Exploring the Epidemiology of Injuries in Athletes of the Olympic Winter Games: A Systematic Review and Meta-Analysis

This study sought to provide a comprehensive assessment of the incidence of sports injuries among athletes participating in the Olympic Winter Games and to investigate contributing factors. We gathered injury data from athletes participating in the recent four Olympic Winter Games, incorporating details on the sports event, sex, injury location, and type. Through a meta-analysis, we calculated the injury incidence rates for each sport and examined the influence of sex and the type of sport on these incidence rates. Out of 11,197 registered athletes, we documented 1,304 sports injuries. The sports events with the highest injury rates were freestyle skiing, snowboarding, alpine skiing, bobsleigh, and ice hockey, with the most frequent injury locations being the knees, thoracic/lumbar/back regions, and the wrist/hand/fingers. Contusions, hematomas, and bruises were the most prevalent injuries, followed by strains (including muscle rupture, tearing, or tendon rupture) and sprains (covering dislocations, subluxations, and ligament ruptures). In the Olympic Winter Games, events such as freestyle skiing, snowboarding, alpine skiing, bobsleigh, and ice hockey pose a particularly high risk. Predominant injury sites include the knee, spine/back, and wrist and hand, with injuries ranging from contusions and hematomas to strains and sprains. For effective injury prevention, it is crucial to emphasize proper medical resource allocation, specialized training for medical personnel, and meticulous venue maintenance.

Managing Accident Prevention in Ski Resorts: Participants' Actual Velocities in Slow Zones

Velocity is one of the main factors affecting the kinematic of snow sports' accidents and the severity of resulting injuries. The aims of the present study were to measure the actual maximum velocities attained by a sample of snow sports participants in slow zones, to compare them to the recommended velocity limits and to assess whether their velocities were in any way related to their personal characteristics and to environmental conditions. Data were drawn from a sample of 1023 recreational skiers and snowboarders during the 2021-2022 winter season at four ski resorts located in the Spanish Pyrenees. Maximum velocity measurements were taken by the authors with a radar speed gun whose precision had been previously validated. Bivariate analysis tests were used to compare the influence that personal characteristics and environmental conditions had on the participants' maximum velocities. Furthermore, a multivariate analysis was performed. The binary logistic regression was used to distinguish the categories of personal and environmental factors that have the highest probabilities of impact on different segments of velocity. As generally accepted, probability values were two-tailed, and values of 0.05 or less were regarded as statistically significant. Participants' mean measured maximum velocity (±SD) was 51.61 (±16.14) km/h. A vast majority of the participants in this study traveled in slow zones at actual maximum velocities well over the recommended limits. Multivariate analysis showed that modality and both environmental conditions (visibility and snow quality) were highly significant and can be used to explain the chances of an increase in velocity in slow zones. Further research is needed to investigate causal relationships between skiers and snowboarders' accidents, injuries and disrespect for velocity limits.

The Global Research Status and Trends in Ice and Snow Sports Injuries from 1995 to 2022: A Bibliometric and Visualized Analysis

OBJECTIVE

The aim of the present study is to focus on the most popular winter sports programs, and to investigate the global research status and trends in sports-related injuries.

METHODS

The Web of Science (WoS) Core Collection database was chosen as original data and used for extracting publications on ice and snow sports injuries on 18 February 2022. Articles published in English between 1995 to 2022 were selected for this study.

RESULTS

Finally, for the topic search, a sum of 1605 articles were extracted and used for further analysis. The country and journal ranked first-in terms of total number, total citations and the highest H-index of publications-were the USA and American Journal of Sports Medicine, respectively. The affiliation with the most cited publications was the Norwegian School of Sport Sciences. The most influential first author with the most citations (2537 times), the greatest average citations per article (65.05 times) and the highest H-index (26) was Bahr R. Articles were divided into five main clusters based on keyword analysis: injuries study, head and neck damage study, risk study, therapy study and epidemiology study. Studies related to epidemiology and brain damage in ice and snow sports will continue to be research hot topics.

