja, Valencia, Spain.
| | - Xavier García-Massó
- Department of Teaching of Physical Education, Arts and Music, Universidad de Valencia, Av. dels Tarongers, 4, 46022 Valencia, Spain.
| | - Jiří Skýpala
- Department of Human Movement Studies, University of Ostrava, Varenská 3098/40A, 702 00 Moravská Ostrava a Přívoz, Czechia.
| | - Denisa Blaschová
- Department of Human Movement Studies, University of Ostrava, Varenská 3098/40A, 702 00 Moravská Ostrava a Přívoz, Czechia.
| | - Isaac Estevan
- Department of Teaching of Physical Education, Arts and Music, Universidad de Valencia, Av. dels Tarongers, 4, 46022 Valencia, Spain.
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Donelon TA, Edwards J, Brown M, Jones PA, O'Driscoll J, Dos'Santos T. Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:29. [PMID: 38561438 PMCID: PMC10984914 DOI: 10.1186/s40798-024-00701-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. OBJECTIVE The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. METHODS Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021-June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18-40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. RESULTS This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098-0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299-1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134-0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: -0.454, 95% CI 0.151-0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally applied KJLs. All retrieved studies failed to control for strength, resistance training or skill history status. CONCLUSION No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females.
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Affiliation(s)
- Thomas A Donelon
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK.
| | - Jamie Edwards
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Mathew Brown
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Paul A Jones
- School of Health Sciences, C702 Allerton Building, University of Salford, Salford, M6 6PU, UK
| | - Jamie O'Driscoll
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences | Manchester Metropolitan University, 2.01 Institute of Sport, 99 Oxford Road, Manchester, M1 7EL, UK
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Dang Y, Koutedakis Y, Chen R, Wyon M. Injury incidence and severity in Chinese pre-professional dancers: A prospective weekly monitoring survey. J Sci Med Sport 2024; 27:86-91. [PMID: 38114411 DOI: 10.1016/j.jsams.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/02/2023] [Accepted: 09/29/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES To determine dance injury incidence and severity in full-time Chinese pre-professional dancers. STUDY DESIGN Prospective weekly online monitoring survey. METHODS Respondents were asked to record all dance-injury incidences between September 2020 and July 2021 using a remote weekly self-report injury monitoring tool. An inclusive definition of injury was used in this study to record all injuries, even if they didn't cause a cessation of training. Data were excluded if respondents completed <90 % of the survey period and had over 3 consecutive weeks of missing data. RESULTS 450 individuals from 11 different schools were included in the analyses. A total of 1157 injuries were reported over a 30-week academic year. Injury prevalence was 64.9 % and injury incidence was 5.51 injuries per 1000 h. Forty-eight percent of the injuries were minor severity and 41 % were of moderate severity, and the main injury sites were knees (0.89/1000 h), lower back (0.80/1000 h), feet (0.58/1000 h) and groin (0.56/1000 h). Female dancers reported significantly higher injury prevalence and injury incidence, and higher rates of moderate to severe injuries than males. The university group reported higher injury incidence than the adolescent group (p < 0.05), whereas the latter reported higher rates of moderate to severe injuries than the former (p < 0.001). CONCLUSIONS The injury incidence found in this study (5.1 injuries/1000 h) is higher than most previous sets of data. Female dancers are at a higher risk of injury and reported higher levels of injury severity than male dancers, especially for the female adolescent group.
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Affiliation(s)
- Yanan Dang
- School of Sport, University of Wolverhampton, United Kingdom.
| | | | - Ruoling Chen
- School of Public Health, University of Wolverhampton, United Kingdom
| | - Matthew Wyon
- School of Sport, University of Wolverhampton, United Kingdom; National Institute of Dance Medicine and Science, United Kingdom. https://twitter.com/mattwyon
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White L, Losciale JM, Squier K, Guy S, Scott A, Prior JC, Whittaker JL. Combined hormonal contraceptive use is not protective against musculoskeletal conditions or injuries: a systematic review with data from 5 million females. Br J Sports Med 2023; 57:1195-1202. [PMID: 37225254 DOI: 10.1136/bjsports-2022-106519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Assess the association between combined hormonal contraceptives (CHC) use and musculoskeletal tissue pathophysiology, injuries or conditions. DESIGN Systematic review with semiquantitative analyses and certainty of evidence assessment, guided by the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SOURCES MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to April 2022. ELIGIBILITY Intervention and cohort studies that assessed the association between new or ongoing use of CHC and an outcome of musculoskeletal tissue pathophysiology, injury or condition in postpubertal premenopausal females. RESULTS Across 50 included studies, we assessed the effect of CHC use on 30 unique musculoskeletal outcomes (75% bone related). Serious risk of bias was judged present in 82% of studies, with 52% adequately adjusting for confounding. Meta-analyses were not possible due to poor outcome reporting, and heterogeneity in estimate statistics and comparison conditions. Based on semiquantitative synthesis, there is low certainty evidence that CHC use was associated with elevated future fracture risk (risk ratio 1.02-1.20) and total knee arthroplasty (risk ratio 1.00-1.36). There is very low certainty evidence of unclear relationships between CHC use and a wide range of bone turnover and bone health outcomes. Evidence about the effect of CHC use on musculoskeletal tissues beyond bone, and the influence of CHC use in adolescence versus adulthood, is limited. CONCLUSION Given a paucity of high certainty evidence that CHC use is protective against musculoskeletal pathophysiology, injury or conditions, it is premature and inappropriate to advocate, or prescribe CHC for these purposes. PROSPERO REGISTRATION NUMBER This review was registered on PROSPERO CRD42021224582 on 8 January 2021.
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Affiliation(s)
- Lynita White
- Tall Tree Physiotherapy and Health Centre, Vancouver, British Columbia, Canada
| | - Justin M Losciale
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kipling Squier
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Guy
- City Sport + Physiotherapy Clinic, Vancouver, British Columbia, Canada
| | - Alex Scott
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, The University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jackie L Whittaker
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Zamankhanpour M, Sheikhhoseini R, Letafatkar A, Piri H, Asadi Melerdi S, Abdollahi S. The effect of dual-task on jump landing kinematics and kinetics in female athletes with or without dynamic knee valgus. Sci Rep 2023; 13:14305. [PMID: 37652971 PMCID: PMC10471762 DOI: 10.1038/s41598-023-41648-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023] Open
Abstract
It has been indicated that dual tasks may multiply the possibility of injuries due to divided attention. This study aimed to investigate the effect of dual-task on kinematics and kinetics of jump landing in female athletes with and without dynamic knee valgus. In this study, 32 recreational athletes between 18 and 30 years old were recruited and divided into with (n = 17) and without (n = 15) dynamic knee valgus groups. The 3-D positions of retroreflective markers were recorded at 200 Hz using a 8-camera Kestrel system (Motion Analysis Corporation, Santa Rosa, CA), while ground reaction forces were synchronously recorded at 1000 Hz using 2 adjacent force plates (FP4060-NC; Bertec Corporation, Columbus, OH). Kinematics and kinetics of jump landing were recorded while counting backward digits as a dual task, and also without counting backward digits as a single task. One-way repeated measures of variance were used to analyse data at the significant level of 95% (α < 0.05). The study found that the dual-task affected the angles and moments of hip, knee, and ankle joints (P < 0.05) in both groups. Additionally, the effect of the dual-task differed significantly between the two groups in the angles hip flexion (P < 0.001), knee abduction (P < 0.001), and ankle internal rotation (P = 0.001), as well as the moments hip flexion (P < 0.001), hip abduction (P = 0.011), knee flexion (P = 0.017), knee internal rotation (P < 0.001), ankle dorsiflexion (P = 0.046), ankle eversion (P < 0.001), and ankle internal rotation (P = 0.046). Athletes with dynamic knee valgus may have been less able to protect themselves during the landing and are more prone to lower extremities injuries. As a result, using kinematics and kinetics in athletes with dynamic knee valgus during landing may help identify potential mechanisms associated with risk factors of lower extremity injuries and ACL injuries as well.
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Affiliation(s)
- Mina Zamankhanpour
- Department of Corrective Exercise and Sports Injury, Faculty of Sport Sciences, Allameh Tabataba'i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
| | - Rahman Sheikhhoseini
- Department of Corrective Exercise and Sports Injury, Faculty of Sport Sciences, Allameh Tabataba'i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran.
| | - Amir Letafatkar
- Department of Biomechanics and Sports Injuries, Kharazmi University, Tehran, Iran
| | - Hashem Piri
- Department of Corrective Exercise and Sports Injury, Faculty of Sport Sciences, Allameh Tabataba'i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
| | - Shakiba Asadi Melerdi
- Department of Philology, Philosophy, and Sports, Otto von Guericke University, Magdeburg, Germany
| | - Sajjad Abdollahi
- Department of Corrective Exercise and Sports Injury, Faculty of Sport Sciences, Allameh Tabataba'i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
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Dos’Santos T, Stebbings GK, Morse C, Shashidharan M, Daniels KAJ, Sanderson A. Effects of the menstrual cycle phase on anterior cruciate ligament neuromuscular and biomechanical injury risk surrogates in eumenorrheic and naturally menstruating women: A systematic review. PLoS One 2023; 18:e0280800. [PMID: 36701354 PMCID: PMC9879429 DOI: 10.1371/journal.pone.0280800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Eumenorrheic women experience cyclic variations in sex hormones attributed to the menstrual cycle (MC) which can impact anterior cruciate ligament (ACL) properties, knee laxity, and neuromuscular function. This systematic review aimed to examine the effects of the MC on ACL neuromuscular and biomechanical injury risk surrogates during dynamic tasks, to establish whether a particular MC phase predisposes women to greater ACL injury risk. METHODS PubMed, Medline, SPORTDiscus, and Web of Science were searched (May-July 2021) for studies that investigated the effects of the MC on ACL neuromuscular and biomechanical injury risk surrogates. Inclusion criteria were: 1) injury-free women (18-40 years); 2) verified MC phases via biochemical analysis and/or ovulation kits; 3) examined neuromuscular and/or biomechanical injury risk surrogates during dynamic tasks; 4) compared ≥1 outcome measure across ≥2 defined MC phases. RESULTS Seven of 418 articles were included. Four studies reported no significant differences in ACL injury risk surrogates between MC phases. Two studies showed evidence the mid-luteal phase may predispose women to greater risk of non-contact ACL injury. Three studies reported knee laxity fluctuated across the MC; two of which demonstrated MC attributed changes in knee laxity were associated with changes in knee joint loading (KJL). Study quality (Modified Downs and Black Checklist score: 7-9) and quality of evidence were low to very low (Grading of Recommendations Assessment Development and Evaluation: very low). CONCLUSION It is inconclusive whether a particular MC phase predisposes women to greater non-contact ACL injury risk based on neuromuscular and biomechanical surrogates. Practitioners should be cautious manipulating their physical preparation, injury mitigation, and screening practises based on current evidence. Although variable (i.e., magnitude and direction), MC attributed changes in knee laxity were associated with changes in potentially hazardous KJLs. Monitoring knee laxity could therefore be a viable strategy to infer possible ACL injury risk.
