Health Problems of Professional Ballet Dancers: an Analysis of 1627 Weekly Self-Reports on Injuries, Illnesses and Mental Health Problems During One Season.

BACKGROUND: Several studies have investigated injuries of (pre-)professional ballet dancers, however most used a medical-attention and/or time-loss definition and did not analyse the prevalence of all health problems. The aim was to analyse the frequency and characteristics of all self-reported physical and mental health complaints (i.e. injuries, illnesses and mental health problems) of professional ballet dancers during one season. METHODS: Three professional ballet companies were prospectively monitored weekly during one season with the Performing artist and Athlete Health Monitor (PAHM). Numerical rating scales (ranging 0-10) were used for severity of musculoskeletal pain, all health problems and impairment of the ability to dance at full potential in the previous seven days. If dancers rated the severity of their health problems or their impairment greater than 0, they were asked to answer specific questions on the characteristics of each health problem. RESULTS: Over a period of 44 weeks, 57 dancers (57.9% female) filled in 1627 weekly reports (response rate of 64.9%), in which 1020 (62.7%) health problem were registered. The dancers reported musculoskeletal pain in 82.2% of the weeks. They felt that their ability to dance at their full potential was affected due to a health problem in about every second week (52.6%) or on at least 29.1% of the days documented in the weekly reports. Almost all dancers (96.5%) reported at least one injury, almost two thirds (64.9%) an illness and more than a quarter (28.1%) a mental health problem. On average, every dancer reported 5.6 health problems during the season. Most of the 320 health problems were injuries (73.1%), 16.9% illnesses and 10.0% mental health problems. Injuries affected mainly ankle, thigh, foot, and lower back and were mostly incurred during rehearsal (41.6%) or training (26.1%). The most frequent subjective reasons of injury were "too much workload" (35.3%), "tiredness/exhaustion" (n = 22.4%) and "stress/overload/insufficient regeneration" (n = 21.6%). CONCLUSION: Preventive interventions are urgently required to reduce the prevalence of health problems and especially injuries of professional dancers. Injury prevention measures should regard the balance of the load capacity of professional dancers and the workload in training, rehearsals and performances.

Injury Prevalence Among Elite Adolescent Ballet Dancers is not Affected by Frequency of Questionnaire Administration: A 6-Month Exploratory Prospective Study.

INTRODUCTION: The Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H) is a valid and reliable registration method for self-reported injuries and is regularly used among dancer populations. Monthly questionnaire administration is acceptable in athlete populations but has not been evaluated in dancers. The aim of this exploratory study was to assess the influence of weekly versus monthly administration of the OSTRC-H on estimated injury outcomes among elite adolescent ballet dancers. METHODS: Participants (n = 103) were prospectively followed for 6 months and completed the OSTRC-H online, evaluating perceived consequences of self-reported health problems during the previous week and the previous 4 weeks, respectively. Four definitions of dance-related injury were utilized: (1) all complaints, (2) substantial, (3) medical attention, and (4) time-loss injuries. Descriptive statistics estimated: (1) the number of injuries reported (count), (2) average injury prevalence [proportion, 95% confidence intervals (CI)], (3) average severity score (0-100), and (4) days of time loss (count) for each injury definition. The 4 outcome measures were then compared between weekly and monthly registration with paired sample t-tests (P < .05) and overlapping 95% CI. RESULTS: A significant difference between the number of all complaints injuries (weekly: 133; monthly: 94; P < .001) and substantial injuries (weekly: 64; monthly: 45; P = .012) was found. Regardless of injury definition, there were no significant differences between injury prevalence, severity scores, and days of time loss when reported weekly versus monthly. CONCLUSION: Monthly administration of the OSTRC-H is an acceptable method to estimate injury prevalence, severity scores, and days of time loss amongst elite adolescent ballet dancers.

Health consultations at a performing arts health centre among classical music students based on electronic health record data: a cross-sectional study.