CONCLUSIONS

In conclusion, our study indicates that the ice and snow sports injuries research domain is more prevalent in North America and Europe. This study contributes to a comprehensive understanding of ice and snow sports injuries and provides hotspot directions.

Clinical characteristics of patients with snow sports trauma transported to a trauma care center: A retrospective observational study

BACKGROUND

Snow sports are a popular recreational activity; however, the incidence of injury of snow sports can be high for skiers and snowboarders. Our hospital receives severe trauma cases from snow resorts and hospitals throughout the region. This study aimed to determine whether the risk of snow sports-related major trauma that requires emergency surgery under general anesthesia varies by the equipment and injury mechanism.

METHODS

This retrospective cohort study included patients with snow sports trauma referred to Gifu University Hospital, Japan between November 2010 and March 2020. We analyzed the need for emergency operation under general anesthesia within 24 h using Fisher's exact test. We identified 106 patients: (1) 90 in the snowboarders' group and 16 in the skiers' group or (2) 46 in the fall after jumping group (jumping group), 27 in the collide with other people and obstacle group (collision group), and 33 in the fall during gliding group (gliding group).

RESULTS

Snowboarders were nearly twice as likely as skiers to require emergency surgery under general anesthesia (44% vs. 25%; p = 0.236]. No significant associations were found between emergency surgery under general anesthesia and injury mechanism, but half of the patients in the jumping group required emergency surgery.

CONCLUSIONS

Snowboard as equipment and falls after jumping as a mechanism of injury tended to be associated with emergency surgery under general anesthesia, with no significant differences. In order to provide adequate resources for snow sports trauma, the cause of the patient's injury is strongly related to the urgency of the condition, and transport to a trauma center should be actively considered. Further studies are warranted with respect to the effects of personal protective equipment and skill level.

Sledding while towed behind motorized vehicles associates with more severe and lethal injuries☆

INTRODUCTION

Our institution has recently experienced an increase in sledding-related injuries, particularly when towed behind motorized vehicles. The purpose of this study was to characterize injury severity and clinical outcomes between pediatric patients who sustain injuries owing to motorized sledding accidents to aid in injury prevention messaging.

METHODS

This retrospective study queried all patients who presented with a sledding-related injury to a single ACS-verified Level 1 Pediatric Trauma Center located in the Southeastern United States between 01/2015 and 01/2022. Demographics, injury details, and clinical outcomes were compared between two groups: patients towed behind a motorized vehicle (MOTOR) and those who were not (GRAVITY).

RESULTS

Of the 67 patients included in our analysis, 15 (22%) were in the MOTOR group. Patients in the MOTOR group presented with significantly higher injury severity (ISS) and lower Glasgow coma scale (GCS) scores. Additionally, patients in this MOTOR group more often received a blood transfusion and intubation, had longer intensive care and overall hospital lengths of stay, and incurred higher hospital costs. In a multivariate analysis, the use of a motorized vehicle to sled was independently associated with increased ISS (OR: 9.7, 95% CI 1.9-17.5; p = 0.02). Two deaths occurred after sledding while being towed behind a motorized vehicle.

CONCLUSION

Children experiencing sledding accidents while being towed by motorized vehicles sustain significantly more severe injuries and require more intensive treatments that together lead to increased hospital costs. These findings provide the framework for community educational initiatives and injury prevention measures to mitigate risk among children engaged in sledding.

LEVEL OF EVIDENCE

IV retrospective cohort study.

Sledding-Related Injuries Among Children and Adults Treated in US Emergency Departments From 2008 to 2017

OBJECTIVE

To describe the epidemiology of sledding-related injuries among children and adults treated in US emergency departments (EDs).

DESIGN

The researchers performed a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS).