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Affiliation(s)
- Thomas Dos’Santos
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
- * E-mail:
| | - Georgina K. Stebbings
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Christopher Morse
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Medha Shashidharan
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Katherine A. J. Daniels
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andy Sanderson
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
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Russell JA, Mueller IF. Force Attenuation Properties of Padded Dance Support Socks. J Dance Med Sci 2022; 26:106-113. [PMID: 35287788 DOI: 10.12678/1089-313x.061522c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Foot injuries occur frequently in dancers, and researchers have investigated different protective measures to reduce their incidence. Research has primarily focused on ballet, but foot injuries also are common in modern and contemporary dance where footwear is not worn. While padded dance socks are a potential solution, the extent to which they provide force reduction for the feet is unknown.<br/> Purpose: This study investigates the extent to which padded dance support socks can reduce force on the foot during a dance sequence and when landing from a sauté jump.<br/> Methods: Twenty-one injury-free dancers (2 M, 19 F; age: 21.5 ± 6.7 years; height: 165.5 ± 6.1 cm; mass: 68.6 ± 15.0 kg) volunteered for this randomized, cross-over design study. Participants per- formed a 40-second modern dance sequence and a sauté jump landing under two conditions: wearing Apolla Performance Shock™ dance socks (DS) and with bare feet (BF). During these activities, 1.0 cm diameter circular force transducers were affixed under the first metatarsophalangeal joint and under the center of the heel. The sensors wirelessly recorded peak toe force, peak heel force, mean toe force, and mean heel force during dancing. A force platform measured vertical ground reaction force (VGRF) and time to peak VGRF, while the foot sensors measured peak toe force and peak heel force, during the jump landings. A Noraxon MR3.12 biomechanics system synchronized and recorded the data. All force data were normalized to body weight (BW). Dependent samples t-tests were used to assess pairwise differences in these measures between the DS and BF conditions. Alpha was set at p < 0.05.<br/> Results: Mean and peak heel forces/BW when dancing with DS were significantly lower than during BF dancing (mean: p = 0.015; peak: p = 0.0004). Peak VGRF/BW when landing from the sauté jump with DS was significantly lower compared with landing in BF (p = 0.035). All other variables were not significantly different between conditions, but all DS force values were lower than BF.<br/> Conclusions: We offer evidence that padded dance socks may reduce foot forces dancers commonly encounter during modern dance. The trends we recorded require further study to assess the extent to which the socks exhibit beneficial effects when considering both the many hours dancers train and the cumulative effects of impacts sustained by their feet.
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Affiliation(s)
- Jeffrey A Russell
- Laboratory for Science and Health in Artistic Performance, School of Applied Health Sciences and Wellness, Ohio University, Athens, Ohio, USA;,
| | - Isabella F Mueller
- Doctor of Physical Therapy Program, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
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Li F, Adrien N, He Y. Biomechanical Risks Associated with Foot and Ankle Injuries in Ballet Dancers: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084916. [PMID: 35457783 PMCID: PMC9029463 DOI: 10.3390/ijerph19084916] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 12/04/2022]
Abstract
Professional ballet dancers can be classified as dance artists and sports performers. This systematic review aims to consider the biomechanical risk factors for foot and ankle injuries in ballet dancers, as this could potentially reduce the impact that ‘cost of injury’ may have on ballet companies. An additional outcome was to examine the effects of injury on the career of ballet dancers. This study searched articles in four electronic databases for information in peer-reviewed journals. The included articles examined the relationships between biomechanical factors and the relationship between ballet shoes and foot performance. There were 9 articles included in this review. Among these articles, two focused on the peak force of the foot using two types of pointe shoes, three focused on overuse injuries of the ballet dancer’s foot, one article focused on the loading of the foot of a dancer, and three articles focused on the function and biomechanics of the foot in dancers. This review also found that the pointe shoe condition was the most important factor contributing to a foot injury; overuse injury related to high-intensity training and affected both the ankle and the foot; and metatarsophalangeal joint injury related to the function and structure of the foot. Finally, strengthening the lower extremity muscle is also a recommendation to improve muscle coordination and reduce injuries.
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Affiliation(s)
- Fengfeng Li
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (F.L.); (N.A.)
| | - Ntwali Adrien
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (F.L.); (N.A.)
- Savaria Institute of Technology, Eötvös Loránd University, 9700 Szombathely, Hungary
| | - Yuhuan He
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (F.L.); (N.A.)
- Department of Physical and Health Education, Udon Thani Rajabhat University, Udon Thani 41000, Thailand
- CEEC Economic and Trade Cooperation Institute, Ningbo University, Ningbo 315211, China
- Correspondence: ; Tel.: +86-574-87600456
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Sha Y, Zhang B, Chen L, Hong H, Chi Q. Mechano Growth Factor Accelerates ACL Repair and Improves Cell Mobility of Mechanically Injured Human ACL Fibroblasts by Targeting Rac1-PAK1/2 and RhoA-ROCK1 Pathways. Int J Mol Sci 2022; 23:ijms23084331. [PMID: 35457148 PMCID: PMC9026312 DOI: 10.3390/ijms23084331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Exceeded mechanical stress leads to a sublethal injury to anterior cruciate ligament (ACL) fibroblasts, and it will hinder cell mobility and ACL regeneration, and even induce osteoarthritis. The mechano growth factor (MGF) could be responsible for mechanical stress and weakening its negative effects on cell physiological behaviors. In this study, effects of MGF on cell mobility and relevant molecules expression in injured ACL fibroblasts were detected. After an injurious mechanical stretch, the analysis carried out, at 0 and 24 h, respectively, showed that the cell area, roundness, migration, and adhesion of ACL fibroblasts were reduced. MGF (10, 100 ng/mL) treatment could improve cell area, roundness and promote cell migration and adhesion capacity compared with the injured group without MGF. Further study indicated that cell mobility-relevant molecules (PAK1/2, Cdc42, Rac1, RhoA, and ROCK1) expression in ACL fibroblasts was down-regulated at 0 or 24 h after injurious stretch (except Rac1 and RhoA at 0 h). Similarly, MGF improved cell mobility-relevant molecule expression, especially the ROCK1 expression level in ACL fibroblasts at 0 or 24 h after injurious stretch. Protein expression of ROCK1 in injured ACL fibroblasts was also reduced and could be recovered by MGF treatment. In a rabbit partial ACL transection (ACLT) model, ACL exhibited poor regenerative capacity in collagen and extracellular matrix (ECM) synthesis after partial ACLT for 2 or 4 weeks, and MGF remarkably accelerated ACL regeneration and restored its mechanical loading capacity after partial ACLT for four weeks. Our findings suggest that MGF weakens the effects of pathological stress on cell mobility of ACL fibroblasts and accelerates ACL repair, and might be applied as a future treatment approach to ACL rupture in the clinic.
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Affiliation(s)
- Yongqiang Sha
- Center for Precision Medicine, School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen 361021, China; (B.Z.); (L.C.); (H.H.)
- National Innovation and Attracting Talents “111” Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China;
- Correspondence:
| | - Beibei Zhang
- Center for Precision Medicine, School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen 361021, China; (B.Z.); (L.C.); (H.H.)
| | - Liping Chen
- Center for Precision Medicine, School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen 361021, China; (B.Z.); (L.C.); (H.H.)
| | - Huhai Hong
- Center for Precision Medicine, School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen 361021, China; (B.Z.); (L.C.); (H.H.)
| | - Qingjia Chi
- National Innovation and Attracting Talents “111” Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China;
- Department of Mechanics and Engineering Structure, Hubei Key Laboratory of Theory and Application of Advanced Materials Mechanics, Wuhan University of Technology, Wuhan 430070, China
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10
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Ruan M, Zhang Q, Zhang X, Hu J, Wu X. Differences in strength and landing biomechanics between female jumpers and swimmers. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-210149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: It remains unclear if plyometric training as a single component could improve landing mechanics that are potentially associated with lower risk of ACL injury in the long term OBJECTIVE: The purpose of this study was to investigate the influence of experience undertaking plyometrics on landing biomechanics in female athletes. METHODS: Non-jumpers with little experience in plyometric training (12 female college swimmers) and jumpers with five years of experience in plyometric training (12 female college long jumpers and high jumpers) were recruited to participate in two testing sessions: an isokinetic muscle force test for the dominant leg at 120∘/s and a 40-cm drop landing test. An independent t test was applied to detect any significant effects between cohorts for selected muscle force, kinematic, kinetic, and electromyography variables. RESULTS: While female jumpers exhibited greater quadriceps eccentric strength (P= 0.013) and hamstring concentric strength (P= 0.023) during isokinetic testing than female swimmers, no significant differences were observed in kinematics, kinetics, and muscle activities during both drop landing and drop jumping. CONCLUSIONS: The results suggest that the female jumpers did not present any training-induced modification in landing mechanics regarding reducing injury risks compared with the swimmers. The current study revealed that plyometric training as a single component may not guarantee the development of low-risk landing mechanics for young female athletes.
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Affiliation(s)
- Mianfang Ruan
- School of Physical Education and Health, Wenzhou University, Wenzhou, Zhejiang, China
- School of Physical Education and Health, Wenzhou University, Wenzhou, Zhejiang, China
| | - Qiang Zhang
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
- School of Physical Education and Health, Wenzhou University, Wenzhou, Zhejiang, China
| | - Xin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jing Hu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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11
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Civilette MD, Rate WR, Haislup BD, Cohen AS, Camire L, Bodendorfer BM, Gould HP. The top 100 most impactful articles on the anterior cruciate ligament: An altmetric analysis of online media. SAGE Open Med 2022; 10:20503121221111694. [PMID: 35924141 PMCID: PMC9340895 DOI: 10.1177/20503121221111694] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/13/2022] [Indexed: 12/17/2022] Open
Abstract
Objectives: To identify the top 100 most impactful anterior cruciate ligament articles in online media as measured by the Altmetric Attention Score and compare their characteristics to the most-cited anterior cruciate ligament articles in the scientific literature. Methods: The Altmetric database was queried to identify all published articles pertaining to the anterior cruciate ligament. The search yielded 9445 articles, which were stratified by highest to lowest Altmetric Attention Score. The top 100 articles were included. Collected data included article type, article topic, journal name, and online mentions in news, blogs, Twitter, Facebook, Wikipedia, and other sources. The geographic origin of each article was also determined based on the institutional affiliation of the first author. Results: Altmetric Attention Score of the top 100 anterior cruciate ligament articles ranged from 109 to 2193 (median 172.0, interquartile range 137.5–271.5). Of the 100 articles, 65 were published in three journals: American Journal of Sports Medicine, British Journal of Sports Medicine, and Journal of Orthopaedic & Sports Physical Therapy. The most prevalent article type was original research (60%), followed by systematic review/meta-analysis (18%). The most prevalent article topic was rehabilitation and return to play after anterior cruciate ligament reconstruction (22%), followed by epidemiology/risk factors (16%), injury prevention (14%), and biomechanics of anterior cruciate ligament injuries (14%). Of the top 100 articles, 54% were American, 31% were European, and 15% were published in other countries outside of the United States and Europe. Conclusion: This study used Altmetric Attention Score to identify the 100 most engaged anterior cruciate ligament articles in online media. The characteristics of these articles differed substantially from the most-cited anterior cruciate ligament articles in the literature with regard to article type, article topic, geographic origin, and publication journal. These findings suggest that alternative metrics measure distinct components of anterior cruciate ligament article engagement and add an important dimension to understanding the overall impact of published research on the anterior cruciate ligament.
