Effects of weight-bearing dance aerobics on lower limb muscle morphology, strength and functional fitness in older women.

Objective: To investigate the effects of 12-week weight-bearing dance aerobics (WBDA) on muscle morphology, strength and functional fitness in older women. Methods: This controlled study recruited 37 female participants (66.31y ± 3.83) and divided them into intervention and control groups according to willingness. The intervention group received 90-min WBDA thrice a week for 12 weeks, while the control group maintained normal activities. The groups were then compared by measuring muscle thickness, fiber length and pennation angle by ultrasound, muscle strength using an isokinetic multi-joint module and functional fitness, such as 2-min step test, 30-s chair stand, chair sit-and-reach, TUG and single-legged closed-eyed standing test. The morphology, strength, and functional fitness were compared using ANCOVA or Mann-Whitney U test to study the effects of 12 weeks WBDA. Results: Among all recruited participants, 33 completed all tests. After 12 weeks, the thickness of the vastus intermedius (F = 17.85, P < 0.01) and quadriceps (F = 15.62, P < 0.01) was significantly increased in the intervention group compared to the control group, along with a significant increase in the torque/weight of the knee flexor muscles (F = 4.47, P = 0.04). Similarly, the intervention group revealed a significant improvement in the single-legged closed-eyed standing test (z = -2.16, P = 0.03) compared to the control group. Conclusion: The study concluded that compared to the non-exercising control group, 12-week WBDA was shown to thicken vastus intermedius, increase muscle strength, and improve physical function in older women. In addition, this study provides a reference exercise program for older women.

The vertical mobility of the first tarsometatarsal joint during demi-plié with forced turnout in ballet dancers.

The forced turnout has a perceived risk of development of hallux valgus (HV) in ballet dancers. We determined how the forced turnout affects the sagittal mobility of the first tarsometatarsal (TMT) joint, which is one of the pathogenic factors of HV development. Seventeen female ballet dancers (body mass index: 18.2 ± 1.8 kg/m2) were included and performed demi-plié in control, functional turnout, and forced turnout conditions. Ultrasound imaging synchronized with a three-dimensional motion analysis system was used for measuring the vertical locations of the first metatarsal and medial cuneiform (MC) to evaluate the first TMT joint mobility. Plantar displacement of MC and the first TMT joint mobility in the forced turnout were the greatest among the 3 conditions. Multiple regression analysis indicated that the greater extent of the forcing angle might increase the displacement of MC and the first TMT joint mobility. Evaluating the sagittal mobility of the first TMT joint in the forced turnout can assist in understanding the association between inappropriate techniques including the forced turnout and HV development in ballet dancers. Since the excessive mobility of the first TMT joint is a factor in HV development, the acquirement of adequate active turnout may have the potential to prevent HV development in ballet dancers.

Impact of pole dancing on mental wellbeing and sexual self-concept: Protocol for a systematic review and meta-analysis.

BACKGROUND: Despite the recognized psychological benefits of traditional dance forms, the impact of newer forms, such as pole dancing, on mental well-being and sexual self-concept remains underexplored. This protocol outlines a systematic review and meta-analysis aimed at elucidating the effects of pole dancing, a burgeoning non-pharmacological intervention, on these dimensions of mental health. METHODS: This systematic review was registered in the PROSPERO. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocol to accomplish the systematic review protocol. This review will systematically search electronic databases, including PubMed, Embase, Web of Science, Medline, and CNKI, for randomized controlled trials (RCTs) assessing the impact of pole dancing on mental well-being and sexual self-concept. Two independent evaluators will screen the literature, extract data, and evaluate study quality and bias. Data synthesis will utilize Stata 14.0 and Revman 5.4, employing random-effects models. The Grading of Recommendations, Development, and Evaluation (GRADE) system will appraise evidence reliability, with subgroup analysis exploring heterogeneity sources. Publication bias will be assessed through funnel plots and Egger's regression tests. DISCUSSION: This review aims to fill the gap in the current literature by providing a comprehensive evaluation of pole dancing's psychological effects. It is anticipated that this systematic review and meta-analysis will offer valuable insights for health policy and practice, advocating for the inclusion of pole dancing in mental health and sexual well-being interventions. TRIAL REGISTRATION: Systematic review registration: PROSPERO CRD42024529369.

Strength and conditioning in dance: A systematic review and meta-analysis.