Physical and mental health problems in music students are usually identified using self-reported data. The use of an Electronic Health Record database can avoid biases to give an overview of the extent of health problems in this population. Therefore, the aim of this study is to gain insight into both physical and mental health related issues in classical music students using this type of data collection. An Electronic Health Record database including five years of data from a Performing Arts Health Centre (PAHC) of a university or the arts, was used to analyze the number and characteristics of health consultations in music students. The total number of students, health consultations and the average number of visits per health consultation were calculated over five years. Furthermore, numbers and percentages of both physical and mental health consultations were registered. Also, the number and percentage of health consultations per instrument group were compared to the proportion of each instrument group within the specific sample. Over a period of five years, 230 students visited the PAHC and 417 health consultations were reported. 43.5% of the students who visited a health professional indicated at least one physical health consultation, 29.1% at least one mental health consultation and 27.4% at least one in both categories. An injury was the most frequently registered physical health consultation (40.2%), followed by performance improvement (9.8%) and stress (9.6%). Voice students registered relatively most health consultations. As far as we know, this is the first cross-sectional study using Electronic Health Record data from a PAHC to gain insight into both physical and mental health related issues in a population of classical music students. Looking at the variety of health consultations registered in the database, a multidisciplinary team and multidisciplinary approach are necessary to meet the needs of the students in terms of physical and mental health support and performance improvement.

Physical and psychosocial work-related exposures and the occurrence of disorders of the shoulder: A systematic review update.

This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.

Aerobic and Anaerobic Fitness Levels of Pre-Professional Contemporary Dancers: An Exploration of 2 Dance-Specific Field Tests.

INTRODUCTION: The primary aim of this study was to present descriptive heart rate (HR), heart rate recovery (HRR) and RPE data for the DAFT and HIDT within one sample of contemporary dance students. The second aim was to explore if objective (HR) and subjective (RPE) data were correlated between tests. METHOD: 40 (11 males, 29 females) university dance students with a mean age of 18.8 ± 1.8 years performed the DAFT and HIDT on 2 separate occasions within 1 week. Measurements were HR after 4 minutes in all stages of the DAFT, the percentage of age-predicted maximal HR (%HRmax) of all stages of the DAFT and at the end of the HIDT, and peak HR (HRpeak) at the end of both tests. Subjective ratings of perceived exertion (RPE) and HR recovery after 1 minute of rest (HRR) were determined after the tests. RESULTS: HRpeak of the DAFT and HIDT were 188.1 ± 11.0 and 185.3 ± 7.3 beats·min-1, respectively. There were high positive correlations between HRpeak of the HIDT and stages 3 to 5 of the DAFT (r = 0.716-0.740, all P-values < .01). HRR (r = .678, P < .01) and %HRmax (r = .746, P < .01) showed moderate to high correlations between the DAFT and HIDT. The anaerobic training zone was reached in stages 4 and 5 of the DAFT and at the end of the HIDT. The subjective RPE scores did not significantly correlate between DAFT and HIDT, neither with objective HR data. CONCLUSION: Although the DAFT and HIDT differ in intensity and work-to-rest ratio, there were high correlations between HR and HRR data of both tests and both tests reached intensities above the anaerobic threshold (%HRmax > 85%).

A Systematic Review of Cardiorespiratory Fitness Tests Used in Dance.

