Considerations for the Medical Management of the Circus Performance Artist and Acrobat

"A sprained ankle is the biggest sign of mental fatigue": A qualitative study of the perceptions and experiences of mental fatigue in professional ballet

Mental fatigue is known to influence endurance, skill, and tactical performance in sport. Research investigating the impact of mental fatigue on tasks that combine physical, cognitive, and aesthetic performance such as professional ballet does not exist.

OBJECTIVE

To understand the perceptions and experiences of mental fatigue in professional ballet.

DESIGN

Qualitative, focus groups and semi-structured interviews.

SETTING

The Australian Ballet.

PARTICIPANTS

Thirty-nine professional ballet dancers (53% of the company) and six dance staff members aged 18 years or above (53% female).

MAIN OUTCOME MEASURES

N/a.

RESULTS

The average focus group and interview length was 48 ± 7 min and 41 ± 8 min. Key categories were; (1) Dancers and dance staff perceive that new learning contributes to mental fatigue, (2) Dancers perceive changes to their mood and perception of effort when they are mentally fatigued, and (3) Dancers and dance staff perceive that mental fatigue negatively affects their physical and cognitive performance and, increases their risk of injury.

CONCLUSION

This is the first study where participants associated mental fatigue with injury risk and provides a springboard to measure the impact of mental fatigue on learning, injury, and performance in professional ballet.

Untangling risk factors including discipline-specific exposure for injuries in preprofessional and professional circus artists in the USA

Objective

This prospective cohort study quantified injury patterns related to specific circus discipline exposure in preprofessional and professional circus artists.

Methods

Circus artists (n=201; ages 13-69; 172 female, 29 male assigned sex at birth) were enrolled in 10 cities across the USA. Participants were followed for 1 year from enrolment, completing a weekly training log and undergoing a physical therapist evaluation for injuries. The circus-specific extension of the International Olympic Committee 2020 consensus on recording injury and illness in sports was used to analyse injury patterns.

Results

The study completion rate was 77% (n=155). Data were analysed by participant subgroup (age, professional status, sex at birth). The highest injury rates in participant subgroups were for males (5.69/1000 exposures) and related to discipline subgroups, were in aerial with ground elements (5.93/1000 exposures) and aerial (4.26/1000 exposures). Adults had more injuries related to aerial, whereas adolescents had more related to ground disciplines (χ² (2)=10.62, p=0.005) and non-time loss injuries (χ² (1)=5.45, p=0.02). Females had a higher proportion of repetitive injuries (70% vs 55%) than males (χ² (1) = 4.43, p=0.035). Individuals with an eating disorder history had more (p<0.004) injuries (mean 2.27±2.29) than those without (mean=1.48±0.96).

Conclusions

This study showed that intrinsic factors (age, sex at birth and history of eating disorder) and extrinsic factors (circus discipline exposure) affect injury risk. We need to account for the intersectionality of these factors to address risk management at an individual and group level.