To assess the evidence for the effect of strength and conditioning on physical qualities and aesthetic competence in dance populations, three electronic databases (PubMed, Scopus, SPORTDiscus) were searched (until September 2022) for studies that met the following criteria: (i) dancers aged >16 years; (ii) structured strength and conditioning intervention; and (iii) with physical qualities and aesthetic competence as outcome measures. Methodological quality and risk of bias of the included studies were assessed through the systematic review tool "QualSyst". Meta-analyses of effect sizes (Hedges' g) with forest plots explored the effects of the strength and conditioning interventions. Thirty-six studies met the inclusion criteria and were included in this review. Meta-analysis indicated strength and conditioning significantly (p < 0.05) improved lower body power (g = 0.90, 95% CI: 0.53-1.27), upper body strength (g = 0.98, 95% CI: 0.39-1.57), lower body strength (g = 1.59, 95% CI: 0.97-2.22), and flexibility (g = 0.86, 95% CI: 0.05-1.66). Strength and conditioning interventions were found to be effective at improving physical qualities in dancers, recommending their participation in additional sessions to enhance overall fitness and ultimately dance performance. It is recommended that future strength and conditioning intervention research should include sample size calculations, with participants recruited from a specific dance genre and skill level in order to evaluate how strength and conditioning influences dance performance.

Women with disabilities, body image, and wellbeing: Assessing the effectiveness of dance sessions.

INTRODUCTION: There is growing research evidence on bodily discourses and body image issues of women with disabilities. Within the art-based intervention repertoire for persons with disabilities, dance and movement-based therapies and interventions are gaining prominence. The aim of this study was to examine the impact of dance sessions (delivered online) on body image, body satisfaction/dissatisfaction, and wellbeing of women with disabilities. METHOD: A quasi-experimental waitlist control design study was conducted with data collected at two time points: baseline or pre-test and five-months later or post-test. Outcomes were measured using the Body Image Scale and the WHO-5-Wellbeing Index. RESULTS: The dance sessions were effective (Hedges' g = -0.56 -0.88; p < 0.01) and post-test body dissatisfaction scores were lower and wellbeing scores were higher for participants with a college degree or postgraduate degree, self-employed or students, and whose intervention compliance was above threshold (>50% dance sessions attended and corresponding homework sessions completed). Tobit regression models indicated that it was possible to estimate post-test outcomes due to dance sessions alone, controlling for significant socio-demographics. DISCUSSION: The domain knowledge of non-pharmacological art-based interventions for persons with disabilities, particularly women, is supported. CONCLUSIONS: Findings commend dance sessions as effective psychotherapeutic mechanisms to mitigate body dissatisfaction, improve body image and wellbeing of women with disabilities. Future research may focus on large-scale cross-sectional trials, variations in the repertoire for women with different disability types and histories, and qualitative narratives.

Translation, cross-cultural adaptation, reliability and validity of the Brazilian Portuguese version of the 'Fit to Dance?' survey.

BACKGROUND: The 'Fit to Dance?' survey has been used in a number of studies to understand the health and wellbeing of dancers. These data have not been collected in Brazil as there is no validated questionnaire available in Brazilian Portuguese, culturally validated in Brazil with a scope as broad and comprehensive as that of 'Fit to Dance?'. OBJECTIVE: Translate into Brazilian Portuguese and culturally validate the questionnaire 'Fit to Dance?' in Brazil. METHODS: This was a validity and reliability study of the Brazilian Portuguese version of the 'Fit to Dance?' SURVEY: The stages of the research were: translation into the target language (Brazilian Portuguese), translation synthesis, translation validation and cross-cultural adaptation by a committee of experts in Dance Medicine and Science (DMS), reverse translation into English, pilot study (test/retest), and final version of the questionnaire. RESULTS: The questionnaire was applied to 21 dancers of different dance genres, with an age average of 25 ± 7.0 years. Cronbach's alpha (0.705), ICC (0.984) and Kappa (0.794) results reached adequate values. CONCLUSION: The Brazilian Portuguese version of the questionnaire 'Fit to Dance?' is effective, has adequate levels of validity and reliability, and can be used to report injuries and aspects of health and well-being of Brazilian dancers.

The geometry of interpersonal synchrony in human dance.

