Biomechanical Risks Associated with Foot and Ankle Injuries in Ballet Dancers: A Systematic Review

Challenges to therapeutic footwear usage for foot ulcer prevention among type 2 diabetes patients: A qualitative study

OBJECTIVE

Many contemporary designs solely prioritize the therapeutic function of footwear, neglecting other crucial social and environmental considerations. The study aimed to explore challenges to therapeutic footwear usage for foot ulcer prevention.

METHODS

A qualitative critical ethnography design was used in this study. Fourteen participants were recruited at the local hospital in Baise City, China. Data were collected through in-depth interview. A thematic analysis approach was conducted for data analyzing.

RESULTS

This study identified two themes: (1) workplace and physical condition, (2) diverse cultural practice. It was worth noting that slipper as a convenient and cheap wearing choice, decreased the usage of therapeutic footwear. The emerging activity of modern square dancing resulted in more requirements for its design. And the symbolic meaning of hard working in barefoot was also challengeable to therapeutic footwear utilization to some extent.

CONCLUSIONS

Therapeutic footwear intervention design should not only focus on the therapeutic functionality, but also consider about individuals' demands towards working environment and physical status, and particular insights regarding culture and social background. We expected these findings could be evidence for improving therapeutic footwear usage in the future.

Body Posture and Low Back Pain: Differences between Folk and Ballroom Dancers

(1) Background: Dance is extremely diverse in its styles. Each of them presents different training, dynamics, and figures that may impact the body posture and the occurrence of low back pain. This observational study aimed to compare the sagittal curvatures and the range of motion (ROM) of the spine, as well as the low back pain occurrence and its intensity between folk and ballroom dancers. (2) Methods: Fifty-one participants took part in the study (nineteen folk dancers, fifteen ballroom dancers, and seventeen non-dancers) aged 18-32. Study groups did not differ in anthropometric parameters as well as in dancing experience and training frequency. Study procedures included a self-administered questionnaire and a physical examination of the sagittal spine curvatures and ROM. The questionnaire included questions about epidemiological data and the occurrence of chronic pain and its intensity using a Visual Analogue Scale (VAS). (3) Results: There was a significant difference in thoracic kyphosis angle between study groups (p = 0.02). The greatest angle was found in folk dancers and the lowest in ballroom dancers (40 vs. 33 respectively). We have found no significant differences in spine ROM, low back pain occurrence, and intensity between study groups (p > 0.05). We have found no correlation between low back pain and spine curvatures and ROM in dancers (p > 0.05), however, we found a very strong and negative correlation between thoracic spine range of motion and the pain intensity in non-dancers (R= -0.95, p = 0.003). The analysis also revealed that only in folk dancers, but not in ballroom dancers, the BMI correlates positively with dancing experience (R = 0.67, p = 0.002). (4) Conclusions: There are no differences in low back pain occurrence and pain intensity between folk and ballroom dancers, however, the prevalence of low back pain in dancers is very high. Folk dancers seem to have more flexed body posture compared to ballroom dancers.

Weighting of visual and auditory inputs in dancers with and without previous ankle injury

Elite dance requires highly controlled balance performance in dynamic visual and auditory environments characterized by the use of stage lighting and music. Perturbing visual input is known to influence balance in dancers, but the effects of sounds have not been clearly established. Ankle inversion injuries are common in dancers and may also play a role in dancers' ability to respond to sensory perturbations. The aims of this study were to identify changes in static balance in response to visual or auditory perturbation in elite collegiate dancers with and without a history of ankle injury, and to describe coupling of measurements obtained from the waist and head during balance. Thirty-seven dancers: 22 controls and 15 with a history of ankle sprain, performed single-leg balance under static and dynamic visual and auditory conditions. Dancers demonstrated increased waist sway when viewing a dynamic visual scene and when presented with moving sounds and increased head sway with dynamic visuals. These results did not vary by history of ankle sprain. While dancers appear to dampen the impact of waist sway on head motion during single leg stance, even highly trained dancers may experience challenges controlling balance under perturbing visual and auditory conditions like those present during stage performance.

Spinal Counts, Impact, and Partnering Movements in Ballet, Modern, and Hip Hop dance: A YouTube Video Analysis Study

INTRODUCTION

Dancers have self-reported a link between spinal extension movements and low back pain (LBP). Researchers have not reported the total number or frequency that spinal movements occur in ballet, modern, or hip-hop dance classes or performances. The purpose of this study was to report the number of spinal movements dancers are exposed to in different dance environments.

MATERIALS AND METHODS

We analyzed 65 dance videos on YouTube.com for dance movements within 7 dance environments: ballet class and performance, modern class and performance, and hip-hop breaking, ciphers (large groups), and battles ("1v1s"). Two reviewers recorded counts of spinal (spinal flexion, extension, lateral flexion, and rotation), impact (jumps, leaps, and falls), and partnering movements (lifts, catches, and leans). Data analyses were processed in Jamovi (the jamovi project, Sydney, Australia). We reported movement totals, percentages, frequency, ranges, means with standard deviations (SD), and medians with interquartile range (IQR). We calculated significant differences using Mann-Whitney U tests.

RESULTS

Video length ranged from 3 to 141 minutes (mean ± SD: 38.4 ± 38.3, range: 138). the average spinal extension movements ranged from 2 ± 0.8 to 7 ± 9.6 movements per minute across genres. Modern dance class had the most spinal flexion (89 ± 53.6), rotation (60 ± 40.8), and lateral flexion (74 ± 20.7) movements. Ballet performance had the most spinal extension movements (77 ± 69.8), jumps (74 ± 48), and leaps (19 ± 18.2). Hip-hop breaking had the highest number of falling movements (2 ± 2.3). Partnering movements were only present in ballet performance, modern dance performance, and hip-hop breaking environments.

