Recent Submissions

  • Changes in Energy Demand of Dance Activity and Cardiorespiratory Fitness During One Year of Vocational Contemporary Dance Training

    Beck, Sarah; Wyon, Matthew A; Redding, Emma (Wolters Kluwer, 2017-11)
    Previous literature has demonstrated that the intensity of dance class, as well as its discontinuous nature, is not sufficient to elicit an aerobic training response and that the aerobic capacity of dancers is relatively low. These findings have raised questions of the suitability of training, through class and rehearsal, as adequate preparation for the physical demands of performance and a sustained, successful career in dance. The aim of this study was to describe changes in aerobic fitness and energy cost of dance movement occurring throughout one year of training. Subjects were thirteen female dance students; seven first year undergraduate students (UG), and six postgraduate students (PG). At three time-points (TP1, TP2, TP3) during one academic year each subject completed a treadmill test, to determine VO2peak (ml.kg-1.min-1) and lactate threshold (LT) (ml.kg-1.min-1 and %VO2peak), and a standardised four-minute dance sequence, where mean demand was expressed as VO2 (ml.kg-1.min-1), heart rate (b.min-1), %VO2peak, and %LT. Both groups displayed an overall decrease in mean VO2peak throughout the year, despite a peak in fitness at TP2 in the PG students. No significant changes in LT were noted over time for either group. A significant reduction in the relative intensity of the dance sequence, particularly in relation to mean VO2 (ml.kg-1.min-1) and %LT data, was observed over time in both groups although the degree of change was less in the UG group than the PG group. Apparent adaptations during a rehearsal period in the PG group are presented in contrast to previous research findings. Recommendations for future research include further investigation into the energy demand of rehearsal and cardiorespiratory adaptation during rehearsal periods as well as further reporting of measures related to LT and movement economy.
  • Self-reported symptoms of eating disorders amongst university dance students

    van Staden, A; Lane, A M; Wyon, Matthew (AFAHPER-SD, 2017)
    Eating disturbances are common amongst female athletes, especially those participating in dance. We investigated the prevalence and correlates of eating disorder risk symptoms amongst female student dancers. Fifty-eight female university dancers completed a self-report measure of eating disorders and eating disorder correlates, along with factors hypothesised to be associated with the concept, including perfectionism and anxiety. Height and body mass were measured to calculate body mass index (BMI). Results indicated that psychological variables correlated positively with eating disorder risk, and that BMI and ineffectiveness were correlates best associated with eating disorder risk for these dancers. Results indicated that the screening of dancers using a self-report measure can help to identify dancers suffering from poor psychological health of which one characteristic is disordered eating. Given the implications of well-being and performance, we suggest that future research should investigate factors associated with eating disorders and that course administrators and health practitioners consider these factors when facilitating and optimising the mental health and performance of dancers.
  • Bone mass of female dance students prior to professional dance training: A cross-sectional study

    Amorim, Tânia; Metsios, George S.; Wyon, Matthew; Nevill, Alan M.; Flouris, Andreas D.; Maia, José; Teixeira, Eduardo; Machado, José Carlos; Marques, Franklim; Koutedakis, Yiannis (Plos, 2017-07-05)
    Summary According to existing literature, bone health in ballet dancers is controversial. We have verified that, compared to controls, young female and male vocational ballet dancers have lower bone mineral density (BMD) at both impact and non-impact sites, whereas female professional ballet dancers have lower BMD only at non-impact sites. Introduction The aims of this study were to (a) assess bone mineral density (BMD) in vocational (VBD) and professional (PBD) ballet dancers and (b) investigate its association with body mass (BM), fat mass (FM), lean mass (LM), maturation and menarche. Methods The total of 152 VBD (13 ± 2.3 years; 112 girls, 40 boys) and 96 controls (14 ± 2.1 years; 56 girls, 40 boys) and 184 PBD (28 ± 8.5 years; 129 females, 55 males) and 160 controls (27 ± 9.5 years; 110 female, 50 males) were assessed at the lumbar spine (LS), femoral neck (FN), forearm and total body by dual-energy X-ray absorptiometry. Maturation and menarche were assessed via questionnaires. Results VBD revealed lower unadjusted BMD at all anatomical sites compared to controls (p < 0.001); following adjustments for Tanner stage and gynaecological age, female VBD showed similar BMD values at impact sites. However, no factors were found to explain the lower adjusted BMD values in VBD (female and male) at the forearm (non-impact site), nor for the lower adjusted BMD values in male VBD at the FN. Compared to controls, female PBD showed higher unadjusted and adjusted BMDfor potential associated factors at the FN (impact site) (p < 0.001) and lower adjusted at the forearm (p < 0.001). Male PBD did not reveal lower BMD than controls at any site. Conclusions Both females and males VBD have lower BMDat impact and non-impact sites compared to control, whereas this is only the case at non-impact site in female PBD. Maturation seems to explain the lower BMDat impact sites in female VBD.
  • Leg-Length in Relation to Selected Ballet Performance Indicators