Dancers need adequate cardiorespiratory fitness (CRF) levels in order to cope with the demands of dance classes and choreographies. Screening and monitoring of CRF is advised. The aim of this systematic review was to provide an overview of tests used to assess CRF in dancers and to examine the measurement properties of these tests. A literature search was performed in three online databases (PubMed, EMBASE, and SPORTDiscus) up until August 16, 2021. Study inclusion criteria were: 1. a CRF test was used; 2. participants were ballet, contemporary or modern, or jazz dancers; and 3. English full-text peer-reviewed article. General study information, participant information, CRF test used, and study outcome were extracted. If available, measurement property data were extracted (i.e., test reliability, validity, responsiveness, and interpretability). Of the 48 articles included in the review, most used a maximal treadmill test (n = 22) or the multistage Dance Specific Aerobic Fitness test (DAFT; n = 11). Out of the 48 included studies, only six examined the measurement properties of CRF tests: Aerobic Power Index (API), Ballet-specific Aerobic Fitness Test (B-DAFT), DAFT, High-Intensity Dance Performance Fitness Test (HIDT), Seifert Assessment of Functional Capactiy for Dancers (SAFD), and the 3-minute step test. Good test-retest reliability was found for the B-DAFT, DAFT, HIDT, and SAFD. Criterion validity was determined for the VO2peak of the API, the 3-MST, HIDT, and SAFD. For HRpeak, criterion validity was studied for the 3-MST, HIDT, and SAFD. While different CRF tests are being used in descriptive and experimental research within dance populations, the body of research supporting the measurement properties of such tests is very small. As many studies have methodological flaws (e.g., small participant numbers or no statistical analysis for validity or reliability), additional good quality research is required to re-examine and complement current measurement property results of the API, B-DAFT, DAFT, HIDT, SAFD, and 3-MST.

An analysis of teachers' instructions and feedback at a contemporary dance university.

Background: Given the demands posed by excessive practice quantities in modern dance, physical and mental health can be compromised. Therefore, there is a need to consider how quality of practice may be improved and possibly even reduce training times. Sports literature has shown that instructions and feedback given by coaches can have an effect on the quality of training and influence self-regulation and the performance of athletes. However, currently little is known about the use of instructions and feedback by dance teachers. The aim of the current study was, therefore, to examine the type of instructions and feedback given by dance teachers during various dance classes. Methods: A total of six dance teachers participated in this study. Video and audio recordings were made of six dance classes and two rehearsals at a contemporary dance university. The dance teacher's coaching behavior was analyzed using the modified Coach Analysis and Intervention System (CAIS). Additionally, feedback and instructions were also examined in terms of their corresponding focus of attention. Absolute numbers, as well as times per minute (TPM) rates were calculated for each behavior before, during, and after an exercise. Absolute numbers were also used to calculate ratios of positive-negative feedback and open-closed questions. Results: Most feedback comments were given after an exercise (472 out of 986 total observed behaviors). Improvisation had the highest positive-negative feedback ratio (29) and open-closed questions ratio (1.56). Out of the focus of attention comments, internal focus of attention comments were used most frequently (572 out of 900). Discussion/conclusion: The results make clear that there is a large variability in instructions and feedback over teachers and classes. Overall, there is room for improvement toward a higher positive-negative feedback ratio, a higher open-closed question ratio and producing more comments eliciting an external focus of attention.

Exposure to hand-arm vibrations in the workplace and the occurrence of hand-arm vibration syndrome, Dupuytren's contracture, and hypothenar hammer syndrome: a systematic review and meta-analysis.

This study provides an overview of the relationships between exposure to work-related hand-arm vibration and the occurrence of pre-defined disorders of the hands. We searched Medline, Embase, Web of Science, Cochrane Central, and PsycINFO for cross-sectional and longitudinal studies on the association between work-related vibration exposure and the occurrence of hand-arm vibration syndrome (including vibration-induced white finger), Dupuytren's contracture, or hypothenar hammer syndrome. We used a 16-item checklist for assessing the risk of bias. We present results narratively, and we conducted random effects meta-analyses if possible. We included 10 studies with more than 24,381 participants. Our results showed statistically significant associations between the exposure to hand-arm vibrations and the occurrence of the selected disorders, with pooled odds ratios ranging between 1.35 (95% CI: 1.28 to 2.80) and 3.43 (95% CI: 2.10 to 5.59). Considerable between-study heterogeneity was observed. Our analyses show that exposure to vibrating tools at work is associated with an increased risk for the occurrence of selected disorders of the hands. Due to the majority of studies being cross-sectional, no firm conclusion is possible regarding causal relationships between vibration exposure and disorder occurrence. Future research should specifically address whether reducing exposure to hand-held vibrating tools at work reduces the incidence of the disorders of the hands investigated in this systematic review.

Physical and psychosocial work-related exposures and the occurrence of disorders of the elbow: A systematic review.