SETTING

The NEISS collects data on consumer products-related and sports-related injuries treated in US EDs from approximately 100 hospitals that represent a probability sample of >5000 hospitals.

PATIENTS

Children (≤19 years of age) and adults who were treated for sledding-related injuries in EDs from 2008 to 2017.

INDEPENDENT VARIABLES

The researchers analyzed characteristics that included sex, body part injured, injury diagnosis, disposition from the ED, injury locale, injury mechanism, and sled type.

MAIN OUTCOME MEASURES

All cases of sledding-related injuries were identified using NEISS product codes for sleds (1217), toboggans (1273), snow disks (1274), and snow tubes (1299).

RESULTS

An estimated 220 488 patients [95% confidence interval (CI): 169 839-271 137] were treated in EDs for sledding-related injuries. Overall, the injury rate decreased significantly for both children and adults. Children accounted for 69.7% of the injury cases. Fractures were the most common injury diagnosis for children (23.9%) and adults (27.4%). Compared to adults, children were more likely to sustain a head injury [relative risk (RR): 1.91 (95% CI: 1.73-2.13)] and be diagnosed with a concussion or closed-head injury (CHI) [RR: 1.58 (95% CI: 1.35-1.84)]. Most patients were injured by a collision (63.2%). Snow tube and disk riders were more likely to sustain a concussion or CHI compared to sled and toboggan riders [RR: 1.53 (95% CI: 1.18-1.99)]. Injuries predominantly occurred when patients collided with objects in the environment (47.2%).

CONCLUSIONS

Although sledding-related injuries decreased over the study period, more research and education to prevent these injuries is needed. The injury patterns and risk of injury type differed by age, with more head injuries sustained by children. Sledding should be performed in obstacle-free areas to reduce the risk of collision and while wearing helmets to mitigate head injuries.

Pediatric snow sport injuries differ by age

BACKGROUND

Unintentional injury is the leading cause of death among pediatric patients. There were 13,436 injuries related to snow sports in those younger than 15 in 2015, with 4.8% requiring admission. These sports are high-risk given the potential for injury even when using protective equipment. We hypothesized that snow sport injury patterns would differ based on patient age.

METHODS

A cross-sectional analysis of the 2009 and 2012 Kids' Inpatient Database was performed. Cases of injuries were identified and analyzed using ICD-9 codes. National estimates were obtained using case weighting. Multivariable logistic regression was used to assess for confounders.

RESULTS

Within 745 admissions, there was a statistically significant decrease in skull/facial fractures with increasing age and a statistically significant increase in abdominal injuries with increasing age. Children in early and middle childhood were at increased odds of being hospitalized with skull/facial fractures, while older children were more likely hospitalized with abdominal injuries.

CONCLUSIONS

Within the pediatric snow sport population, younger children are more likely to experience head injuries, while older children are more likely to experience abdominal injuries. Further research is needed to determine the origin of this difference, and continued legislation on helmets is also necessary in reducing intracranial injuries.

LEVEL OF EVIDENCE

III.

Investigating the effects of incremental conditioning and supplemental dietary tryptophan on the voluntary activity and behaviour of mid-distance training sled dogs