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Affiliation(s)
- Matthew D Civilette
- Georgetown University Medical Center, Washington, DC, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - William R Rate
- Georgetown University Medical Center, Washington, DC, USA
| | - Brett D Haislup
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Andrew S Cohen
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Lyn Camire
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Blake M Bodendorfer
- Division of Sports Medicine and Shoulder Surgery, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA
| | - Heath P Gould
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
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12
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Nagy P, Brogden C, Orr G, Greig M. Within- and between-day loading response to ballet choreography. Res Sports Med 2021; 30:616-627. [PMID: 34085896 DOI: 10.1080/15438627.2021.1929223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Overuse pathologies are prevalent in ballet injury. Ten amateur ballet dancers (age: 23.20 ± 3.08 years) completed a progressive 5-stage choreographed routine on two consecutive days. Tri-axial accelerometers positioned at C7 and the dominant and non-dominant lower-limb were used to calculate accumulated PlayerLoadTM (PLTOTAL) and uni-axial contributions of the anterior-posterior (PLAP), medial-lateral (PLML), and vertical (PLV) planes. PLTOTAL increased significantly (p = 0.001) as a function of exercise duration within-trial, however there was no significant change between trials (p = 0.18). PLTOTAL at C7 was significantly (p = 0.001) lower than both lower-limbs, with no bilateral asymmetry evident (p = 0.97). Planar contributions to PLTOTAL were significantly greater in PLV than PLAP and PLML (p = 0.001). PlayerLoadTM demonstrated within-trial sensitivity to the progressive routine, however no residual fatigue effect was observed between trials. The results of this study suggest that accelerometers have efficacy in athlete monitoring and injury screening protocols, however unit placement should be considered for practical interpretation.
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Affiliation(s)
- Philip Nagy
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
| | - Chris Brogden
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
| | - Gabrielle Orr
- Department of Creative Arts, Edge Hill University, Ormskirk, Lancashire, UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
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Long KL, Milidonis MK, Wildermuth VL, Kruse AN, Parham UT. The Impact of Dance-Specific Neuromuscular Conditioning and Injury Prevention Training on Motor Control, Stability, Balance, Function and Injury in Professional Ballet Dancers: A Mixed-Methods Quasi-Experimental Study. Int J Sports Phys Ther 2021; 16:404-417. [PMID: 33842036 PMCID: PMC8016435 DOI: 10.26603/001c.21150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 10/11/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Professional ballet dancers suffer high injury rates and are less likely than other athletes to specifically train to improve muscular strength, coordination, agility, speed and motor control because of heavy training demands, aesthetic appearances and financial barriers. HYPOTHESIS/PURPOSE The purpose of this study was to examine the effects of a supplemental conditioning program on professional and pre-professional contemporary ballet dancers. The authors hypothesized that those participating in a training program would reduce injury rate by improving their motor control, stability, balance and physical function. The authors aimed to observe the feasibility and qualitative phenomena related to a conditioning program from the dancer's perspective. STUDY DESIGN A mixed-methods study; within subject quasi-experimental design and qualitative interviews. METHODS Six professional classical and contemporary ballet dancers completed the five-week conditioning and injury prevention training program. Non-parametric analysis of baseline, posttest and four-month follow-up physical performance measures, subjective outcomes, and qualitative follow-up interviews, were reported. RESULTS Significant post-test improvements included: The Dance Functional Outcome Survey (Z= -2.2, p= 0.04), composite Modified Star Excursion Balance Test (Z= -2.2, p= 0.03 bilaterally), Single Leg Hop for Distance (Z= -2.02, p= 0.04), and Upper Extremity Closed Kinetic Chain Test (Z=-2.03, p= 0.04). Significant changes from baseline to the four-month follow up remained for: (1) Dance Functional Outcome Survey (Z= -2.2, p= 0.03), (2) Single Leg Hop for Distance (Z= -2.2, p= 0.03), and (3) Modified Star Excursion Balance Test composite maximum reach for the left lower extremity (Z= -2.2, p= 0.03). CONCLUSION Completing a conditioning and prevention program for professional ballet dancers was related to improved function, balance, hop distance/stability and upper extremity stability. Dancers found the program beneficial, identified barriers to participation, and elucidated factors making the program feasible and successful. More research is necessary to determine the effect of such programs on injury incidence. LEVEL OF EVIDENCE 3b.
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Aksu N, Atansay V, Karalök I, Aksu T, Kara AN, Hamzaoglu A. Relationship of Patellofemoral Angles and Tibiofemoral Rotational Angles With Jumper's Knee in Professional Dancers: An MRI Analysis. Orthop J Sports Med 2021; 9:2325967120985229. [PMID: 33796584 PMCID: PMC7970196 DOI: 10.1177/2325967120985229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Jumper’s knee is a type of tendinopathy affecting the distal insertion of the
quadriceps tendon (25% of cases) or the patellar tendon. It has been shown
that frontal-plane measurements, such as genu valgum, genu varum, an
increased quadriceps angle, a protuberant tibial tuberosity, patella alta,
and short hamstring muscles, may be related to jumper’s knee. Purpose: To investigate the effects of tibiofemoral rotational angles and
patellofemoral (PF) angles on the development of jumper’s knee in
professional folk dancers. Study Design: Case-control study; Level of evidence, 3. Methods: We examined 26 dancers (16 male, 10 female) with knee pain using magnetic
resonance imaging (MRI), for a total of 32 knees. Of the knees, 21 with
quadriceps tendinopathy (QT) and 7 with patellar tendinopathy (PT) were
detected. Using MRI scans, we measured PF angles (PF sulcus angle, lateral
PF angle, patellar tilt angle, lateral trochlear inclination angle, lateral
patellar tilt angle, and PF congruence angle) and tibiofemoral rotational
angles (condylar twist angle, posterior condylar angle, femoral Insall
angle, tibial Insall angle, posterior tibiofemoral angle, and angle between
the Whiteside line and posterior femoral condylar line) and noted specifics
such as patella alta, patella baja, and the Wiberg classification of the
patellar shape between the patients with versus without QT and between
patients with versus without PT to understand if there was any relationship
with tendinopathy. Results: No statistically significant difference was observed in age, sex, patella
alta, or the Wiberg classification between the QT groups (with vs without)
and between the PT groups (with vs without) (P > .05).
Having QT was found to be significantly associated with the PF sulcus angle
(P = .009), and having PT was found to be significantly
associated with the femoral Insall angle (P = .029). Conclusion: Jumper’s knee was found to be associated with anatomic variations of the PF
sulcus angle and rotation of the patellar tendon in relation to the femur
(femoral Insall angle) on axial MRI scans in professional dancers. Unlike
those of other athletes, dancers’ knees are exposed more to external
rotation forces because of turnout, and this can be the cause of jumper’s
knee.
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Affiliation(s)
- Neslihan Aksu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Vefa Atansay
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Işık Karalök
- Department of Radiology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Taner Aksu
- Istanbul Neuro-orthopaedics Clinic, Istanbul, Turkey
| | - Ayhan Nedim Kara
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Azmi Hamzaoglu
- Orthopaedic and Spine Center, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
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Cardoso AA, Reis NM, Silva JD, Borgatto A, Folle A, Resende R, Guimarães ACDA. [Fatigue and quality of life among professional ballroom dancers in Brazil]. CIENCIA & SAUDE COLETIVA 2021; 26:757-764. [PMID: 33605350 DOI: 10.1590/1413-81232021262.08542019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/02/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to analyze the relationship between quality of life, fatigue and injuries among professional Brazilian ballroom dancers. A total of 320 professionals from the five regions of Brazil participated, and the data were collected through a self-administered online questionnaire concerning general information, WHOQOL-bref, Yoshitake Fatigue Questionnaire and Injury Identification in Dancers Questionnaire. For data analysis, descriptive statistics were used, followed by inferential analysis and the Multiple Linear Regression test. The results show that greater fatigue is associated with a negative quality of life, revealing that, for each additional increment in total fatigue, the quality of life is expected to decrease by 0.218 points in the physical domain; 0.226 points in the psychological domain; 0.420 points in the social domain; and 0.304 points in the environmental domain. In contrast, the incidence and intensity of injuries were not associated with quality of life. The conclusion drawn is that the context of professional ballroom dance can influence both the presence of fatigue and the quality of life. It is suggested that health professionals working with these dancers perform multifactorial interventions in order to reduce fatigue, attenuating its effects on quality of life.
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Affiliation(s)
- Allana Alexandre Cardoso
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Santa Catarina (UFSC). Campus Universitário s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Nycolle Martins Reis
- Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. Florianópolis SC Brasil
| | - Jaqueline da Silva
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Santa Catarina (UFSC). Campus Universitário s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Adriano Borgatto
- Departamento de Informática e Estatística, UFSC. Florianópolis SC Brasil
| | - Alexandra Folle
- Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. Florianópolis SC Brasil
| | - Rui Resende
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Santa Catarina (UFSC). Campus Universitário s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Adriana Coutinho de Azevedo Guimarães
- Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. Florianópolis SC Brasil
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Steinberg N, Tenenbaum S, Zeev A, Pantanowitz M, Waddington G, Dar G, Siev-Ner I. Generalized joint hypermobility, scoliosis, patellofemoral pain, and physical abilities in young dancers. BMC Musculoskelet Disord 2021; 22:161. [PMID: 33563260 PMCID: PMC7874653 DOI: 10.1186/s12891-021-04023-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 01/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Many young girls with generalized joint hypermobility (GJH) choose to participate in dance because their bodies are suited for this activity. Scoliosis tends to occur often in thin girls, who also are more likely to choose dance. Both anomalies (GJH and scoliosis) may be related to reduced abilities such as diminished strength and insufficient postural balance, with increased risk for musculoskeletal conditions. The main objectives of the present study were to determine the prevalence of dancers with GJH, the prevalence of dancers with scoliosis, and the prevalence of dancers with these two anomalies; and, to determine differences in physical abilities and the presence of patellofemoral pain (PFP) between young female dancers with and without such anomalies. Methods One hundred thirty-two female dancers, aged 12–14 years, were assessed for anthropometric parameters, GJH, scoliosis, knee muscle strength, postural balance, proprioception ability, and PFP. Results GJH was identified in 54 dancers (40.9%) and scoliosis in 38 dancers (28.8%). Significant differences were found in the proportion of dancers with no anomalies (74 dancers, 56.1%) and dancers with both anomalies (34 dancers, 25.8%) (p < .001). Dancers with both anomalies had reduced dynamic postural balance in the anterior direction (p = .023), reduced proprioception ability (p < .001), and weaker knee extensors (p = .036) and flexors (p = .040) compared with dancers with no anomalies. Among dancers with both anomalies, 73.5% suffered bilateral PFP, 17.6% suffered unilateral PFP, and 8.8% had no PFP (p < .001). Conclusions A high prevalence of young girls participating in dance classes had GJH, as the increased joint flexibility probably provides them with some esthetic advantages. The high prevalence of scoliosis found in these young dancers might be attributed to their relatively low body mass, their delayed maturation, and the selection process of dancers. Dancers with both GJH and scoliosis had decreased muscle strength, reduced postural balance, reduced proprioception, with higher risk of PFP. The main clinical implications are the need to reduce the risk of PFP among dancers by developing appropriate strength and stabilizing exercises combined with proprioceptive and postural balance training, to improve the correct alignment of the hyperextended and hypermobile joints, and to improve their supporting muscle strength.