Collective synchronized behavior has powerful social-communicative functions observed across several animal taxa.1,2,3,4,5,6,7 Operationally, synchronized behavior can be explained by individuals responding to shared external cues (e.g., light, sound, or food) as well as by inter-individual adaptation.3,8,9,10,11 We contrasted these accounts in the context of a universal human practice-collective dance-by recording full-body kinematics from dyads of laypersons freely dancing to music in a "silent disco" setting. We orthogonally manipulated musical input (whether participants were dancing to the same, synchronous music) and visual contact (whether participants could see their dancing partner). Using a data-driven method, we decomposed full-body kinematics of 70 participants into 15 principal movement patterns, reminiscent of common dance moves, explaining over 95% of kinematic variance. We find that both music and partners drive synchrony, but through distinct dance moves. This leads to distinct kinds of synchrony that occur in parallel by virtue of a geometric organization: anteroposterior movements such as head bobs synchronize through music, while hand gestures and full-body lateral movements synchronize through visual contact. One specific dance move-vertical bounce-emerged as a supramodal pacesetter of coordination, synchronizing through both music and visual contact, and at the pace of the musical beat. These findings reveal that synchrony in human dance is independently supported by shared musical input and inter-individual adaptation. The independence between these drivers of synchrony hinges on a geometric organization, enabling dancers to synchronize to music and partners simultaneously by allocating distinct synchronies to distinct spatial axes and body parts.

Carving and making space through dance - Older people using dance to experience their ageing body and challenge ageist discourse.

Drawing on qualitative data from a study of older adults' participation in a contemporary dance group, this paper asks what can be gained from new materialist concepts of the older body, and how they can expand cultural gerontological thinking about embodiment. This paper examines the connections between the older body, movement, thoughts, words and spaces, arguing that dance demonstrates that there is a spatial dimension to embodiment. In drawing from models of materiality emerging in gerontology, this paper provides insights about the experience of age, questioning fundamental categorizations promoted in Western culture, and re-thinks agency in relation to the body and space. Emphasising the importance of the material world in the production of the social has important implications in terms of understanding the experience of ageing within an ageist society.

Multi-person dance tiered posture recognition with cross progressive multi-resolution representation integration.

Recognizing postures in multi-person dance scenarios presents challenges due to mutual body part obstruction and varying distortions across different dance actions. These challenges include differences in proximity and size, demanding precision in capturing fine details to convey action expressiveness. Robustness in recognition becomes crucial in complex real-world environments. To tackle these issues, our study introduces a novel approach, i.e., Multi-Person Dance Tiered Posture Recognition with Cross Progressive Multi-Resolution Representation Integration (CPMRI) and Tiered Posture Recognition (TPR) modules. The CPMRI module seamlessly merges high-level features, rich in semantic information, with low-level features that provide precise spatial details. Leveraging a cross progressive approach, it retains semantic understanding while enhancing spatial precision, bolstering the network's feature representation capabilities. Through innovative feature concatenation techniques, it efficiently blends high-resolution and low-resolution features, forming a comprehensive multi-resolution representation. This approach significantly improves posture recognition robustness, especially in intricate dance postures involving scale variations. The TPR module classifies body key points into core torso joints and extremity joints based on distinct distortion characteristics. Employing a three-tier tiered network, it progressively refines posture recognition. By addressing the optimal matching problem between torso and extremity joints, the module ensures accurate connections, refining the precision of body key point locations. Experimental evaluations against state-of-the-art methods using MSCOCO2017 and a custom Chinese dance dataset validate our approach's effectiveness. Evaluation metrics including Object Keypoint Similarity (OKS)-based Average Precision (AP), mean Average Precision (mAP), and Average Recall (AR) underscore the efficacy of the proposed method.

6-week time-restricted eating improves body composition, maintains exercise performance, without exacerbating eating disorder in female DanceSport dancers.