Serotonin is a neurotransmitter synthesized by the amino acid tryptophan, that has the potential to impact the behaviour and activity of dogs. The objective of this study was to assess the effects of supplemental tryptophan and a 12-week incremental training regimen on the voluntary activity and behaviour of client-owned Siberian Huskies. Sixteen dogs were blocked for age, BW and sex and then randomly allocated to either the control or treatment group. Both groups were fed the same dry extruded diet; however, the treatment group were supplemented with tryptophan to achieve a tryptophan: large neutral amino acid ratio of 0.075:1. Once a week, a 5-minute video recording was taken immediately pre- and post- exercise to evaluate dogs' behaviours. Activity monitors were used to record voluntary activity on both training and rest days. Linear regression analysis was used to assess the relationship between training week and time spent performing each behaviour. Additionally, a repeated measure mixed model was used to test differences between diet groups and training week for both behavioural and activity count data. The time spent performing agonistic behaviours prior to exercise was negatively associated with week for treatment dogs (β = -0.32, 95% CI [-0.55, -0.10], P < 0.05) and no change was observed for control dogs (β = -0.13, 95% CI [-0.41, 0.15], P > 0.10). Treatment did not have any effect on activity levels (P > 0.10). For all dogs, locomotive behaviours decreased prior to exercise as weeks progressed (P < 0.05), while run day voluntary activity depended on the distance run that day (P < 0.05). These data suggest that sled dogs experience an exercise-induced reduction in voluntary locomotion in response to both single bouts and repetitive bouts of exercise. Additionally, tryptophan supplementation may decrease agonistic behaviours, without having any effect on voluntary activity.

[Effect of snow sports on knee cartilage maturation in children and adolescent with MRI quantitative analysis Zhang]

Objective: To evaluate the effect of snow sports to the knee cartilage maturation of children and adolescent with quantitative analysis of 3.0 T MRI. Methods: Twenty children and adolescent who underwent snow sports training more than 6 months (11 males and 9 females) were recruited and named with sports group, and twenty children and adolescent who live regularly without any exercise (10 males and 10 females) were recruited as control group from June 2014 to June 2015.Each group was divided into subgroups according to their gender.Both groups were scanned by 3.0 T MR.According to the loading features of knee articular cartilage in snow sports, medial femoral condyle, lateral femoral condyle, medial tibial condyle and lateral tibial condyle were divided into subareas.T₂ values and cartilage thickness were measured in all areas. Results: The median ages of the sports group and control group were 14.2 and 13.6 years old, which showed no statistical difference between two groups.The BMI of the sports group and control group were 18.3 and 17.9 kg/m^2, which showed no statistical difference between two groups.Both in sports group and control group, the thickness and T₂ values of all areas showed significant differences between man and women in each group (all P<0.05). The cartilage thickness of sports group was higher than control group (P<0.05). The T₂ values showed no statistical difference in anterior central, posterior central of femoral condyles and anterior, central areas of tibial condyles between sports group and control group(P≥0.05). The T₂ values of anterior part of posterior femur and posterior areas of tibial condyle in sports group was higher than control group (P≥0.05). Conclusion: Gender difference may be an important effect factor of cartilage thickness. Scientific snow sports training maybe has positive influence for cartilage maturation of children and adolescent.

Spatially explicit modeling of conflict zones between wildlife and snow sports: prioritizing areas for winter refuges

Outdoor winter recreation exerts an increasing pressure upon mountain ecosystems, with unpredictable, free-ranging activities (e.g., ski mountaineering, snowboarding, and snowshoeing) representing a major source of stress for wildlife. Mitigating anthropogenic disturbance requires the spatially explicit prediction of the interference between the activities of humans and wildlife. We applied spatial modeling to localize conflict zones between wintering Black Grouse (Tetrao tetrix), a declining species of Alpine timberline ecosystems, and two free-ranging winter sports (off-piste skiing [including snow-boarding] and snowshoeing). Track data (snow-sports and birds' traces) obtained from aerial photographs taken over a 585-km transect running along the timberline, implemented within a maximum entropy model, were used to predict the occurrence of snow sports and Black Grouse as a function of landscape characteristics. By modeling Black Grouse presence in the theoretical absence of free-ranging activities and ski infrastructure, we first estimated the amount of habitat reduction caused by these two factors. The models were then extrapolated to the altitudinal range occupied by Black Grouse, while the spatial extent and intensity of potential conflict were assessed by calculating the probability of human-wildlife co-occurrence. The two snow-sports showed different distribution patterns. Skiers' occurrence was mainly determined by ski-lift presence and a smooth terrain, while snowshoers' occurrence was linked to hiking or skiing routes and moderate slopes. Wintering Black Grouse avoided ski lifts and areas frequented by free-ranging snow sports. According to the models, Black Grouse have faced a substantial reduction of suitable wintering habitat along the timberline transect: 12% due to ski infrastructure and another 16% when adding free-ranging activities. Extrapolating the models over the whole study area results in an overall habitat loss due to ski infrastructure of 10%, while there was a > 10% probability of human-wildlife encounters on 67% of the remaining area of suitable wintering habitat. Only 23% of the wintering habitat was thus free of anthropogenic disturbance. By identifying zones of potential conflict, while rating its relative intensity, our model provides a powerful tool to delineate and prioritize areas where wildlife winter refuges and visitor steering measures should be implemented.