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Affiliation(s)
- Nili Steinberg
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel.
| | - Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical Center Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Zeev
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Michal Pantanowitz
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | | | - Gali Dar
- Department of Physical Therapy, Faculty of Social Welfare & Health Studies, University of Haifa, Haifa, Israel
| | - Itzhak Siev-Ner
- Orthopedic Rehabilitation Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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Lim BO, An KO, Cho EO, Lim ST, Cho JH. Differences in anterior cruciate ligament injury risk factors between female dancers and female soccer players during single- and double-leg landing. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The Effects of a 9-Week Hip Focused Weight Training Program on Hip and Knee Kinematics and Kinetics in Experienced Female Dancers. J Hum Kinet 2020; 75:29-39. [PMID: 33312293 PMCID: PMC7706665 DOI: 10.2478/hukin-2020-0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Increased involvement of the hip musculature during some movements is associated with enhanced performance and reduced injury risk. However, the impact of hip dominant weight training methods on movement strategy has seen limited attention within the literature. The aim of this study was to evaluate if a 9-week hip dominant weight training intervention promotes a more hip dominant movement strategy leading to an improvement in countermovement jump performance. Twenty-two experienced female dancers were recruited and separated into an intervention (age 24.4 ± 6.3 years, body height 165.5 ± 5.8 cm, body mass 65.9 ± 5.6 kg) and a control (age 22.9 ± 5.6 years, body height 163.3 ± 5.4 cm, body mass 57.4 ± 6.8 kg) group. The intervention group participated in a 9-week hip dominant training intervention, which consisted of a wide stance back squat, Romanian deadlift, hip thrusters, and a bent over row. Hip and knee kinematics and kinetics, and countermovement jump performance were assessed pre and post training. Significant interaction effects were found for peak hip joint moment (p = 0.030, η2 = 0.214) and countermovement jump performance (p = 0.003, η2 = 0.356), indicating an increase in peak hip joint moment and countermovement jump performance for the intervention group. Specifically, the intervention group showed a mean increase in jump height of 11.5%. The data show that the use of a hip dominant weight training strategy can improve hip contribution in the propulsion phase of the countermovement jump. Strength and conditioning specialists should incorporate hip dominant weight training exercises to increase hip strength and improve performance.
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Abergel RE, Tuesta E, Jarvis DN. The effects of acute physical fatigue on sauté jump biomechanics in dancers. J Sports Sci 2020; 39:1021-1029. [PMID: 33274691 DOI: 10.1080/02640414.2020.1854425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Dancers spend large amounts of time practicing and performing, where fatigue may occur, resulting in adverse movement patterns. The purpose of this study was to compare sauté landings before and after acute physical fatigue in experienced female dancers. Twenty-one dancers completed 10 sauté jumps before and after a dance-specific fatigue protocol. A 12-camera motion capture system and a force plate were utilized to collect three-dimensional kinematic and kinetic data. After fatigue, dancers demonstrated an increase in mediolateral centre of mass displacement, pelvis excursion, peak knee abduction, peak ankle eversion and external rotation, as well as decreased peak metatarsophalangeal (MTP) joint extension, indicating less desirable movement patterns. Peak vertical ground reaction force was decreased after fatigue due to a softer landing strategy, demonstrated by increased peak hip flexion, knee flexion, and ankle dorsiflexion. There was some indication of shifting demands demonstrated by an increased peak knee extensor moment and decreased peak MTP flexor moment after fatigue. With jump landing kinematics and kinetics affected after only an average of 5 minutes of dancing, dancers may benefit from developing greater endurance and more eccentric strength to allow them to slow down properly while landing and to sustain the aesthetic demands throughout performance.
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Affiliation(s)
- Rachel E Abergel
- Department of Kinesiology, California State University Northridge, Northridge, CA, USA
| | - Erick Tuesta
- Department of Kinesiology, California State University Northridge, Northridge, CA, USA
| | - Danielle N Jarvis
- Department of Kinesiology, California State University Northridge, Northridge, CA, USA
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20
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Oldfather T, Zabala M, Goodlett M, Murrah WH. Knee Valgus Versus Knee Abduction Angle: Comparative Analysis of Medial Knee Collapse Definitions in Female Athletes. J Biomech Eng 2020; 142:121002. [PMID: 34043757 DOI: 10.1115/1.4047549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Indexed: 11/08/2022]
Abstract
The knee valgus angle (KVA) is heavily researched as it has been shown to correlate to anterior cruciate ligament (ACL) injuries when measured during jumping activities. Many different methods of KVA calculation are often treated as equivalent. The purpose of this study is to elucidate differences between these commonly used angles within and across activities to determine if they can indeed properly be treated as equivalent. The kinematics of 23 female athletes, D1 soccer, D1 basketball, and club soccer (height = 171.2 ± 88.9 cm, weight = 66.3 ± 8.6 kg, age = 19.8 ± 1.9 years), was analyzed using a motion capture system during activities related to their sport and daily living. The abduction KVA, measured using body fixed axes, only correlated to the two-dimensional (2D) global reference frame angle (KVA 2G) in three of the six activities (walking, squatting, and walking down stairs), and one out of six in the three-dimensional (3D) measurements (jogging). This suggests that the abduction KVA does not always relate to other versions of KVA. The KVA with reference to the pelvis coordinate system (KVA 2P) correlated to the KVA 2G in six out of six activities (r = 0.734 ± 0.037, P << 0.001) suggesting the pelvis can be utilized as a reference plane during rotating tasks, such as run-to-cut, when a fixed global system is less meaningful. Not all measures of KVA are equivalent and should be considered individually. A thorough understanding of the equivalence or nonequivalence of various measures of KVA is essential in understanding ACL injury risk.
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Affiliation(s)
- Taylor Oldfather
- Auburn Biomechanical Engineering (AUBE) Lab, Department of Mechanical Engineering, Auburn University, Auburn, AL 36849
| | - Michael Zabala
- Auburn Biomechanical Engineering (AUBE) Lab, Department of Mechanical Engineering, Auburn University, Auburn, AL 36849
| | - Michael Goodlett
- Auburn University Sports Medicine, Auburn University, Auburn, AL 36849
| | - William Hank Murrah
- Department of Educational Foundations, Leadership, and Technology, Auburn University, Auburn, AL 36849
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Russell JA, McIntyre L, Stewart L, Wang T. Concussions in Dancers and Other Performing Artists. Phys Med Rehabil Clin N Am 2020; 32:155-168. [PMID: 33198893 DOI: 10.1016/j.pmr.2020.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dancers and other performing artists are subject to head impacts that result in concussion-like symptoms. In spite of this, performing arts do not have access to the continual, focused emphasis on the diagnosis, management, and prevention of concussions that is commonplace in sports. Performing arts present a unique environment in which concussions occur and must be managed. This article outlines what is known about performing arts concussions, describes mechanisms of head impacts sustained by participants in dance and the related artforms of theater, circus, and film and television stunts, and offers concussion management guidelines for these artistic fields.
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Affiliation(s)
- Jeffrey A Russell
- Ohio University, College of Health Sciences and Professions, School of Applied Health Sciences and Wellness, Grover Center E182, Athens, OH 45701, USA.
| | - Lauren McIntyre
- Harkness Center for Dance Injuries at NYU Langone Health, 614 2nd Avenue, Floor 2, Suite G, New York, NY 10016, USA
| | - Lori Stewart
- Union of British Columbia Performers/ACTRA, 300 - 380 West 2nd Avenue, Vancouver, British Columbia V5Y 1C8, Canada
| | - Tina Wang
- Loma Linda School of Medicine, Loma Linda VA Hospital, 429 N Central Ave, Upland, CA 91786, USA
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Abstract
Rehabilitation of dance injury should be a team-based approach lead by a medical practitioner with experience in both musculoskeletal medicine and dance specific demands. The rehabilitation protocol begins with a dance specific initial assessment, followed by injury management, progression of the rehabilitation program including dance specific movement, advancing to full independence.
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Affiliation(s)
- Melody Hrubes
- Rothman Orthopaedics, 645 Madison Avenue, New York, NY 10022, USA.
| | - Jennifer Janowski
- Athletico Physical Therapy, 24 E. Chicago Ave, Chicago, IL 60611, USA
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Does forced or compensated turnout lead to musculoskeletal injuries in dancers? A systematic review on the complexity of causes. J Biomech 2020; 114:110084. [PMID: 33338756 DOI: 10.1016/j.jbiomech.2020.110084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/24/2020] [Accepted: 10/16/2020] [Indexed: 11/21/2022]
Abstract
Injury prevalence in dancers is high, and misaligned turnout (TO) is claimed to bear injury risk. This systematic review aimed to investigate if compensating or forcing TO leads to musculoskeletal injuries. A systematic literature review was conducted according to the PRISMA Guidelines using the databases of PubMed, Embase, Emcare, Web of Science, Cochrane Library, Academic Search Premier, and ScienceDirect. Studies investigating the relationship between compensated or forced TO and injuries in all genders, all ages, and levels of dancers were included. Details on misaligned TO measurements and injuries had to be provided. Screening was performed by two researchers, data extraction and methodological quality assessment executed by one researcher and checked by another. 7 studies with 1293 dancers were included. Methodological quality was low due to study designs and a general lack of standardised definition of pathology and methods of assessment of misaligned TO. The studies investigating the lower extremities showed a hip-focus only. Non-hip contributors as well as their natural anatomical variations were not accounted for, limiting the understanding of injury mechanisms underlying misaligned TO. As such no definite conclusions on the effect of compensating or forcing TO on musculoskeletal injuries could be made. Total TO is dependent on complex motion cycles rather than generalised (hip) joint dominance only. Objective dual assessment of maximum passive joint range of motion through 3D kinematic analysis in combination with physical examination is needed to account for anatomical variations, locate sites prone to (overuse)injury, and investigate underlying injury mechanisms.
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Jarvis DN, Sigward SM, Lerch K, Kulig K. What goes up must come down, part II: Consequences of jump strategy modification on dance leap landing biomechanics. J Sports Sci 2020; 39:446-452. [PMID: 32966154 DOI: 10.1080/02640414.2020.1825059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Knee injuries are common in jumping athletes; modifying jump strategy may impact loads placed on the body and reduce injury risk. The purpose of this study was to determine if modifying strategy in a saut de chat leap to focus on height would decrease sagittal plane knee loading. Biomechanical data were collected while 28 dancers performed saut de chat leaps with instructions to jump far (FAR) or jump high (UP). In the UP condition, there was greater vertical GRF and less braking GRF. Also in UP, lower extremity contact angle was greater (71.3 ± 2.9º FAR; 75.8 ± 3.3º UP; p = 0.0178), peak knee extensor moment was greater (2.8 ± 0.7 Nm FAR; 3.2 ± 0.8 Nm UP; p = 0.01), and peak ankle plantar flexor moment was lower (3.19 ± 0.4 Nm FAR; 2.94 ± 0.4 Nm UP; p < 0.01). A more acute LECA was related to greater braking force and braking force was related to greater knee extensor moments. Despite these relationships, we observed greater knee extensor moments in UP. While the relationship among these whole-body variables and knee joint loading exists, it may not be the primary factor driving load distribution during dance leap landings.