This systematic review updates a previous systematic review on work-related physical and psychosocial risk factors for elbow disorders. Medline, Embase, Web of Science, Cochrane Central and PsycINFO were searched for studies on associations between work-related physical or psychosocial risk factors and the occurrence of elbow disorders. Two independent reviewers selected eligible studies and assessed risk of bias (RoB). Results of studies were synthesized narratively. We identified 17 new studies and lateral epicondylitis was the most studied disorder (13 studies). Five studies had a prospective cohort design, eight were cross-sectional and four were case-control. Only one study had no items rated as high RoB. Combined physical exposure indicators (e.g. physical exertion combined with elbow movement) were associated with the occurrence of lateral epicondylitis. No other consistent associations were observed for other physical and psychosocial exposures. These results prevent strong conclusions regarding associations between work-related exposures, and the occurrence of elbow disorders.

Circus-specific extension of the International Olympic Committee 2020 consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport.

Indepth knowledge of injury and illness epidemiology in circus arts is lacking. Comparing results across studies is difficult due to inconsistent methods and definitions. In 2020, the International Olympic Committee (IOC) consensus group proposed a standard method for recording and reporting epidemiological data on injuries and illnesses in sports and stated that sport-specific extension statements are needed to capture the context of each sport. This is the circus-specific extension to be used with the IOC consensus statement. International circus arts researchers in injury and illness epidemiology and performing arts medicine formed a consensus working group. Consensus statement development included a review of literature, creation of an initial draft by the working group, feedback from external reviewers, integration of feedback into the second draft and a consensus on the final document. This consensus statement contains circus-specific information on (1) injury definitions and characteristics; (2) measures of severity and exposure, with recommendations for calculating the incidence and prevalence; (3) a healthcare practitioner report form; (4) a self-report form capturing health complaints with training and performance exposure; and (5) a demographic, health history and circus experience intake questionnaire. This guideline facilitates comparing results across studies and enables combining data sets on injuries in circus arts. This guideline informs circus-specific injury prevention, rehabilitation, and risk management to improve the performance and health of circus artists.

Quantifying Internal Load in Pre-Professional Contemporary Dancers: The Association Between Objective Heart-Rate Derived Outcome Measures and Subjective Dancers' and Teachers' Perceptions.

BACKGROUND: Monitoring heart rate is one of the most common methods used to quantify internal training load (ITL) in athletes. The aim of this study was to determine whether subjective measurements can be used as a simple, non-invasive, and inexpensive method for assessing ITL in pre-professional contemporary dancers.
Method: A total of 16 first-year contemporary dance students participated in this study. Students wore heart rate monitors during 56 training sessions. After each session, students completed the rate of perceived exertion (RPE) scale and teachers completed the rate of observed exertion (ROE) scale. For each session, we calculated the session-RPEs (sRPE), session-ROEs (sROE), and heart-rate-derived ITLs [i. e., Banister TRaining IMPulse method (TRIMP) and Edwards TRIMP]. Pearson correlation coefficients were calculated to determine the association between sRPE, sROE, Banister TRIMP, and Edwards TRIMP.
Results: Between-individual correlation between Banister TRIMP and subjective dancers' (sRPE) and teachers' perceptions (sROE) were moderate (r = .49, p < 0.01) to large (r = .57, p < 0.01). Between-individual correlations between Edwards TRIMP and the subjective perceptions (sRPE and sROE) were very large (r = .74, p < 0.01; and r = .79, p < 0.01). There was a statistically significant large (r = 0.52, p < 0.01) to almost perfect (r = 0.93, p < 0.01) within-individual correlation between the sRPE and the two measured TRIMP methods. There was a statistically significant small (r = .29, p < 0.01) to almost perfect (r = .92, p < 0.01) within-individual correlation between the sROE and the two measured TRIMP methods.
Conclusion: The results of this study suggest that the sRPE is a simple, non-invasive, inexpensive, and valid method for quantifying ITL in pre-professional dancers.

The Association Between Stress and Injury: A Prospective Cohort Study Among 186 First-Year Contemporary Dance Students.