Comparative fate of organohalogen contaminants in two top carnivores in Greenland: captive sledge dogs and wild polar bears

The limited knowledge and/or the inability to control physiological condition parameters that influence the fate of organohalogen contaminants (OHCs) has been the foremost confounding aspect in monitoring programs and health risk assessments of wild top predators in the Arctic such as the polar bear (Ursus maritimus). In the present comparative study, we used a potential surrogate Canoidea species for the East Greenland polar bear, the captive sledge dog (Canis familiaris), to investigate some factors that may influence the bioaccumulation and biotransformation of major chlorinated and brominated OHCs in adipose tissue and blood (plasma) of control (fed commercial pork fat) and exposed (fed West Greenland minke whale (Balaenoptera acutorostrata) blubber) adult female sledge dogs. Furthermore, we compared the patterns and concentrations of OHCs and their known or suggested hydroxylated (OH) metabolites (e.g., OH-PCBs) in sledge dogs with those in adipose tissue and blood (plasma) of East Greenland adult female polar bears, and blubber of their main prey species, the ringed seal (Pusa hispida). The two-year feeding regime conducted with sledge dogs led to marked differences in overall adipose tissue (and plasma) OHC residue accumulation between the control and exposed groups. Characteristic prey-to-predator OHC bioaccumulation dynamics for major PCB and PBDE congeners (patterns and concentrations) and biotransformation capacity with respect to PCB metabolite formation and OH-PCB retention distinguished, to some extent, captive sledge dogs and wild polar bears. Based on the present findings, we conclude that the use of surrogate species in toxicological investigations for species in the Canoidea family should be done with great caution, although they remain essential in the context of contaminants research with sensitive arctic top carnivore species such as the polar bear.

Spreading free-riding snow sports represent a novel serious threat for wildlife

Stress generated by humans on wildlife by continuous development of outdoor recreational activities is of increasing concern for biodiversity conservation. Human disturbance often adds to other negative impact factors affecting the dynamics of vulnerable populations. It is not known to which extent the rapidly spreading free-riding snow sports actually elicit detrimental stress (allostatic overload) upon wildlife, nor what the potential associated fitness and survival costs are. Using a non-invasive technique, we evaluated the physiological stress response induced by free-riding snow sports on a declining bird species of Alpine ecosystems. The results of a field experiment in which radiomonitored black grouse (Tetrao tetrix) were actively flushed from their snow burrows once a day during four consecutive days showed an increase in the concentration of faecal stress hormone (corticosterone) metabolites after disturbance. A large-scale comparative analysis across the southwestern Swiss Alps indicated that birds had higher levels of these metabolites in human-disturbed versus undisturbed habitats. Disturbance by snow sport free-riders appears to elevate stress, which potentially represents a new serious threat for wildlife. The fitness and survival costs of allostatic adjustments have yet to be estimated.

