Injury Occurrence in Modern and Hip-Hop Dancers: A Systematic Literature Review

Umbrella review of musculoskeletal injury burden in dancers: implication for practice and research

BACKGROUND

Dancers are susceptible to injury. Nevertheless, injury epidemiology research in dancers is inconsistent. Furthermore, ballet dancing has dominated the huge body of reviews analyzing the epidemiology of musculoskeletal injuries in a variety of artistic dance forms, making it challenging to acquire a thorough, comprehensive, and understandable reporting of the available data.

PURPOSE

The overview and reanalysis of dancers' musculoskeletal pain and injury load across artistic dance forms.

STUDY DESIGN

Systematic review of systematic reviews and meta-analysis.

METHODS

A search was conducted online for literature written in English using PubMed and Google Scholar (2012-2021). The data gathered was then analyzed using predetermined qualifying criteria.

RESULTS

12 reviews were determined to be qualified, the majority of which had moderate to low confidence and raised concerns about bias based on JBI-URARI and ROBIS. The prevalence of dance-related musculoskeletal injuries ranged from 26% to 84% in any artistic dancers and 42% to 343% in ballet dancers. The incidence was less than 5 per 1000 dance hours in both groups, with lower extremities and back being the commonly reported sites. Reviews themselves stated that the quality of the reviews was often poor. Due to the study's heterogeneity and methodological inconsistency, data pooling and meta-analysis were not possible.

CONCLUSION

The current review emphasizes the gaps and restrictions in the dance epidemiology literature that make it challenging to quantify and report a single overall injury rate for dancers. These results underline the need for better primary investigations and evidence synthesis. As injury epidemiology is a critical component of the overall injury-prevention puzzle, there is a need for standardization in future research, particularly with active and prospective injury surveillance, injury classification, injury evaluation, and injury reporting.

LEVEL OF EVIDENCE

Systematic Review, Level III.

Injury, Training, Biomechanical, and Physiological Profiles of Professional Breakdancers

Background

Breakdancing or breaking will enter the Olympics in 2024, however, there is a paucity of literature exploring the epidemiology, demands, and performance.

Purpose

The purpose of this study was to describe injury and training profiles, along with the results of a short performance test battery, in a group of elite breakers.

Study Design

Cross-sectional study (retrospective).

Methods

Fourteen breakdancers (breakers) (4 Bgirls, 10 Bboys) participated in an interview regarding their injury and training history, endurance test (cycle VO2max testing), counter movement jump, squat jump, drop jump, isometric hip abduction, adduction, shoulder external and internal rotation strength testing on a fixed-frame dynamometer. Breakers were divided into elite (n=10) and developing (n=4) based on their qualification for a world finals competition; Wilcoxen rank sums were used to compare the two groups, or in the case of strength testing between those with and without an injury history.

Results

The breakers had a median 11.0 [10.0 - 14.0] years breaking experience and trained 24.4 [20.5 - 30.0] hours per week. The knee was the most commonly injured body part and most frequently injured joint, with the thigh being the most common site for muscle injuries. There were no differences in endurance testing or jump height testing results between elite and developing breakers. There was no difference in shoulder external or internal rotation strength between athletes with a history of shoulder injury and those without. Similarly, there was no difference in hip abduction or adduction strength in those with a history of hip injury and those without.

Conclusion

The results of this study should be viewed with caution due to the small sample size. However, this study is the first to publish functional and physiological descriptives on breakers. The authors hope these results support clinicians treating breakers as well as encourages future research related to breaking.

Level of Evidence

2b.

Injuries of Primary School Children during Sports Activities

Introduction

The purpose of the research was to analyse the injuries of primary school children in the framework of organised sports activities at school and in clubs or associations, and in leisure time without professional guidance.

Methods

We surveyed 631 participants, of which there were 282 boys and 349 girls from eight Slovenian primary schools. Frequencies were calculated and a Chi-square test was performed.

Results

In physical education (PE) at school, 32% of the participants were injured in one school year, and there were no statistically significant differences in the number of injuries according to sex (p=0.18) and age (p=0.12). Most injuries were recorded in the lower extremities (50%), in the form of wounds. The participants were injured less often in PE at school than in a club or association, and more often than in their leisure time. The participants were absent from PE classes for longer after an injury in a club or association than in PE, while no significant differences in absences after injury were found. At school, the participants were most often injured in ball games, boys in football (43%) and girls in volleyball (19%). In activities in a club or association, we recorded the most injuries in boys in martial arts (18%) and dance for girls (19%). In their leisure time, boys suffered the most injuries from football (26%) and cycling, while girls suffered the most from running and rollerblading.

Conclusion

In the last ten years, the number of injuries in PE has increased in Slovenia. Based on the obtained results, we propose measures to reduce injuries and thus encourage more sports activities among children and adolescents, while ensuring their safety.