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Affiliation(s)
- Danielle N Jarvis
- Department of Kinesiology, California State University Northridge , Northridge, CA, USA
| | - Susan M Sigward
- Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, CA, USA
| | - Katie Lerch
- Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, CA, USA
| | - Kornelia Kulig
- Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, CA, USA
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Ground Reaction Forces Are Predicted with Functional and Clinical Tests in Healthy Collegiate Students. J Clin Med 2020; 9:jcm9092907. [PMID: 32916814 PMCID: PMC7563648 DOI: 10.3390/jcm9092907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/31/2020] [Accepted: 09/07/2020] [Indexed: 12/26/2022] Open
Abstract
Increased vertical and posterior ground reaction forces (GRFs) are associated with anterior cruciate ligament (ACL) injury. If a practical means to predict these forces existed, ACL injury risk could be attenuated. Forty-two active college-age individuals (21 females, 20.66 ± 1.46 y, 70.70 ± 2.36 cm, 82.20 ± 7.60 kg; 21 males, 21.57 ± 1.28 y, 65.52 ± 1.87 cm, 64.19 ± 9.05 kg) participated in this controlled laboratory study. GRFs were ascertained by having the subjects perform a unilateral landing task onto a force plate. Several clinical measures (Fat Free Mass (FFM), dorsiflexion passive range of motion (DPROM), isometric peak force of the lateral hip rotators, knee flexor/extensor peak force ratio (H:Q), the completion of the overhead deep squat), two functional tests (Margaria–Kalamen, Single Leg Triple Hop (SLTH)), and sex served as the predictor variables. Regression models to predict the GRFs normalized to the FFM (nGRFz, nGRFy) were generated. nGRFz was best predicted with a linear regression equation that included SLTH and DPROM (adjusted R2 = 0.274; p = 0.001). nGRFy was best predicted with a linear regression equation that included H:Q, FFM, and DPROM (adjusted R2 = 0.476; p < 0.001). Simple clinical measures and functional tests explain a small to moderate amount of the variance associated with the FFM normalized vertical and posterior GRFs in active college-age individuals.
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Estevan I, Monfort-Torres G, Farana R, Zahradnik D, Jandacka D, García-Massó X. Children's Single-Leg Landing Movement Capability Analysis According to the Type of Sport Practiced. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176414. [PMID: 32899167 PMCID: PMC7503518 DOI: 10.3390/ijerph17176414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: Understanding children's motor patterns in landing is important not only for sport performance but also to prevent lower limb injury. The purpose of this study was to analyze children's lower limb joint angles and impact force during single-leg landings (SLL) in different types of jumping sports using statistical parametric mapping (SPM). (2) Methods: Thirty children (53.33% girls, M = 10.16 years-old, standard deviation (SD) = 1.52) divided into three groups (gymnastics, volleyball and control) participated in the study. The participants were asked to do SLLs with the dominant lower limb (barefoot) on a force plate from a height of 25 cm. The vertical ground reaction force (GRF) and lower limb joint angles were assessed. SPM{F} one-way analysis of variance (ANOVA) and SPM{t} unpaired t-tests were performed during the landing and stability phases. (3) Results: A significant main effect was found in the landing phase of jumping sport practice in GRF and joint angles. During the stability phase, this effect was exhibited in ankle and knee joint angles. (4) Conclusions: Evidence was obtained of the influence of practicing a specific sport in childhood. Child volleyball players performed SLL with lower impact force and higher knee flexion than child gymnasts. Training in specific jumping sports (i.e., volleyball and gymnastics) could affect the individual capacity to adapt SLL execution.
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Affiliation(s)
- Isaac Estevan
- Activitat Física i Promoció de la Salut (AFIPS) Research Group, Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
- Correspondence:
| | - Gonzalo Monfort-Torres
- Human Movement Analysis Research Group (HUMAG), Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
- Education Unit, Florida Universitaria, 46470 Catarroja, Spain
| | - Roman Farana
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, 70100 Ostrava, Czech; (R.F.); (D.Z.); (D.J.)
| | - David Zahradnik
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, 70100 Ostrava, Czech; (R.F.); (D.Z.); (D.J.)
| | - Daniel Jandacka
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, 70100 Ostrava, Czech; (R.F.); (D.Z.); (D.J.)
| | - Xavier García-Massó
- Activitat Física i Promoció de la Salut (AFIPS) Research Group, Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
- Human Movement Analysis Research Group (HUMAG), Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
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Vera AM, Barrera BD, Peterson LE, Yetter TR, Dong D, Delgado DA, McCulloch PC, Varner KE, Harris JD. An Injury Prevention Program for Professional Ballet: A Randomized Controlled Investigation. Orthop J Sports Med 2020; 8:2325967120937643. [PMID: 32782904 PMCID: PMC7388110 DOI: 10.1177/2325967120937643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Few investigations have examined dance-specific injury prevention programs (IPPs), and no published randomized controlled trials are available that evaluate IPPs for dance. HYPOTHESIS The implementation of an IPP will significantly reduce the risk of injury in professional ballet dancers. STUDY DESIGN Randomized controlled trial; Level of evidence, 2. METHODS A randomized controlled trial was designed that entailed a superiority model for the intervention group. All professional dancers from a single ballet company were eligible to participate. Randomization and allocation were performed before the start of the season. The control group practiced and performed without change to preexisting standard operating practice. The IPP group was instructed to perform a 30-minute exercise program 3 times per week over the 52-week study period. Injuries were recorded. Standard continuous and categorical data comparisons and correlations were used. Cox proportional hazards regression models for recurrent failures were used wherein the hazard ratio indicates the relative likelihood of injury in the control versus intervention groups. RESULTS Of the 52 eligible dancers, 75% (n = 39) participated. Of these 39 dancers, 19 (9 males, 10 females; mean age, 26.6 ± 4.0 years) were randomized to the control group and 20 (11 males, 9 females; mean age, 25.1 ± 5.1 years) to the IPP group. No significant (P > .05) difference was found in baseline demographics between groups. A total of 116 injuries were recorded for the entire study population (49 IPP; 67 control). Traumatic and chronic injuries accounted for 54% and 46% of injuries, respectively. The injury rate was 82% less (IPP hazard ratio, 0.18; z = -2.29; P = .022) in the IPP group after adjustment for confounding variables, and time between injuries was 45% longer (IPP hazard ratio, 0.55; z = -2.20; P = .028) than for controls. CONCLUSION The present study is the first prospective randomized controlled investigation of an IPP for professional ballet. The results showed an 82% decrease in injury rate for the intervention group and an extended period from previous injury to subsequent injury. REGISTRATION NCT04110002 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Angelina M. Vera
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Bene D. Barrera
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Leif E. Peterson
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Thomas R. Yetter
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - David Dong
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | | | | | - Kevin E. Varner
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Joshua D. Harris
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
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López-López D, Fernández-Espiño C, Losa-Iglesias ME, Calvo-Lobo C, Romero-Morales C, Rodríguez-Sanz D, Navarro-Flores E, Becerro-de-Bengoa-Vallejo R. Women's Foot Health-Related Quality of Life in Ballet Dancers and Nondancers. Sports Health 2020; 12:347-351. [PMID: 32511070 DOI: 10.1177/1941738120922962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prevalence and severity of symptoms related to muscle and joint pain seem to be high in most dancers. HYPOTHESIS There will be a worse quality of life related to foot health for ballet dancers compared with nondancers. STUDY DESIGN Case-control study. LEVEL OF EVIDENCE Level 4. METHODS A sample of 156 women was recruited from a clinic of podiatric medicine and surgery. Self-reported data were measured by the Foot Health Status Questionnaire (FHSQ), which has 33 questions that assess 8 health domains of the feet and general health, namely, foot pain, foot function, general foot health, footwear, general health, physical activity, social capacity, and vigor. RESULTS Statistically significant differences (P < 0.05) were shown for foot pain, foot function, foot health, and general health, which together revealed a worse foot health-related quality of life (lower FHSQ scores) but a better general health (higher FHSQ scores) for ballet dancers compared with nondancers. The remaining domains did not show statistically significant differences (P > 0.05). According to multivariate linear regression models (P < 0.05), the practice of ballet dance (group) was the only independent variable that predicted the dependent variables, such as foot pain (R2 = 0.052;β = +8.349), foot function (R2 = 0.108; β = +11.699), foot health (R2 = 0.039; β = +10.769), and general health (R2 = 0.019; β = -6.795). CONCLUSION Ballet dancers showed a negative impact on quality of life related to foot health but better overall quality of life (general health) compared with nondancers. CLINICAL RELEVANCE Paying attention to a dancer's foot health could provide important benefits for the dancer's foot health and physical practice of dance.
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Affiliation(s)
- Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | - Cristina Fernández-Espiño
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | | | - César Calvo-Lobo
- School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - David Rodríguez-Sanz
- School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Emmanuel Navarro-Flores
- Departament d'infermeria, Facultat d'infermeria i podología, Universitat de València, Valencia, Spain
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29
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Fuller M, Moyle GM, Hunt AP, Minett GM. Injuries during transition periods across the year in pre-professional and professional ballet and contemporary dancers: A systematic review and meta-analysis. Phys Ther Sport 2020; 44:14-23. [PMID: 32339996 DOI: 10.1016/j.ptsp.2020.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/04/2020] [Accepted: 03/30/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To 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. METHODS Six 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. RESULTS Fifteen 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. CONCLUSIONS Meta-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.
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Affiliation(s)
- M Fuller
- School of Creative Practice, Creative Industries Faculty, Queensland University of Technology, Kelvin Grove, QLD, Australia.
| | - G M Moyle
- School of Creative Practice, Creative Industries Faculty, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - A P Hunt
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - G M Minett
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
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30
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Fox A, Bonacci J, Hoffmann S, Nimphius S, Saunders N. Anterior cruciate ligament injuries in Australian football: should women and girls be playing? You're asking the wrong question. BMJ Open Sport Exerc Med 2020; 6:e000778. [PMID: 32341803 PMCID: PMC7173994 DOI: 10.1136/bmjsem-2020-000778] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Anterior cruciate ligament (ACL) injuries have been a rising concern in the early years of the women’s Australian Football League (AFLW), eliciting headlines of a ‘knee crisis’ surrounding the league. There has been a focus on female biology as the primary factor driving the high rate of ACL injuries in the AFLW. Emphasising Australian football (AF) as being dangerous predominantly due to female biology may be misrepresenting a root cause of the ACL injury problem, perpetuating gender stereotypes that can restrict physical development and participation of women and girls in the sport. We propose that an approach addressing environmental and sociocultural factors, along with biological determinants, is required to truly challenge the ACL injury problem in the AFLW. Sports science and medicine must therefore strive to understand the whole system of women in AF, and question how to address inequities for the benefit of the athletes.