BACKGROUND: Despite the high risk of eating disorder (ED)-related attitudes and behaviors among female dancers, targeted scientific dietary regimens are currently inadequate. Time-restricted eating (TRE), a popular intermittent fasting protocol, has been shown to be effective in enhancing body composition and exercise performance in athletes. In this study, TRE was employed as a dietary regimen to improve body composition and exercise performance and address ED attitudes and behaviors in DanceSport dancers. METHODS: Twenty female DanceSport dancers were recruited and divided into two groups: TRE (n = 10) and normal diet (ND) (n = 10). The TRE group consumed their self-selected necessary energy intake exclusively between 11 a.m. and 7 p.m. (utilizing a 16-hour fasting and 8-hour eating window) for 6 weeks, while the ND group maintained their regular dieting patterns. The consumption of water, black tea, or coffee without added sugar or milk was not restricted. Physical activity and calorie intake were systematically recorded during the TRE intervention. Body composition, aerobic and anaerobic performance, and ED attitudes and behaviors were assessed before and after the TRE intervention. The trial was registered in the Chinese Clinical Trial Registry under the identifier ChiCTR2200063780. RESULTS: The fixed effects tests (p < 0.0001) and estimates for the intercept (p < 0.0001) of hunger level indicated a noticeable effect on the initial state of hunger during TRE. No significant differences were observed in ED attitudes or behaviors (p > 0.05). TRE resulted in a reduction in hip circumference (p = 0.039), fat mass (kg) (p = 0.0004), and body fat percentage (p = 0.0005), with no significant decrease in fat-free mass (p > 0.05). No significant improvement was observed in aerobic performance (p > 0.05). The average power (AP) (p = 0.01) and AP/Body weight ratio (p = 0.003) significantly increased. Additionally, the power drop decreased significantly (p = 0.019). Group-by-time interactions were observed for fat mass (kg) (p = 0.01), body fat percentage (p = 0.035), and AP/Body weight (p = 0.020). CONCLUSION: TRE can be considered a feasible nutritional strategy for DanceSport dancers, facilitating improvements in body composition without compromising aerobic and anaerobic exercise performance or exacerbating ED attitudes and behaviors. Moreover, TRE may facilitate more favorable physiological adaptations, potentially contributing to improved exercise performance.

Image analysis and teaching strategy optimization of folk dance training based on the deep neural network.

To improve the recognition effect of the folk dance image recognition model and put forward new suggestions for teachers' teaching strategies, this study introduces a Deep Neural Network (DNN) to optimize the folk dance training image recognition model. Moreover, a corresponding teaching strategy optimization scheme is proposed according to the experimental results. Firstly, the image preprocessing and feature extraction of DNN are optimized. Secondly, classification and target detection models are established to analyze the folk dance training images, and the C-dance dataset is used for experiments. Finally, the results are compared with those of the Naive Bayes classifier, K-nearest neighbor, decision tree classifier, support vector machine, and logistic regression models. The results of this study provide new suggestions for teaching strategies. The research results indicate that the optimized classification model shows a significant improvement in classification accuracy across various aspects such as action complexity, dance types, movement speed, dance styles, body dynamics, and rhythm. The accuracy, precision, recall, and F1 scores have increased by approximately 14.7, 11.8, 13.2, and 17.4%, respectively. In the study of factors such as different training images, changes in perspective, lighting conditions, and noise interference, the optimized model demonstrates a substantial enhancement in recognition accuracy and robustness. These findings suggest that, compared to traditional models, the optimized model performs better in identifying various dances and movements, enhancing the accuracy and stability of classification. Based on the experimental results, strategies for optimizing the real-time feedback and assessment mechanism in folk dance teaching, as well as the design of personalized learning paths, are proposed. Therefore, this study holds the potential to be applied in the field of folk dance, promoting the development and innovation of folk dance education.

Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis.

INTRODUCTION: Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence. METHODS: Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE. RESULTS: Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2,451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low-impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance versus usual care, mean difference (MD) = 1.36; 95% CI -3.57 to 0.85), Sit-to-Stand (dance versus exercise MD = -0.85; 95% CI -2.64 to 0.93: dance versus education MD = -1.64; 95% CI -4.12 to 0.85), Berg Balance Scale (dance versus usual care MD = 0.61; 95% CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall, certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls. CONCLUSIONS: There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found. PROSPERO REGISTRATION: CRD42022382908.

Step type is associated with loading and ankle motion in tap dance.

Tap dance generates forces and joint motions that can lead to injury; however, little is known about the magnitude of load across different tap steps. The purpose of this study was to calculate peak vertical forces, average vertical foot velocities, and maximum/minimum ankle angles produced by tap dancers with different levels of experience performing the toe cannon, heel cannon, flap, and cramp roll. This prospective cross-sectional study included 14 female tap dancers aged ≥18 years with varying tap experience. Participants were recorded by three cameras while performing a choreographed tap combination containing four steps of interest on a force platform. Adjusting for experience and dancer-level clustering, we identified the steps-cramp roll and toe cannon-that had the highest peak vertical ground reaction force, angles, and velocities compared to flap and heel cannon. There was no effect of experience. The results supported our hypothesis and provide new insights into step production. Over time, the larger forces associated with these steps could pose an increased risk of injury to bones and joints when compared to smaller forces, which may suggest the importance of adjusting routines to reduce or avoid injury.