Effects of a dynamic stretching warm-up on functional movement patterns in female hip-hop dancers

Background: A large percentage of dancers suffer an injury to their musculoskeletal system at least once in their careers, as well as from pain caused by overloading or overtraining this system. A high frequency of injuries has been observed in hip-hop dancers. Before each workout, there should be a solid warm-up and stretching period. The lack of these two important elements increases the risk of injury. Aim of the study: This study aimed to examine the effects of dynamic stretching warm-ups on fundamental movement patterns in female hip-hop dancers. Material and methods: This study included 14 hip-hop female dancers, aged 15–17. Dancers participated in 6 weeks of dynamic stretching warm-ups. Anthropometric and demographic variables were measured. The effectiveness of dynamic stretching warm-ups in improving fundamental movement patterns was assessed using the Functional Movement Screen (FMS) test including qualitative assessments using Deep Squat (DS) Hurdle Step (HS), In-Line Lunge (ILL), Shoulder Mobility (SM), Active Straight-Leg Raise (ASLR), Trunk Stability Push-Ups (TSPU) and Rotational Stability (RS). Results: Before the intervention, the mean composite FMS™ score was 15.00 ± 1.84 points and after the intervention was 16.64 ± 1.39 (p < 0.05). There were also statistically significant differences before and after the intervention in the DS (1.86 ± 0.53 vs. 2.36 ± 0.49, p < 0.05) and ASLR (2.21 ± 0.69 vs. 2.57 ± 0.65, p < 0.05). The number of dancers who scored 14 points or less on the FMS test before and after dynamic stretching warm-ups decreased from 50% to 0%. HS (r = 0.63, p = 0.01) and TPSU (r = 0.79, p = 0.01) were positively correlated with composite FMS scores before the intervention. After the intervention, positive correlations were observed between ASLR and composite FMS scores (r = 0.68; p = 0.01). Conclusions: Dynamic stretching warm-ups significantly improve functional movement patterns, including DS, ASLR, and composite FMS scores. It is important to use movement competency screenings in injury prevention programs.

Prevalence and Risk Factors of Dance Injury During COVID-19: A Cross-Sectional Study From University Students in China

Objectives: Although coronavirus disease 2019 (COVID-19) has transformed the training environment of dancers worldwide, little is known on how this has affected injury prevalence, causes, and risk factors. Methods: An online investigation involving Chinese full-time dance students was conducted (September-November 2020), which covered two 6-month periods just before and during the first COVID-19 lockdown. Results: 2086 students (19 ± 2.4 years) responded to the investigation. Injury prevalence dropped from 39.6% (before the lockdown) to 16.5% (during the lockdown) (p < 0.01). It was noted that a significant increase in injury severity during the lockdown was caused due to a 4.1% increase in moderate-to-severe injuries (p < 0.05). During the lockdown, the injuries on the lower back, feet, and shoulders decreased significantly (p < 0.01), but the knee, ankle, and groin/hip joint injuries remained the same. Fatigue and the recurrence of an old injury remained as the top two perceived causes of an injury between the two periods with the increase in an unsuitable floor (p < 0.01), a cold environment (p < 0.05), and set/props (p < 0.05). The fatigue degree of students decreased (p < 0.01) and their hours of sleep increased (p < 0.01) during the lockdown. Binary Logistic Regression analysis indicated that dance injury is associated with fatigue, the hours of sleep, and the actions taken if they suspect an injury during the lockdown (p < 0.05), but is only related to the time set aside for a cooldown and age before the lockdown period (p < 0.05). Conclusion: Although injury prevalence dropped significantly during the first COVID-19 lockdown in Chinese dance students, the main dance injury characteristics remained the same. Decreased fatigue and longer hours of sleep could explain the aforementioned drop in injury prevalence during the lockdown.

Predicting Injury Status in Adolescent Dancers Involved in Different Dance Styles: A Prospective Study

The positive effects of dance on health indices in youth are widely recognized, but participation in dance is accompanied with a certain risk of injury. This prospective study aimed to investigate injury occurrence and to evaluate the possible influences of specific predictors on the occurrence of musculoskeletal problems and injuries in adolescent dancers. Participants were 126 dancers (21 males; 11–18 years), who were competitors in the urban dance, rock and roll, and standard/Latin dance genres. Predictors included sociodemographic factors, anthropometric/body build indices, sport (dance) factors, and dynamic balance. The outcome variable was injury status, and this was evaluated by the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC). Predictors were evaluated at baseline, and outcomes were continuously monitored during the study period of 3 months. During the study course, 53% of dancers reported the occurrence of a musculoskeletal problem/injury, and dancers suffered from an average of 0.72 injuries over the study period (95% CI: 0.28–1.41), giving a yearly injury rate of 280%. Gender and dance styles were not significantly related to the occurrence of injury. Higher risk for injury was evidenced in older and more experienced dancers. Dynamic balance, as measured by the Star Excursion Balance Test (SEBT), was a significant protective factor of injury occurrence, irrespective of age/experience in dance. Knowing the simplicity and applicability of the SEBT, continuous monitoring of dynamic balance in adolescent dancers is encouraged. In order to prevent the occurrence of musculoskeletal problems/injuries in youth dancers, we suggest the incorporation of specific interventions aimed at improving dynamic balance.