CONCLUSIONS

Movements that increase LBP occur often in all 3 dance genres. Dancers can expect frequent exposure to spinal extension movements; therefore, we recommend strengthening back and core musculature for all dancers. We recommend that ballet dancers also strengthen their lower extremity muscles. For modern dancers, we recommend strengthening their obliques. For hip-hop dancers, we recommend increasing muscular power and muscular endurance.

Don't stop me now: A qualitative study of how Brazilian dancers and staff perceive injury and its prevention

OBJECTIVE

To investigate how Brazilian dancers and dance staff perceive and deal with injury and its prevention in professional and non-professional contexts.

DESIGN

Qualitative study.

SETTING

Semi-structured interviews conducted using an online platform.

PARTICIPANTS

Thirteen participants (8 women, 5 men) from four different dance styles (classical ballet, jazz, contemporary and urban): 6 dancers, 6 staff and 1 classified as both.

MAIN OUTCOME MEASURES

Interviews were recorded, transcribed and analyzed based on Grounded Theory principles using comparative data analysis.

RESULTS

The main themes and findings were: 1) Injury definition: Injury was defined and classified based on pain, structural damage and consequent limitations and restrictions. 2) Dealing with injury: Dancers' fear of having to stop dancing justifies different behaviours facing injury. 3) Injury factors: Overload and many personal and environmental factors were perceived as related to injury. 4) Injury prevention: it is linked with physical preparation and additional measures and influenced by communication, trust, experience, time, access to preventive programs, dancers' personalities and environmental factors. Responsibility for injury prevention should be shared by all stakeholders.

CONCLUSIONS

To improve injury prevention, we need to acknowledge the dancers' drive to keep dancing, consider the multiple factors that influence their behaviours, and develop education and self-efficacy to help them make better decisions to reduce the risk of injury.

Epidemiological Characteristics of Foot and Ankle Injuries in 2 Professional Ballet Companies: A 3-Season Cohort Study of 588 Medical Attention Injuries and 255 Time-Loss Injuries

Background

The foot and ankle are often reported as the most common sites of injury in professional ballet dancers; however, epidemiological research focusing on foot and ankle injuries in isolation and investigating specific diagnoses is limited.

Purpose

To investigate the incidence rate, severity, burden, and mechanisms of foot and ankle injuries that (1) required visiting a medical team (medical attention foot and ankle injuries; MA-FAIs) and (2) prevented a dancer from fully participating in all dance-related activities for at least 24 hours after the injury (time-loss foot and ankle injuries; TL-FAIs) in 2 professional ballet companies.

Study Design

Descriptive epidemiological study.

Methods

Foot and ankle injury data across 3 seasons (2016-2017 to 2018-2019) were extracted from the medical databases of 2 professional ballet companies. Injury-incidence rate (per dancer-season), severity, and burden were calculated and reported with reference to the mechanism of injury.

Results

A total of 588 MA-FAIs and 255 TL-FAIs were observed across 455 dancer-seasons. The incidence rates of MA-FAIs and TL-FAIs were significantly higher in women (1.20 MA-FAIs and 0.55 TL-FAIs per dancer-season) than in men (0.83 MA-FAIs and 0.35 TL-FAIs per dancer-season) (MA-FAIs, P = .002; TL-FAIs, P = .008). The highest incidence rates for any specific injury pathology were ankle impingement syndrome and synovitis for MA-FAIs (women 0.27 and men 0.25 MA-FAIs per dancer-season) and ankle sprain for TL-FAIs (women 0.15 and men 0.08 TL-FAIs per dancer-season). Pointe work and jumping actions in women and jumping actions in men were the most common mechanisms of injury. The primary mechanism of injury of ankle sprains was jumping activities, but the primary mechanisms of ankle synovitis and impingement in women were related to dancing en pointe.

Conclusion

The results of this study highlight the importance of further investigation of injury prevention strategies targeting pointe work and jumping actions in ballet dancers. Further research for injury prevention and rehabilitation strategies targeting posterior ankle impingement syndromes and ankle sprains are warranted.

Managing the Wellbeing of Elite Rugby Union Players from an Occupational Safety and Health Perspective

The intense, physical contact nature of rugby union often encourages the normalization of risk-taking behaviour resulting in a relatively high acceptance of risk. This study aims to explore safety culture in rugby union from an OSH perspective, with the purpose of assisting coaches and management in their decision-making processes to improve players' health, welfare, and long-term well-being. In terms of data collection, this study involved semi-structured interviews with senior support staff (n = 15) in elite rugby union. Interview transcripts underwent inductive analysis prior to an abductive analysis that was guided by an established occupational-safety-and-health (OSH) framework. Rugby union players' safety can be considered from two dimensions: management's commitment to safety (i.e., safety prioritization, safety empowerment, and safety justice), players' involvement in safety (i.e., safety prioritization, and trust in other players' safety competence, and players' safety concern for the opposition players). Within the themes identified, players' attitude towards their opponents' safety which has been rarely considered as a factor for injury prevention is also discussed in this study. If sport support staff (i.e., managers/coaches/medical) can become more involved in players' performance-orientated training using OSH management processes to aid in their decision-making, their exists the capacity to benefit players' safe return to play after injury rehabilitation. Meanwhile, directing the development of appropriate behavioural educational interventions to raise safety-awareness amongst players can improve their long-term health and well-being and provide them with the necessary safety and health information to support their own decision-making processes. As a multidisciplinary design, this study contributes new multidisciplinary insights that have the potential to advance managerial practices utilizing an OSH perspective, including decision-making supporting risk alleviation for safety and long-term health and wellbeing initiatives in competitive team sports.