The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (N = 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0-100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as "all injuries" (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and "substantial injuries" (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann-Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March, p < 0.05), and in 5 months for substantial injuries (September, October, November, December, April, p < 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries [F(1.87,216.49) = 3.10, p = 0.051] and substantial injuries [F(2,138) = 4.16, p = 0.018]. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.

Prevalence of Mental Health Complaints Among Performing Arts Students Is Associated With COVID-19 Preventive Measures.

The aim of this study was to investigate the effect of COVID-19 preventive measures on the mental health of performing arts students. In a prospective cohort study, performing arts students (N = 213) from Codarts Rotterdam, University of the Arts, were invited to monitor their health during one academic year (September 2019-May 2020). Every month, students completed items on mental health complaints, stress, and sleep quality. Chi-square tests and repeated-measures ANOVA with deviation contrasts were performed to investigate whether COVID-19 preventive measures were associated with changes in mental health complaints, stress scores, and sleep quality. During the COVID-19 lockdown, subjective mental health, Mental Health Inventory-5 (MHI-5), and items on loneliness were additionally completed by the respondents. A total of 98 students (46.0%) were included in the analyses. The 3-month prevalence of mental health complaints was significantly higher during the COVID-19 lockdown compared to the two pre-COVID-19 periods (p < 0.001). Mean stress scores were significantly lower for February (35.20) and March (36.41) when compared to the overall mean (40.38). Sleep quality scores (mean) were significantly higher for April (6.90), and May (6.89) when compared to overall mean (6.58). Furthermore, at least 75.5% of the participants dealt with moderate to very severe loneliness in all 3 months during the COVID-19 lockdown. During lockdown, performing arts students perceived less stress and their sleep quality increased. However, the prevalence of mental health complaints increased. Besides, 3 out 4 students dealt with moderate to very severe loneliness.

Incidence and prediction of ankle injury risk: a prospective cohort study on 91 contemporary preprofessional dancers.

OBJECTIVES: This study examines the incidence of ankle injuries and identifies ankle injury risk among contemporary preprofessional dancers. METHODS: A total of 91 first-year contemporary preprofessional dancers were prospectively followed during one academic year. Self-reported ankle injuries, assessed with the Oslo Sports Trauma Research Centre questionnaire, were categorised as all complaint ankle injuries, substantial ankle injuries or time-loss ankle injuries. In addition, ankle injuries leading to medical attention were included. Regression analyses were used to determine the association between potential risk factors (dancer characteristics, history of ankle injury in the previous year, ankle range of motion and dorsiflexion) and ankle injuries. RESULTS: The 1-year ankle injury incidence proportion was 18.7% (n=17), 8.8% (n=8), 15.4% (n=14) and 7.7% (n=7), respectively, for all complaint ankle injuries, ankle injuries requiring medical attention, time-loss injuries and substantial injuries. Being male (OR=0.27; 95% CI 0.09 to 0.75) and being a student of the Bachelors in Dance and Education (OR=0.27; 95% CI 0.08 to 0.97) were univariately associated with a lower risk of an ankle injury. CONCLUSION: Almost 20% of first-year preprofessional dancers reported an ankle injury, with more than 80% of the dancers reporting that their injury leads to dance time loss. Males and students of the bachelors in dance and education were at lower risk of ankle injuries. As ankle injuries are common among dancers, studies with larger sample sizes, a more heterogeneous population (eg, different dance styles) and longer follow-up periods are necessary to evaluate the impact of ankle injuries in further detail.

Generalized Joint Hypermobility and Injuries: A Prospective Cohort Study of 185 Pre-Professional Contemporary Dancers.