Neuro-mechanical and chemical influences on locomotor respiratory coupling in humans

Mechanisms of coordination between breathing and movement during dynamic exercise are still a matter of debate. This study aimed to examine the degree of coordination between breathing and arm propulsion patterns and to compare the relative contribution of neuro-mechanical and chemical factors. Thirteen trained cross-country skiers performed constant submaximal 6-min roller skiing exercises on a motorized driven treadmill in two different poling techniques (V2A and V2 skating techniques) at two exercise intensity levels corresponding to the first and second ventilatory thresholds. The timing of arm propulsion movements in V2A and V2 techniques was considered as a mechanical/neural influence on breathing whereas exercise intensity represented the metabolic demand to breathing. The degree of coordination, expressed as the percentage of breaths presenting a constant phase interval (time between an arbitrarily chosen point of the arm movement cycle and the onset of expiration) was significantly higher in V2A than V2 (P<0.05) while exercise intensity had no effect on the degree of coordination. We concluded that locomotor-respiratory coupling occurs in cross-country skiing as simulated by roller skiing because of strong influences from neuro-mechanical factors.

Sun-safety behaviors of skiers and snowboarders on the South Island of New Zealand

AIMS

To study sun-protective behaviors among skiers and snowboarders on the South Island of New Zealand and to identify associations with personal characteristics or weather conditions.

METHODS

Two hundred twenty-six skiers and snowboarders completed an interviewer-administered questionnaire during September and October 2002. Reported behaviors were used to derive a composite sun-protection index, which was used to divide the sample into "protected" and "unprotected" groups. Odds ratios of being unprotected were calculated by logistic regression.

RESULTS

Forty-eight percent (95% CI 42-54%) of interviewees recalled being sunburned while skiing or snowboarding in the past. Sixty-eight percent (95% CI 62-74%) were unaware of any educational messages specific to sun protection while skiing or snowboarding. Women were more likely to be protected from the sun (OR 0.47; 95% CI 0.27-0.81). Having a skin type resistant to burning (OR 1.93; 95% CI 0.92-4.06) and reported awareness of education messages (OR 1.66; 95% CI 0.92-2.99) were associated with not using sun protection.

CONCLUSIONS

Sunburn is common and sun protection not used by all. Men are less likely to report use of sun-protection measures. There is no evidence from this study that current strategies are effective in promoting skin protection while skiing or snowboarding.

The appropriateness of snowmobiling in national parks: an investigation of the meanings of snowmobiling experiences in yellowstone national park

The debate over snowmobiling and other types of motorized recreation in US national parks signals the need for a better understanding of the meanings of these experiences. The fundamental issue facing many parks is whether snowmobiling is an appropriate activity. The matter of appropriateness is anchored in two questions: (1) Does snowmobiling in national parks cause unacceptable biophysical and social impacts? (2) Are snowmobiling experiences consistent with the fundamental purposes of national parks? This article particularly addresses the appropriateness issue and presents the findings of an interpretive study of the meanings of snowmobiling experiences in Yellowstone National Park (YNP). Sixty-five semistructured interviews were conducted with winter visitors who used snowmobiles in the park during the winter season of 1999. Overall, the study findings reveal that visitors on snowmobiles view YNP as a place to experience its wildland attributes, such as natural scenery, geothermal features, and, especially, wildlife. Snowmobiling is perceived as a mode of transportation rather than the experience in and of itself. The results challenge the popular image of snowmobiles as thrill-craft and snowmobilers as thrill-seekers. The study demonstrates that snowmobiling in YNP affords highly meaningful recreational experiences, grounded in appreciating the park's unique natural features and attributes.

Sledding accidents in children: potential for serious injury, risk of fatality

Though a pastime rarely considered rough or dangerous, sledding is not risk-free. The presentation of several serious injuries to Rainbow Babies and Children's Hospital in Cleveland, Ohio, led us to examine our emergency department and admitting records to determine the incidence of neurological injury among children involved in sledding accidents. We discovered 24 children who had sustained brain or spine injuries as sequelae to sledding mishaps during a 5-year period. The ages ranged from 3 months to 15 years. Injuries included multiple skull fractures, 2 epidural hematomas, 1 subdural hematoma, 1 odontoid fracture and 1 anoxic brain injury. There was 1 death. Twenty-one of 24 patients incurred their injuries by colliding with fixed objects. Both improvised crafts and models intended for sledding were involved in the injuries. Only 3 sleds possessed steering capability. Eight of the 9 children who sustained a serious neurosurgical injury were supervised by an adult. Only 2 children had received instruction before sledding. The lack of awareness of the potential for injury together with the dearth of instruction and lack of control over a vehicle dashing down a hill studded with obstacles can change a carefree pastime into a hazardous activity.