    Karpodini, C.C.; Wyon, M.A.; Comoutos, N.; Koutedakis, Y. (Science & Medicine, Inc, 2017-09-08)
    It is unclear whether the modern ballet body stereotype of long limbs is advantageous in dance performance. Therefore, we investigated the relationship between leg-length and selected dance movements representative of power, dexterity, and range of motion in ballet dancers at different competence levels. METHODS: The total of 10 recreational, 24 vocational, and 10 professional ballerinas volunteered. They were subjected to: a) lower limb-length measurements, b) power tests (vertical jump-sautés and unilateral countermovement jump-temps levé), c) dexterity tests (tendus and double battement frappes), and d) flexibility tests (lateral active and passive-développé à la seconde). RESULTS: For power, regression analyses revealed negative leg-length relationships in recreational dancers (p<0.05) and positive leg-length relationships in vocational dancers (p<0.05). We also found negative relationships between leg-length and dexterity in the vocational group (p=0.01). No significant predictions of leg-length on power, dexterity, and range of motion were found in professional dancers. Multiple comparisons revealed significant differences between groups only for dexterity (p<0.01) and range of motion (p<0.01). CONCLUSION: Based on selected movements representative of power, dexterity, and range of motion, the present exploratory data indicate that lower limb length is not a determinative criterion for ballet success. Further studies should investigate whether body stereotypes, such as long limbs, are linked to dance injuries
  • Bone mass of female dance students prior to professional dance training: A cross-sectional study

    Amorim, Tânia; Metsios, Giorgos S.; Nevill, Alan M.; Wyon, Matthew; Flouris, Andreas D.; Maia, José; Teixeira, E; Machado, José Carlos; Marques, Franklim; Koutedakis, Yiannis (PLOS one, 2017-07)
    Article Authors Metrics Comments Related Content Abstract Introduction Methods Results Discussion Conclusions Acknowledgments References Reader Comments (0) Media Coverage (0) Figures Abstract Background Professional dancers are at risk of developing low bone mineral density (BMD). However, whether low BMD phenotypes already exist in pre-vocational dance students is relatively unknown. Aim To cross-sectionally assess bone mass parameters in female dance students selected for professional dance training (first year vocational dance students) in relation to aged- and sex-matched controls. Methods 34 female selected for professional dance training (10.9yrs ±0.7) and 30 controls (11.1yrs ±0.5) were examined. Anthropometry, pubertal development (Tanner) and dietary data (3-day food diary) were recorded. BMD and bone mineral content (BMC) at forearm, femur neck (FN) and lumbar spine (LS) were assessed using Dual-Energy X-Ray Absorptiometry. Volumetric densities were estimated by calculating bone mineral apparent density (BMAD). Results Dancers were mainly at Tanner pubertal stage I (vs. stage IV in controls, p<0.001), and demonstrated significantly lower body weight (p<0.001) and height (p<0.01) than controls. Calorie intake was not different between groups, but calcium intake was significantly greater in dancers (p<0.05). Dancers revealed a significantly lower BMC and BMD values at all anatomical sites (p<0.001), and significantly lower BMAD values at the LS and FN (p<0.001). When adjusted for covariates (body weight, height, pubertal development and calcium intake), dance students continued to display a significantly lower BMD and BMAD at the FN (p<0.05; p<0.001) at the forearm (p<0.01). Conclusion Before undergoing professional dance training, first year vocational dance students demonstrated inferior bone mass compared to controls. Longitudinal models are required to assess how bone health-status changes with time throughout professional training.
  • Towards a new training methodology