Generalized joint hypermobility (GJH) has been mentioned as one of the factors associated with dance injuries, but the findings are inconclusive. This study aims to investigate whether GJH, based on different Beighton score cut-off points, is a potential risk factor for injuries in pre-professional dancers. Four cohorts of first-year pre-professional dancers (N = 185), mean age 19.1 ± 1.3 years, were screened on musculoskeletal functioning at the start of their academic year. The Beighton score was used to measure GJH. During the academic year, the dancers completed monthly questionnaires about their physical and mental health. Based on the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC), three injury definitions were used (i.e., all complaints, substantial injury, and time-loss injury). To examine potential risk factors for injuries, univariate and multivariate regression models were applied. The response rate of monthly completed questionnaires was 90%. The overall mean (SD) Beighton score was 2.8. The 1-year injury incidence proportion was 67.6% (n = 125), 43.2% (n = 80), and 54.6% (n = 101) for all complaint injuries, substantial injuries, and time-loss injuries, respectively. The multivariate analyses showed a significant association between a previous long lasting injury in the past year and the three injury definitions (p < 0.05). Pre-professional contemporary dancers are at high risk for injuries and hypermobility. However, these two variables are not associated with each other. Health professionals should take injury history into account when assessing dance students, because this variable is associated with increased injury risk.

The Association Between Training Load and Injury Risk in Elite Youth Soccer Players: a Systematic Review and Best Evidence Synthesis.

BACKGROUND: Injury risk in elite youth soccer players is high. Implementing an optimal training load is of utmost importance to reduce the risk of injuries. OBJECTIVE: To conduct a systematic review and best evidence synthesis to explore the effects of internal and external training load on injury risk in elite youth soccer players. METHODS: MEDLINE, Embase, Web of Science, CENTRAL, and CINAHL were searched up until 17 January 2020. Each article had to meet all of the following criteria: (1) the study population consisted of male elite youth soccer players aged between 12 and 21 years; (2) a longitudinal, prospective study design was used; (3) soccer-related injuries were registered (i.e., self-reported or by medical staff); (4) external and/or internal load parameters were described; and (5) the article was published in an English peer-reviewed scientific journal. The quality of the included articles was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). A best evidence synthesis was performed to rank the level of evidence. RESULTS: Five studies (2 high quality, 3 low quality) were included. Best evidence synthesis highlighted that there was moderate evidence for (1) no association between 2-, 3-, and 4-week cumulative loads for total distance covered; (2) no association between 1-week workloads (sRPE × duration); and (3) no association between A:C workload ratios (4 weeks) and injury risk. For all other comparisons, only insufficient or conflicting evidence was found. CONCLUSION: There is a paucity of evidence for an association between internal and external training load parameters and injury risk in elite youth soccer players.

Health Problems in Conservatoire Students: A Retrospective Study Focusing on Playing-Related Musculoskeletal Disorders and Mental Health.

OBJECTIVE: To gain insight into the prevalence and characteristics of physical health problems and mental health problems in first-, second- and third-year conservatoire students of the classical music department. Also, differences in mental health and general health were investigated between students with playing-related musculoskeletal disorders (PRMDs) and students without PRMDs. METHODS: Eighty-nine classical music students of Codarts Rotterdam, University of the Arts, were asked to complete a questionnaire targeting PRMDs (components derived from Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians, MPIIQM), mental health (Mental Health Inventory-5), and self-rated general health (SF-1 from Short Form health survey SF-12). RESULTS: The response rate was 52% (n=46). Of all participants, 17.8% (n=8) had experienced PRMDs in the past 12 months and 45.7% (n=21) of the students reported poor mental health (MHI-5≤60). Students experiencing PRMDs in the past 12 months reported poorer general health compared to students without PRMDs (43.8 vs 67.1 [range 0-100], p=0.012). No significant difference was found between the groups with regard to mental health (62.0 vs 66.5 [range 0-100], p=0.522). CONCLUSION: The burden of PRMD complaints in this population of conservatoire students seems relatively low. However, the number of students facing mental problems in this population is a cause for concern. Conservatoires should focus on the subject of mental health in their curricula to increase more awareness and prevent mental problems. To investigate possible causality between PRMDs and general health, prospective studies are needed.

The impact of injury definitions on measures of injury occurrence in classical music students: a prospective cohort study.