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Affiliation(s)
- Aaron Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jason Bonacci
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Samantha Hoffmann
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sophia Nimphius
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Natalie Saunders
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Azevedo AM, Oliveira R, Vaz JR, Cortes N. Oxford foot model kinematics in landings: A comparison between professional dancers and non-dancers. J Sci Med Sport 2019; 23:347-352. [PMID: 31734168 DOI: 10.1016/j.jsams.2019.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 10/14/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Dancers frequently perform jump-landing activities, with the foot-ankle complex playing an essential role to attenuate the landing forces. However, scarce research has been conducted in professional dancers multi-segmented foot in landings. The aim of this study was to compare the multi-segmented foot kinematics between professional dancers and non-dancers, during forward and lateral single-leg jump-landings. DESIGN Descriptive group comparison. METHODS Marker trajectories and synchronized ground reaction forces of 15 professional dancers and 15 non-dancers were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Sagittal and frontal hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot kinematics of the multi-segmented foot model were computed at initial contact, peak vertical ground reaction force and peak knee flexion. Repeated measures ANOVAs were conducted (p < 0.05). RESULTS Professional dancers landed with higher hindfoot-tibia and forefoot-hindfoot plantarflexion angles at initial contact (p < 0.001), and hindfoot-tibia dorsiflexion angles at peak vertical ground reaction force and peak knee flexion (p < 0.001) than non-dancers. Also, dancers exhibited higher sagittal hindfoot-tibia and forefoot-hindfoot excursions than non-dancers (p < 0.001). No statistically significant differences were found in the frontal plane. CONCLUSIONS The multi-segmented foot allows a comprehensive kinematic analysis of the different foot joints. In jump-landings, professional dancers higher hindfoot-tibia, and forefoot-hindfoot plantarflexion at initial contact, compared to non-dancers, contributed to a subsequent higher foot joints excursion. This pattern is commonly linked to a better shock absorption mechanism in landings.
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Affiliation(s)
- Ana M Azevedo
- Faculty of Human Kinetics, University of Lisbon, Portugal; George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, USA
| | - Raúl Oliveira
- Faculty of Human Kinetics, University of Lisbon, Portugal; CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - João R Vaz
- CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal; Universidade Europeia, Portugal
| | - Nelson Cortes
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, USA; Department of Bioengineering, George Mason University.
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Azevedo AM, Oliveira R, Vaz JR, Cortes N. Foot modeling affects ankle sagittal plane kinematics during jump-landing. J Biomech 2019; 96:109337. [PMID: 31547999 DOI: 10.1016/j.jbiomech.2019.109337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/18/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
Abstract
The foot-ankle complex is a key-element to mitigate impact forces during jump-landing activities. Biomechanical studies commonly model the foot as a single-segment, which can provide different ankle kinematics compared to a multi-segmented model. Also, it can neglect intersegmental kinematics of the foot-ankle joints, such as the hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot joints, that are used during jump-landing activities. The purpose of this short communication was to compare ankle kinematics between a three- and single-segmented foot models, during forward and lateral single-leg jump-landings. Marker trajectories and synchronized ground reaction forces of 30 participants were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Ankle kinematics were computed using a three- (hindfoot-tibia) and a single-segmented (ankle) foot models, at initial contact (IC), peak vertical ground reaction force (PvGRF) and peak knee flexion (PKF). Repeated measures ANOVAs were conducted (p < 0.05). The findings of this study showed that during lateral and forward jump-landing directions, the three-segmented foot model exhibited lower hindfoot-tibia dorsiflexion angles (PvGRF and PKF, p < 0.001) and excursions (sagittal: p < 0.001; frontal: p < 0.05) during the weightbearing acceptance phase than the single-segmented model. Overall, the two foot models provided distinctive sagittal ankle kinematics, with lower magnitudes in the hindfoot-tibia of the three-segmented foot. Furthermore, the three-segmented foot model may provide additional and representative kinematic data of the ankle and foot joints, to better comprehend its function, particularly in populations whose foot-ankle complex plays an important role (e.g., dancers).
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Affiliation(s)
- Ana M Azevedo
- Faculty of Human Kinetics, University of Lisbon, Portugal; George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, VA, USA
| | - Raúl Oliveira
- Faculty of Human Kinetics, University of Lisbon, Portugal; CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - João R Vaz
- CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal; Universidade Europeia, Lisbon, Portugal
| | - Nelson Cortes
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, VA, USA.
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Montalvo AM, Schneider DK, Yut L, Webster KE, Beynnon B, Kocher MS, Myer GD. "What's my risk of sustaining an ACL injury while playing sports?" A systematic review with meta-analysis. Br J Sports Med 2019; 53:1003-1012. [PMID: 29514822 PMCID: PMC6561829 DOI: 10.1136/bjsports-2016-096274] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 02/03/2018] [Accepted: 02/11/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To estimate the incidence proportion (IP) and incidence rate (IR) for ACL injury in athletes. DESIGN Systematic review with meta-analysis DATA SOURCES: The PubMed, CINAHL and SPORTDiscus electronic databases were searched from inception to 20 January 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies were included if they reported total number of participants/population by sex, total number of ACL injuries by sex and total person-time by sex. RESULTS Fifty-eight studies were included. The IP and IR of ACL injury in female athletes were 3.5% (1 out of every 29 athletes) and 1.5/10 000 athlete-exposures over a period of 1 season-25 years. The IP and IR of ACL injury in male athletes were 2.0% (1 out of every 50 athletes) and 0.9/10 000 athlete-exposures over a period of 1-25 years. Female athletes had a higher relative risk (RR) for ACL injury compared with males (RR=1.5; 95% CI 1.2 to 1.9; P<0.01) and a higher incidence rate ratio (IRR) of ACL injury compared with males over 1 season-25 years (IRR=1.7; 95% CI 1.4 to 2.2; P<0.010). When accounting for participation level, the disparity in the IR between female and male athletes was highest for amateur athletes compared with intermediate and elite athletes (IRR=2.1; 95% CI 1.3 to 3.4; P<0.01; I²=82%). Amateur female athletes remained at higher risk of ACL injury than did with amateur male athletes. In studies where follow-up length was <1 year, female athletes had a higher IR of ACL injury than did to males (IRR=1.7; 95% CI 1.3 to 2.2; P<0.01). Where follow-up was 1 year and beyond, there was no sex difference in the IR of ACL injury (IRR=2.1; 95% CI 0.9 to 4.8; P=0.06; I²=65%). SUMMARY/CONCLUSIONS One in 29 female athletes and 1 in 50 male athletes ruptured their ACL in a window that spanned from 1season to 25 years. The IR of ACL injury among female athletes in a season was 1.7 times higher than the IR of ACL injury among male athletes and the IP of ACL injury among female athletes was 1.5 times higher than the IP of ACL injury among male athletes. The reported sex disparity in ACL injury rates is independent of participation level and length of follow-up.
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Affiliation(s)
- Alicia M Montalvo
- Department of Athletic Training, Florida International University, Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA
| | - Daniel K Schneider
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Laura Yut
- Department of Biostatistics, Robert Stempel School of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Kate E Webster
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Bruce Beynnon
- Department of Orthopedics and Rehabilitation, University of Vermont College of Medicine, Burlington, Vermont, USA
| | - Mininder S Kocher
- Department of Orthopedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory D Myer
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Sports Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- Athletic Training Division, School of Allied Medical Professions, The Ohio State University, Columbus, Ohio, USA
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
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Characteristics of Contact Force and Muscle Activation During Choreographed Falls With 2 Common Landing Techniques in Contemporary Dance. J Appl Biomech 2019; 35:256-262. [PMID: 31034327 DOI: 10.1123/jab.2018-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated the contact forces and muscle activation during 2 choreographed fall techniques in contemporary dancers and how these were affected by the fall technique. Ten collegiate-level dancers were instructed in 2 choreographed falls: (1) an anteriorly focused fall involving ankle plantar flexion, knee flexion, and hip flexion with dispersion of forces up the anterior surface of the shank (technique 1) and (2) a laterally focused fall involving inversion at the ankle with dispersion of forces up the lateral aspect of the shank (technique 2). The knee and hip contact forces were 26.3% smaller (technique 1: 1743 N vs technique 2: 1284 N) and 24.1% greater (technique 1: 1334 N vs technique 2: 1656 N), respectively, in technique 2 (P < .03). At the time of knee contact, percentage of maximal voluntary isometric contraction (%MVIC) was 45.8% greater for rectus femoris muscle (technique 1: 7.2% vs technique 2: 10.5%) and 96.9% greater for gluteus medius muscle (technique 1: 3.2% vs technique 2: 6.3%) (P < .01) in technique 2. The results provide insight into determining safer landing strategies to avoid knee injuries in individuals who experience a fall (ie, dancers, athletes, and older adults).
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Wielandt T, van den Wyngaert T, Uijttewaal JR, Huyghe I, Maes M, Stassijns G. Bone mineral density in adolescent elite ballet dancers. J Sports Med Phys Fitness 2019; 59:1564-1570. [PMID: 31215202 DOI: 10.23736/s0022-4707.19.09700-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Data documenting BMD in pre-professional adolescent ballet dancers is limited. This cross-sectional study assesses bone mineral density (BMD) in young adolescent elite ballet dancers and compares BMD values between males and females (with and without normal menarche) and body composition between dancers with and without low Z-score. METHODS Cross-sectional study of third year ballet students (female=23; male=15; mean age 14.7 years; SD: 0.5) of The Royal Ballet School of Antwerp (Belgium) training 22 hours a week. They completed questionnaires and underwent dual energy X-ray absorptiometry (DXA) to measure BMD and body composition. Each female participant completed questionnaires assessing menstrual status. RESULTS DXA revealed that 12 out of 38 (32%) of the dancers had Z-score <-1. On average, male dancers had a lower BMD compared to an age-matched reference population (mean Z-score -0.9; SD 0.5), with 7 out of 15 having Z-score <-1. Overall, absolute BMD values were highest in the legs, followed by spine and arms. Dancers with Z-score <-1 had a significantly lower total mass. 43% of female ballet dancers had not yet had their first period and 39% had oligomenorrhea, but no significant differences between groups was detected. CONCLUSIONS A third of adolescent elite ballet dancers had low to very low Z-score. Nearly 2 out of 3 dancers with a Z-score <-1 were males, showing that low BMD is not limited to female dancers. Among female dancers menstrual dysfunction was frequent, without apparent impact on BMD or body composition in the studied age group.