Moving together - benefits of an online dance program on physical and mental health for older women: an exploratory mixed-method study.

BACKGROUND: Previous studies show that in-person dance training is a beneficial form of physical activity that involves mental, social, and physical dimensions. This exploratory study investigated the benefits of a 12-week online dance training intervention on mental and physical health outcomes for older women. METHODS: A convergent parallel mixed-method design was used. Forty-five older adults (74.0 ± 5.3 yrs old, 44 women) were recruited through advertisements at activity and rehabilitation centers in the North Denmark region. The intervention consisted of two weekly 60-min classes of improvisation and salsa delivered online through video call applications. Changes in physical health outcomes (body mass and composition, resting blood pressure, Senior Fitness Test battery) and self-rated health and wellbeing (health-related quality of life (HRQOL), feelings of loneliness) were assessed prior to and after 12 weeks of dancing. Focus group interviews were conducted post-intervention to further explore the benefits as well as the participant's experience of the intervention. Thematic analysis of the qualitative data was conducted. RESULTS: Thirty-two participants (all women) completed the study. Significant improvements in fitness were found for the number of arm curls performed (baseline: 12.3 ± 3.0; post-intervention: 13.7 ± 3.0, P = 0.005), 2-min step test performance (baseline: 66.5 ± 20.0 reps.; post-intervention: 73.8 ± 22.6 reps., P = 0.016), and chair sit-and-reach (baseline: 0.4 ± 11.3 cm; post-intervention: 5.5 ± 10.1 cm, P < 0.001). There was a significant increase in body mass from baseline to post-intervention (P < 0.015). The themes from the focus groups included (1) Participation, (2) Challenges, (3) Progression, (4) Motivation, (5) Perceived health and wellbeing, and (6) Online dance instruction. No significant changes were reported in HRQOL and loneliness from the quantitative data, although the qualitative data did reveal improved feelings of physical health and wellbeing. CONCLUSIONS: The intervention improved several aspects of fitness in older women and improved the participants' perceptions of their own physical abilities and wellbeing. While most participants found the online intervention enjoyable, several participants missed the feedback from the instructors that naturally occurs with in-person instruction.

The impact of square dancing on psychological well-being and life satisfaction among aging women.

As the most popular sport among middle-aged and elderly women in China, square dancing has both physical and psychological benefits for menopausal women. Previous studies have shown that square dance exercises can promote the physical health of older women, but there is a lack of research on the influence of middle-aged and elderly women on mental health and mediating variables. Therefore, this study starts with one of the important indicators of mental health-positive affects, aiming to explore the impact of square dance on the positive emotions of elderly women and further explore the mediating mechanisms involved. We send out The Physical Activity Rating Scale, the Positive and Negative Affect Scale, the Connor-Davidson Resilience Scale, and the Satisfaction With Life Scale to a total of 2311 middle-aged and elderly women. SPSS 23 software and PROCESS were used to perform regression analysis and establish mediation models. Modeling results show square dance exercises could positively predict positive affect through the chain mediating effect of psychological resilience and life satisfaction. The results of this study are of great significance for promoting the extensive participation of middle-aged and elderly women in sports and protecting their mental health.

Incidence, Prevalence, and Characteristics of Injuries in Pole Dancers: A Systematic Review.

OBJECTIVES: Pole dancing is an extreme form of performance physical activity, combining considerable feats of muscular strength, flexibility, dancing and acrobatics on a vertical metal apparatus. Despite rapid growth in the artform, many pole dancers continue to participate without fulfilling physical requirements to withstand the forces and physicality required. The aim of this systematic review was to determine the incidence, prevalence and characteristics of injuries sustained by pole dancing participants reported in published studies. METHODS: Five databases were comprehensively searched in February 2023. Authors independently screened titles and abstracts, with full copies of eligible studies reviewed using specific inclusion/exclusion criteria. Studies were included if they referenced pole dancing, were in English language and Level I-III-3 in accordance with the Australian National Health and Medical Research Council, with case reports considered if included 10 or more participants. The National Institute of Health quality assessment tool for observational cohort and cross-sectional studies was used to review the quality of reporting of selected studies. RESULTS: Eleven articles were retrieved based on searches, with five studies meeting full inclusion/exclusion criteria, published between 2020-2022. In total 787 study participants were identified, with 623 sustaining a total of 1,803 pole dancing injuries. Data from all studies in injury profiles reported 42.4% of injuries sustained to the upper limb, 44.8% lower limb, 10.5% trunk, 0.02% associated with the head and neck, and several injuries affecting multiple regions. Acute injuries comprised 51.6% of reported injuries compared to 48.4% chronic. Injury characteristics were varied due to inconsistencies in reporting across studies. CONCLUSIONS: This systematic review highlights a paucity of knowledge regarding injuries in pole dancing, perhaps expected with a relatively young sport. Improvement in reporting is required to aid in identification of injuries and opportunities for development of injury risk reduction strategies. PROSPERO Registration no. CRD42023401012.