BACKGROUND: Multiple definitions are used to investigate injuries in musicians, resulting in a wide range of prevalence rates. The aim of this study is to establish the impact of different injury definitions on the prevalence of injuries and disability in classical music students. Moreover, the practical implications of using different injury definitions are considered. METHODS: A prospective cohort study among first-year classical music students was performed using bi-monthly questionnaires focusing on injuries. Three injury definitions were used: 1) all MSK complaints injury (any MSK complaint resulting in a VAS pain score > 0 in the past eight weeks), 2) medical attention injury (any MSK complaint that resulted in a student consulting a health provider in the past eight weeks), 3) time-loss injury (any MSK complaint that resulted in partly/completely missing music classes or activities in the past eight weeks). For all injury definitions prevalences were calculated and compared. Furthermore, the Disabilities of the Arm, Shoulder and Hand performing arts module (DASH-pa) was used to calculate disability scores for all three injury definitions. RESULTS: Twenty-nine classical music students participated in the current study. The total response rate over one academic year was 85.3%. One year prevalences of all MSK complaints, medical attention and time-loss were 96.6, 17.2 and 13.8% respectively. The bi-monthly prevalences ranged from 74.1 to 96.0% for all MSK complaints, from 5.6 to 11.5% for medical attention injuries and from 0 to 11.5% for time loss injuries. Scores on the DASH-pa ranged from 15.6 to 26.9 for MSK complaints, 33.3 to 50 for medical attention and 47.9 to 62.5 for time-loss injuries. CONCLUSION: The choice of injury definition is a critical factor affecting the outcome of music injury surveillance studies. To reach a consensus, it is therefore important to consider the different injury definitions depending on the goal of the injury surveillance and the practical implications.

Limited Coping Skills, Young Age, and High BMI Are Risk Factors for Injuries in Contemporary Dance: A 1-Year Prospective Study.

This study investigated potential risk factors (coping, perfectionism, and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program, and history of injury) and psychological constructs (coping, perfectionism, and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e., student characteristics and psychological constructs) and substantial injuries. Ninety-nine students were included in the analyses. During the academic year 2016/2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84-0.98), age (OR: 0.67; 95% CI: 0.46-0.98), and BMI (OR: 1.38; 95% CI: 1.05-1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger sample sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career.

Characteristics, Properties, and Associations of Self-Assessed Pain Questionnaires: A Literature Review and Prospective Cohort Study Among Dance Students.

OBJECTIVES: To provide an overview of measurement properties of the Oslo Sports Trauma Research Center Questionnaire (OSTRCQ), pain visual analogue scale (VAS-pain) and Self-Estimated Functional Inability Because of Pain (SEFIP) scale in dance populations, and to investigate the relationship between these questionnaires in pre-professional contemporary dancers. METHODS: A search of PubMed was conducted and studies were included if they 1) used one of the three questionnaires within a dance population and 2) assessed the reliability, validity, or responsiveness of the questionnaire(s). 134 dance students (67.5% female; 19.4±1.5 yrs) were prospectively followed during 1 academic year. The OSTRCQ, VAS-pain, SEFIP, and injuries were self-assessed on a monthly basis. Pearson correlation analyses and repeated measures correlation analyses were performed to identify possible associations. RESULTS: The literature overview resulted in two studies describing measurement properties of the SEFIP (n=1) and OSTRCQ (n=1). Prevalence of injuries ranged from 23.1 to 42.6%. Weak monthly correlations (r=0.14-0.50) were found between OSTRCQ and SEFIP. Moderate monthly correlations (r=0.54-0.71) were found between OSTRCQ and VAS-pain, and weak/moderate monthly correlations (r=0.30-0.62) were found between SEFIP and VAS-pain. Repeated measures correlation demonstrated a moderate overall correlation between ORSTCQ and VAS-pain (r=0.57), with weak overall correlations between ORSTCQ and SEFIP (r=0.26) and SEFIP and VAS-pain (r=0.34). CONCLUSIONS: Studies on measurement properties of questionnaires in dance are scarce. Weak/moderate associations were found between the OSTRCQ, SEFIP, and the VAS-pain questionnaires. Future high-quality research should investigate measurement properties of these questionnaires within dance populations. The results contribute by substantiating choices when developing a surveillance system.