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Affiliation(s)
- Tim Wielandt
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Physical Medicine and Rehabilitation, Antwerp University Hospital, Edegem, Belgium
| | - Tim van den Wyngaert
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Johanna R Uijttewaal
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Physical Medicine and Rehabilitation, Antwerp University Hospital, Edegem, Belgium
| | - Ivan Huyghe
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Michiel Maes
- Department of Neurology, Heilig-Hart Hospital, Lier, Belgium
| | - Gaëtane Stassijns
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium - .,Department of Physical Medicine and Rehabilitation, Antwerp University Hospital, Edegem, Belgium
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Montalvo AM, Schneider DK, Webster KE, Yut L, Galloway MT, Heidt RS, Kaeding CC, Kremcheck TE, Magnussen RA, Parikh SN, Stanfield DT, Wall EJ, Myer GD. Anterior Cruciate Ligament Injury Risk in Sport: A Systematic Review and Meta-Analysis of Injury Incidence by Sex and Sport Classification. J Athl Train 2019; 54:472-482. [PMID: 31009238 DOI: 10.4085/1062-6050-407-16] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate sex differences in incidence rates (IRs) of anterior cruciate ligament (ACL) injury by sport type (collision, contact, limited contact, and noncontact). DATA SOURCES A systematic review was performed using the electronic databases PubMed (1969-January 20, 2017) and EBSCOhost (CINAHL, SPORTDiscus; 1969-January 20, 2017) and the search terms anterior cruciate ligament AND injury AND (incidence OR prevalence OR epidemiology). STUDY SELECTION Studies were included if they provided the number of ACL injuries and the number of athlete-exposures (AEs) by sex or enough information to allow the number of ACL injuries by sex to be calculated. Studies were excluded if they were analyses of previously reported data or were not written in English. DATA EXTRACTION Data on sport classification, number of ACL injuries by sex, person-time in AEs for each sex, year of publication, sport, sport type, and level of play were extracted for analysis. DATA SYNTHESIS We conducted IR and IR ratio (IRR) meta-analyses, weighted for study size and calculated. Female and male athletes had similar ACL injury IRs for the following sport types: collision (2.10/10 000 versus 1.12/10 000 AEs, IRR = 1.14, P = .63), limited contact (0.71/10 000 versus 0.29/10 000 AEs, IRR = 1.21, P = .77), and noncontact (0.36/10 000 versus 0.21/10 000 AEs, IRR = 1.49, P = .22) sports. For contact sports, female athletes had a greater risk of injury than male athletes did (1.88/10 000 versus 0.87/10 000 AEs, IRR = 3.00, P < .001). Gymnastics and obstacle-course races were outliers with respect to IR, so we created a sport category of fixed-object, high-impact rotational landing (HIRL). For this sport type, female athletes had a greater risk of ACL injury than male athletes did (4.80/10 000 versus 1.75/10 000 AEs, IRR = 5.51, P < .001), and the overall IRs of ACL injury were greater than all IRs in all other sport categories. CONCLUSIONS Fixed-object HIRL sports had the highest IRs of ACL injury for both sexes. Female athletes were at greater risk of ACL injury than male athletes in contact and fixed-object HIRL sports.
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Affiliation(s)
- Alicia M Montalvo
- Department of Athletic Training, Florida International University, Miami
| | | | | | - Laura Yut
- Department of Athletic Training, Florida International University, Miami
| | | | | | - Christopher C Kaeding
- Department of Orthopaedics, Sports Medicine Institute, The Ohio State University, Columbus
| | | | - Robert A Magnussen
- Department of Orthopaedics, Sports Medicine Institute, The Ohio State University, Columbus
| | | | | | | | - Gregory D Myer
- Department of Athletic Training, Florida International University, Miami.,Cincinnati Children's Hospital Medical Center, OH
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Konopka JA, Hsue LJ, Dragoo JL. Effect of Oral Contraceptives on Soft Tissue Injury Risk, Soft Tissue Laxity, and Muscle Strength: A Systematic Review of the Literature. Orthop J Sports Med 2019; 7:2325967119831061. [PMID: 30923726 PMCID: PMC6431771 DOI: 10.1177/2325967119831061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Female patients are more likely than male patients to experience various musculoskeletal (MSK) injuries. Because MSK tissues are sensitive to the female hormones relaxin, estrogen, and progesterone, studies have examined whether hormonal contraceptives, which change female hormone levels, can alter the female MSK injury risk. These studies have reached contradictory conclusions, leaving unclear the influence of hormonal contraception on female MSK injury risk. HYPOTHESIS Hormonal contraceptives act to decrease female soft tissue injury risk and soft tissue laxity. STUDY DESIGN Systematic review; Level of evidence, 3. METHODS Reviewers searched for clinically relevant studies evaluating the relationship between hormonal contraceptive use and soft tissue injuries, soft tissue laxity, muscle injuries, and muscle strength in the PubMed, Cochrane, Scopus, CINAHL, and Embase databases. Studies meeting inclusion criteria were scored by 2 independent researchers for risk of bias, imprecision, inconsistency, and indirectness with a template designed using the British Medical Journal Clinical Evidence GRADE (Grades of Recommendation Assessment, Development and Evaluation) scoring system and GRADEPro guidelines. Scores were uploaded into the GRADEPro scoring system software, which calculated each study's final GRADE score (very low, low, moderate, or high quality). RESULTS A total of 29 studies met inclusion criteria. Of the 7 studies evaluating oral contraceptive (OC) use and soft tissue injury risk, only 2 received a high quality-of-evidence score; all other studies received a very low score. The high-quality studies concluded that OC use decreases anterior cruciate ligament (ACL) injury risk. Only 1 of the 10 studies evaluating OC use and soft tissue laxity was found to have a high quality of evidence; this study determined that OC use decreases ACL laxity. CONCLUSION Higher quality studies suggest that OCs decrease a female patient's risk of ACL injuries and ACL laxity. The strength of these findings, however, is weak. Female patients are up to 8 times more likely to tear their ACLs than male patients. OCs may serve a therapeutic role in decreasing the sex disparity in ACL injury rates.
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Affiliation(s)
- Jaclyn A. Konopka
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Lauren J. Hsue
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Jason L. Dragoo
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
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AZEVEDO ANAM, OLIVEIRA RAÚL, VAZ JOÃOR, CORTES NELSON. Professional Dancers Distinct Biomechanical Pattern during Multidirectional Landings. Med Sci Sports Exerc 2019; 51:539-547. [DOI: 10.1249/mss.0000000000001817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Yin AX, Geminiani E, Quinn B, Owen M, Kinney S, McCrystal T, Stracciolini A. The Evaluation of Strength, Flexibility, and Functional Performance in the Adolescent Ballet Dancer During Intensive Dance Training. PM R 2019; 11:722-730. [DOI: 10.1002/pmrj.12011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/04/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Amy X. Yin
- Department of OrthopedicsKaiser Permanente Northern California, Podiatry, and Sports Medicine 2500 Merced St, 4th Floor, San Leandro CA 94577
| | - Ellen Geminiani
- Department of Orthopedics, Division of Sports MedicineBoston Children's Hospital Boston MA
- Harvard Medical School Boston MA
- The Micheli Center for Sports Injury Prevention Waltham MA
| | - Bridget Quinn
- Department of Orthopedics, Division of Sports MedicineBoston Children's Hospital Boston MA
- Harvard Medical School Boston MA
- The Micheli Center for Sports Injury Prevention Waltham MA
| | - Michael Owen
- Director of Dance, Walnut Hill School for the Arts Natick MA
| | | | | | - Andrea Stracciolini
- Department of OrthopedicsDivision of Sports Medicine, Boston Children's Hospital Boston MA
- Harvard Medical School Boston MA
- The Micheli Center for Sports Injury Prevention Waltham MA
- Department of Medicine, Division of Emergency MedicineBoston Children's Hospital Boston MA
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40
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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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41
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Greene A, Lasner A, Deu R, Oliphant S, Johnson K. Inter-rater and intra-rater reliability of a clinical protocol for measuring turnout in collegiate dancers. Physiother Theory Pract 2019; 35:94-99. [PMID: 29393715 PMCID: PMC6368850 DOI: 10.1080/09593985.2018.1434708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Reliable methods of measuring turnout in dancers and comparing active turnout (used in class) with functional (uncompensated) turnout are needed. Authors have suggested measurement techniques but there is no clinically useful, easily reproducible technique with established inter-rater and intra-rater reliability. We adapted a technique based on previous research, which is easily reproducible. We hypothesized excellent inter-rater and intra-rater reliability between experienced physical therapists (PTs) and a briefly trained faculty member from a university's department of dance. Thirty-two participants were recruited from the same dance department. Dancers' active and functional turnout was measured by each rater. We found that our technique for measuring active and functional turnout has excellent inter-rater and intra-rater reliability when performed by two experienced PTs and by one briefly trained university-level dance faculty member. For active turnout, inter-rater reliability was 0.78 among all raters and 0.82 among only the PT raters; intra-rater reliability was 0.82 among all raters and 0.85 among only the PT raters. For functional turnout, inter-rater reliability was 0.86 among all raters and 0.88 among only the PT raters; intra-rater reliability was 0.87 among all raters and 0.88 among only the PT raters. The measurement technique described provides a standardized protocol with excellent inter-rater and intra-rater reliability when performed by experienced PTs or by a briefly trained university-level dance faculty member.
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Affiliation(s)
- Amanda Greene
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD
| | - Andrea Lasner
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD
| | - Rajwinder Deu
- Department of bOrthopaedic Surgery, Johns Hopkins University, Baltimore, MD
| | - Seth Oliphant
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD
| | - Kenneth Johnson
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD
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Vassallo AJ, Trevor BL, Mota L, Pappas E, Hiller CE. Injury rates and characteristics in recreational, elite student and professional dancers: A systematic review. J Sports Sci 2018; 37:1113-1122. [DOI: 10.1080/02640414.2018.1544538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Amy Jo Vassallo
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Bronwyn L Trevor
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Liana Mota
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Evangelos Pappas
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Claire E Hiller
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
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Analysis of Lower Extremity Proprioception for Anterior Cruciate Ligament Injury Prevention: Current Opinion. Sports Med 2018; 48:1303-1309. [PMID: 29488166 DOI: 10.1007/s40279-018-0889-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Lower extremity musculoskeletal injuries-such as ACL injury-are common, and the majority of those injuries occur without external player contact. In order to prevent non-contact musculoskeletal injuries, athletes must rely on accurate sensory information (such as visual, vestibular, and somatosensory) and stabilize joints during athletic tasks. Previously, proprioception tests (the senses of joint position, movement, tension or force) have been examined using static tests. Due to the role of proprioception in achievement of joint stability, it is essential to explore the development of dynamic proprioception tests. In this current opinion, the basic background on proprioception is covered, and the research gaps and future directions are discussed.
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Ward RE, Fong Yan A, Orishimo KF, Kremenic IJ, Hagins M, Liederbach M, Hiller CE, Pappas E. Comparison of lower limb stiffness between male and female dancers and athletes during drop jump landings. Scand J Med Sci Sports 2018; 29:71-81. [PMID: 30242920 DOI: 10.1111/sms.13309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 09/07/2018] [Accepted: 09/18/2018] [Indexed: 01/03/2023]
Abstract
Repetition of jumps in dance and sport training poses a potential injury risk; however, non-contact landing injuries are more common in athletes than dancers. This study aimed to compare the lower limb stiffness characteristics of dancers and athletes during drop landings to investigate possible mechanisms of impact-related injuries. Kinematics and kinetics were recorded as 39 elite modern and ballet dancers (19 men and 20 women) and 40 college-level team sport athletes (20 men and 20 women) performed single-legged drop landings from a 30-cm platform. Vertical leg stiffness and joint stiffness of the hip, knee, and ankle were calculated using a spring-mass model. Stiffness data, joint kinematics, and moments were compared with a group-by-sex 2-way analysis of variance. Multiple linear regression was used to assess the relative contribution of hip and knee and ankle joint stiffness to variance in overall vertical leg stiffness for dancers and athletes. Dancers had lower leg (P < 0.001), knee joint (P = 0.034), and ankle joint stiffness (P = 0.043) than athletes. This was facilitated by lower knee joint moments (P = 0.012) and greater knee (P = 0.029) and ankle joint (P = 0.048) range of motion in dancers. Males had higher leg (P < 0.001) and ankle joint stiffness (P < 0.001) than females. This occurred through lower ankle range of motion (P < 0.001) and greater ankle moment (P = 0.022) compared to females. Male and female dancers demonstrated reduced lower limb stiffness compared to athletes, indicating a more pliable landing technique. Dance training techniques could potentially inform approaches to injury prevention in athletes.