The Cresta Run: a uniquely evolving tradition

The Cresta Run is a unique toboggan run and exists in only one place in the world, namely, St. Moritz, Switzerland. The height of the resort is over 6,000 feet (1828 metres). Therefore there is a diminution of oxygen content in the air. Normally it takes from three to seven days for a person from lower habitat altitudes, visiting the resort, to become fully acclimatized if they are to be involved in energetic competitive sport. The age and fitness of the toboggan rider is a factor. The Cresta Run takes place each year and has, since its inception under the auspices of the St Moritz Tobogganing Club, been built from virgin snow to a formula determined by a brilliant 22-year-old Swiss geometrician, Peter Bonorand, who devised the first Run in 1884. Using his exceptional mathematical knowledge to determine a course from St. Moritz to Celerina, he drew up plans and drawings for the first Cresta Run. The Run therefore is constructed to a known formula and it is significant that in over 115 years the times on the Run have only improved on average by a few tenths of a second progressively each year despite improvements to riding equipment. Since the Run's inception in 1885 there has always been an element of danger, but accidents have invariably occurred on the section of the Run that comprises the competition course between the start line and the finish line. During the past few seasons, an increasing number of accidents have taken place after the finish line. The problem is short-term blackout while riding (Reader, 1978). There is now a need to investigate what changes have been made or have evolved to cause this. However, certain immutable facts have remained constant and these must be identified and then considered in the context of recent changes as a result of improvements in equipment. Considerable improvements have been made over the past 25 years to safety helmets. These are the result of different materials, their suitability and ease of manufacture, particularly with regard to the full-face type helmet. The full-face helmet could be a significant contributing factor to the problem of accidents, particularly after the finish line, on the Cresta Run.

The effect of dance training on joint mobility, muscle flexibility, speed and agility in young cross-country skiers--a prospective controlled intervention study

We evaluated a short-term (3 months) and a long-term (8 months) effect of dance training on joint mobility and muscle flexibility of the spine, hip and ankle and on speed and agility in young cross-country skiers. Twenty elite cross-country skiers - aged 12-15 years - participated in the study. Five males and five females received dance training (intervention group) and five males and five females did not dance (reference group). Joint mobility and muscle flexibility of the spine, hip and ankle joints were measured using a goniometer, a kyphometer, a measuring tape and a ruler. Two sports-related functional tests - the slalom-test and the hurdle-test - were also performed. These measurements/tests were performed before the start of the dancing period and after 3 and 8 months. The subjects from the intervention group increased their speed with 0.3 s after 3 (P = 0.05) and 8 months (P = 0.02), respectively, when measured with the slalom-test. They also improved their speed and agility according to the hurdle-test after 3 months with 0.8 s (P = 0.000) and 8 months with 0.6 s (P = 0.01). Furthermore, they increased flexion-extension of the thoracic spine with 7.5 degrees after 3 months (P = 0.05) and with 9 degrees degrees after 8 months (P = 0.03) and lateral flexion of the spine with 0.04 m (P = 0.005) and 0.03 m (P = 0.02) after 3 and 8 months, respectively. The reference group was impaired or unchanged in the studied parameters after both 3 and 8 months. We conclude that dance training has a positive effect on speed and agility and on joint mobility and muscle flexibility in flexion-extension and lateral flexion of the spine in young cross-country skiers.