Muscle Strength Asymmetries of the Lower Limbs and Trunk in Ballet Dancers.

BACKGROUND: Ballet dancers are expected to use their bodies symmetrically during training, because dance movements are performed on both sides. However, there is a general belief that ballet training encourages the use of one side of the body more than the other. Frequent repetition of a particular exercise can lead to body asymmetries and musculoskeletal injuries. The aim of this cross-sectional study was to investigate the presence of lower limbs and trunk muscle strength asymmetries in ballet dancers and secondly to assess whether there is a difference between professional dancers and ballet students. METHODS: Ballet students (n=19) and professional ballet dancers (n=23) performed maximal voluntary isometric contractions of the trunk (flexion, extension, lateral flexion), hip (flexion, extension, adduction, abduction, external and internal rotation), knee (flexion, extension) and ankle (flexion, extension) on isometric dynamometer. RESULTS: The results showed that the percentage of ballet dancers with contralateral muscle strength asymmetries >10% ranged from 22.5% (ballet students) to 31.6% (professional dancers). The percentage of ballet dancers deviating by >10% from the normative maximum torque agonist/antagonist ratio ranged from 56.5% to 100%. A statistically significant difference between ballet students and professional ballet dancers was found in the trunk flexion/extension ratio (t(40) = -3 .55; p = 0.001; d = 0.55). CONCLUSION: This study revealed strength asymmetries in the lower limbs and trunk in ballet dancers, both professionals and students. Further research is needed to develop appropriate complementary exercise to address and eliminate asymmetries in muscle strength in ballet dancers.

Perspectives of Ballet Dancers on Causes of Their Injuries and Implementation of Injury Preventive Measures by Ballet Teachers and Masters.

OBJECTIVES: Ballet dancers have a high injury risk. We aimed to gain insight into the causes for acute and overuse injuries in ballet dancers and the level of implementation of injury prevention by ballet teachers/masters, as perceived by dancers. METHODS: An international cross-sectional online-survey was based on the Fit-to-Dance Questionnaire and literature. Adult amateur, pre-professional, and professional ballet dancers reported the perceived causes of their injuries sustained in the previous 2 years. Multiple answers per injury were possible. Also, dancers rated the level of implementation of measures to prevent injury by their ballet teachers and ballet masters based on 21 items using a 5-point Likert scale. Causes were analyzed per-injury as well as per-dancer. RESULTS: 188 ballet ensembles and 51 dance organizations were contacted, from which 192 ballet dancers (mean age 27 ±7.8 yrs, 83% females) responded. 119 dancers (62%) reported 203 acute and 164 (85%) reported 469 overuse injuries. Fatigue was the most frequently perceived cause for acute injuries in the per-injury (n=89, 43.8%) and per-dancer analysis (n=63, 32.8%). For overuse injuries, pressure from the teacher/master was most frequently perceived as cause in the per-injury analysis (n=240, 51.2%), specifically in pre-/professional dancers (n=233, 61.3%). In the per-dancer analysis, fatigue/overtraining scored highest for overuse injuries (n=107; 55.7%). Other causes were previous/repetitive injuries (acute-per-injury 26.1%, acute-per-dancer 22.4%; overuse-per-injury 46.3%, overuse-per-dancer 53.1%) or erroneous dance technique (acute-per-injury 24.6%, acute-per-dancer 21.9%; overuse-per-injury 47.8%, overuse-per-dancer 45.3%). With regard to perceived level of implementation of injury preventive measures by ballet teachers/masters to prevent musculoskeletal injuries, 2 items received high ratings, 12 moderate ratings and 6 low ratings. CONCLUSIONS: Fatigue and pressure accounted for the majority of perceived causes for injuries. Perceived support by ballet teachers/masters regarding injury prevention was moderate to low. Future research should focus on the awareness, attitudes, and the important role of ballet teachers/masters for injury prevention in dancers.