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Affiliation(s)
- Rachel E Ward
- School of Medical Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - Alycia Fong Yan
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Karl F Orishimo
- Nicholas Institute for Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York
| | - Ian J Kremenic
- Nicholas Institute for Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York
| | - Marshall Hagins
- Division of Physical Therapy, Long Island University, Brooklyn, New York.,Harkness Center for Dance Injuries, NYU Langone Orthopedic Hospital, New York, New York
| | - Marijeanne Liederbach
- Harkness Center for Dance Injuries, NYU Langone Orthopedic Hospital, New York, New York
| | - Claire E Hiller
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
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45
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The effect of pointe shoe deterioration on foot and ankle kinematics and kinetics in professional ballet dancers. Hum Mov Sci 2018; 60:72-77. [DOI: 10.1016/j.humov.2018.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/22/2018] [Accepted: 05/22/2018] [Indexed: 11/27/2022]
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Harwood A, Campbell A, Hendry D, Ng L, Wild CY. Differences in lower limb biomechanics between ballet dancers and non-dancers during functional landing tasks. Phys Ther Sport 2018; 32:180-186. [PMID: 29800796 DOI: 10.1016/j.ptsp.2018.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the differences in the lower limb landing biomechanics of adolescent ballet dancers compared to non-dancers when performing a hop and a stop jump task. DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS Thirteen adolescent female ballet dancers (11.8 ± 1.1 years) and 17 non-dancers (10.9 ± 0.8 years) performed hop and stop jump tasks. MAIN OUTCOME MEASURES Vertical ground reaction force, and three-dimensional ankle, knee and hip joint angles and moments during the landing phase. RESULTS Dancers displayed greater sagittal plane joint excursions during the hop and stop jump at the ankle (mean difference = 22.0°, P < 0.001, 14.8°, P < 0.001 respectively), knee (mean difference = 18.1°, P = 0.001, 9.8°, P = 0.002 respectively) and hip (stop jump task; mean difference = 8.3°, P = 0.008). Dancers displayed a larger hip extensor moment compared to non-dancers (P < 0.001) during the stop jump task only. Dancers also took longer to reach peak vGRF and jumped three times higher than non-dancers (P < 0.001) during the stop jump task. No difference in peak vGRF between groups was displayed for either task. CONCLUSIONS Adolescent dancers demonstrate a transfer of landing technique to non-ballet specific tasks, reflective of the greater jump height and sagittal plane joint excursions. This landing strategy may be associated with the low rate of non-contact ACL injuries in female dancers.
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Affiliation(s)
- Annissa Harwood
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Amity Campbell
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Danica Hendry
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Leo Ng
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Catherine Y Wild
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
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47
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Turner C, Crow S, Crowther T, Keating B, Saupan T, Pyfer J, Vialpando K, Lee SP. Preventing non-contact ACL injuries in female athletes: What can we learn from dancers? Phys Ther Sport 2018; 31:1-8. [DOI: 10.1016/j.ptsp.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/14/2017] [Accepted: 12/19/2017] [Indexed: 12/17/2022]
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48
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Hansberger BL, Acocello S, Slater LV, Hart JM, Ambegaonkar JP. Peak Lower Extremity Landing Kinematics in Dancers and Nondancers. J Athl Train 2018. [PMID: 29528687 DOI: 10.4085/1062-6050-465-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
CONTEXT Anterior cruciate ligament (ACL) injuries often occur during jump landings and can have detrimental short-term and long-term functional effects on quality of life. Despite frequently performing jump landings, dancers have lower incidence rates of ACL injury than other jump-landing athletes. Planned versus unplanned activities and footwear may explain differing ACL-injury rates among dancers and nondancers. Still, few researchers have compared landing biomechanics between dancers and nondancers. OBJECTIVE To compare the landing biomechanics of dancers and nondancers during single-legged (SL) drop-vertical jumps. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 39 healthy participants, 12 female dancers (age = 20.9 ± 1.8 years, height = 166.4 ± 6.7 cm, mass = 63.2 ± 16.4 kg), 14 female nondancers (age = 20.2 ± 0.9 years, height = 168.9 ± 5.0 cm, mass = 61.6 ± 7.7 kg), and 13 male nondancers (age = 22.2 ± 2.7 years, height = 180.6 ± 9.7 cm, mass = 80.8 ± 13.2 kg). INTERVENTION(S) Participants performed SL-drop-vertical jumps from a 30-cm-high box in a randomized order in 2 activity (planned, unplanned) and 2 footwear (shod, barefoot) conditions while a 3-dimensional system recorded landing biomechanics. MAIN OUTCOME MEASURE(S) Overall peak sagittal-plane and frontal-plane ankle-, knee-, and hip-joint kinematics (joint angles) were compared across groups using separate multivariate analyses of variance followed by main-effects testing and pairwise-adjusted Bonferroni comparisons as appropriate ( P < .05). RESULTS No 3-way interactions existed for sagittal-plane or frontal-plane ankle (Wilks λ = 0.85, P = .11 and Wilks λ = 0.96, P = .55, respectively), knee (Wilks λ = 1.00, P = .93 and Wilks λ = 0.94, P = .36, respectively), or hip (Wilks λ = 0.99, P = .88 and Wilks λ = 0.97, P = .62, respectively) kinematics. We observed no group × footwear interactions for sagittal-plane or frontal-plane ankle (Wilks λ = 0.94, P = .43 and Wilks λ = 0.96, P = .55, respectively), knee (Wilks λ = 0.97, P = .60 and Wilks λ = 0.97, P = .66, respectively), or hip (Wilks λ = 0.99, P = .91 and Wilks λ = 1.00, P = .93, respectively) kinematics, and no group × activity interactions were noted for ankle frontal-plane (Wilks λ = 0.92, P = .29) and sagittal- and frontal-plane knee (Wilks λ = 0.99, P = .81 and Wilks λ = 0.98, P = .77, respectively) and hip (Wilks λ = 0.88, P = .13 and Wilks λ = 0.85, P = .08, respectively) kinematics. A group × activity interaction (Wilks λ = 0.76, P = .02) was present for ankle sagittal-plane kinematics. Main-effects testing revealed different ankle frontal-plane angles across groups ( F2,28 = 3.78, P = .04), with male nondancers having greater ankle inversion than female nondancers ( P = .05). CONCLUSIONS Irrespective of activity type or footwear, female nondancers landed with similar hip and knee kinematics but greater peak ankle eversion and less peak ankle dorsiflexion (ie, positions associated with greater ACL injury risk). Ankle kinematics may differ between groups due to different landing strategies and training used by dancers. Dancers' training should be examined to determine if it results in a reduced occurrence of biomechanics related to ACL injury during SL landing.
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Cardoso AA, Reis NM, Marinho APR, Vieira MDCS, Boing L, Guimarães ACDA. INJURIES IN PROFESSIONAL DANCERS: A SYSTEMATIC REVIEW. REV BRAS MED ESPORTE 2017. [DOI: 10.1590/1517-869220172306170788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Movement is a fundamental element of dance, and the dancer’s body is the raw material through which the art of dance is expressed; for this, it demands the utmost discipline in the pursuit of technical and artistic excellence. To meet the professional demands, dancers are subjected to strenuous training routines, which can lead to the development of injuries in this environment. The objective was to examine the etiology, main affected segments, prevalence, and instruments used to evaluate the lesions in studies with professional dancers and/or in comparison with similar populations. We selected articles published in the last decade in the databases BIREME, LILACS, MEDLINE EBSCO, WEB OF SCIENCE, SCOPUS (Elsevier), and PubMed, with cross-sectional, observational cohort and case control design published in Portuguese, English, or Spanish. Systematic reviews, case studies, dissertations, theses, book chapters, cross-referenced articles, and studies published outside of the last decade were not included. The search used combinations of the terms “dancing* and athletic injuries* and musculoskeletal* and pain*”. A principal investigator and two reviewers conducted the survey and analyzed all the potentially relevant articles, initially by the abstract and title. Twelve articles were included, with 1,149 participants (965 professional dancers of classical ballet, modern dance, contemporary dance, and breakdance, 104 amateur dancers, and 80 elite athletes). Nine studies found simultaneous lesions with emphasis on the foot and ankle (n=4), upper and lower limbs lesions (n=4) and lower and upper limb joints (n=1). Other studies have found lesions in the anterior cruciate ligament (n=3). There was no agreement regarding the instruments for detecting lesions in professional, pre-professional, and amateur dancers. There was a prevalence of studies aimed at classical ballet modality, evidencing a higher frequency of lower limb involvement in professional dancers.
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Goldring AE, Ashok AP, Casey EK, Mulcahey MK. Key components and potential benefits of a comprehensive approach to women's musculoskeletal health. PHYSICIAN SPORTSMED 2016; 44:417-424. [PMID: 27548840 DOI: 10.1080/00913847.2016.1222854] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Over the last 40 years there has been a significant increase in the number of female athletes, as well as a rise in musculoskeletal injuries observed in women. There is sufficient evidence from past medical research identifying various musculoskeletal injuries and conditions that more commonly affect women, such as osteoarthritis, osteoporosis, stress fractures, and anterior cruciate ligament tears. Several women's sports medicine and musculoskeletal health programs have been developed throughout the United States in an attempt to provide more tailored care to the female athlete. The goal of a comprehensive approach to women's musculoskeletal health is to create an interdisciplinary team to facilitate treatment for a variety of injuries and related conditions. This manuscript outlines the musculoskeletal conditions that commonly affect women and highlights the various etiologies of these sex disparities. We discuss the role of interdisciplinary women's musculoskeletal health and sports medicine programs, and define the potential benefits of such an approach. Future studies should focus on assessing the outcomes of multidisciplinary women's sports medicine programs as current literature in this area is lacking.
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Affiliation(s)
- Anne E Goldring
- a Drexel University College of Medicine , Philadelphia , PA , USA
| | - Annie P Ashok
- b Drexel University College of Medicine , Department of Orthopaedic Surgery , Philadelphia , PA , USA
| | - Ellen K Casey
- c Department of Physical Medicine and Rehabilitation , University of Pennsylvania , Philadelphia , PA , USA
| | - Mary K Mulcahey
- b Drexel University College of Medicine , Department of Orthopaedic Surgery , Philadelphia , PA , USA
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