    Wyon, Matthew (ArtEZ Publishers, 2014-04)
    Elite dance and sport attract highly motivated, perfectionistic individuals to environments that are highly competitive and physically demanding[1, 2]. At an elite level both sport and dance performances can speak directly to the emotions of the observer through their physical movement and highly trained bodies. While dancers have been referred to as the embodiment of artist and athlete[3], dance is not generally considered a sport and as such, the sharing of knowledge between dance and sport is rarely exploited to the mutual benefit of sport and dance participants. While philosophical debate may continue regarding the artistic side of dance that may not be present in sport, or the lack of competition in dance that is traditionally seen in sports but not in dance, in the context of physical activity and resultant impact on health, dance should be considered an equal and afforded the same attention to its effect on the body as seen in sporting disciplines
  • Challenging habit: planning and preparation, the art of periodisation and optimising performance.

    Wyon, Matthew (Uitgeverij International Theatre and Film Books, 2004-01)
    A question to start - what is the goal, raison d’etre of a dance company? Hopefully you will agree that it is the performance, but a lot of current practice within the dance world is actually having the opposite effect. For example, rehearsing long hours right up to the start of a tour or performance; whilst on tour rehearsing all afternoon prior to an evening performance; the training focus being one-dimensional with too much emphasis on the technical aspects of dance and only paying lip service to the other components of performance. The concept of periodisation is to help optimise the preparation for performance for the dancers so they reach opening night mentally, physically and technically ready to perform. Needs analysis and planning is the key to good periodisation. And for that, co-operation between the different parties involved is vital, in addition to – of course – the basic will to challenge one’s own habits and to check out other knowledge can be useful for dance. Needs analysis refers to the examination of the possible demands that the performance is going to place on the dancer. Depending on how the piece is developed (experimentation, previously set etcetera) will determine the amount of prior knowledge of its demands is available to the planner. Hopefully the choreographer will have a broad concept of the piece and this will form the basis of initial plans, but the planner will need to be flexible. Some other questions that need to be answered are the extent of lifting, jumping, partner work within the piece, the length of time that the choreographer has to produce the work, the present physical, mental and technical condition of the dancers, the group dynamics of the company, the length of the performance period, the amount of travel that needs to be done. The planning component is the difficult part. The planner needs to decide on the importance of all the different components of the `whole’ that makes up performance preparation and then decide how to organise and prioritise them; within this need to be included rest and travel days. The main thing to remember is to work backwards from the start of the performance period and this is where some controversies begin.
  • LOWER EXTREMITY HYPERMOBILITY, BUT NOT CORE MUSCLE ENDURANCE INFLUENCES BALANCE IN FEMALE COLLEGIATE DANCERS.

    Ambegaonkar, Jatin P; Cortes, Nelson; Caswell, Shane V; Ambegaonkar, Gautam P; Wyon, Matthew (International Federation of Sports Physical Therapy, 2016-04)
    Background Dance is a physically demanding activity, with almost 70% of all injuries in dancers occurring in the lower extremity (LE). Prior researchers report that muscle function (e.g. muscle endurance) and anatomical factors (e.g. hypermobility) affect physical performance (e.g. balance) and can subsequently influence LE injury risk. Specifically, lesser core muscle endurance, balance deficits, and greater hypermobility are related to increased LE injury risk. However, the potentials interrelationships among these factors in dancers remain unclear. Purpose The purposes of this study were to examine the relationships among core muscle endurance, balance, and LE hypermobility, and determine the relative contributions of core muscle endurance and LE hypermobility as predictors of balance in female collegiate dancers. Study Design Cross-sectional Methods Core muscle endurance was evaluated using the combined average anterior, left, and right lateral plank test time scores(s). LE hypermobility was measured using the LE-specific Beighton hypermobility measure, defining hypermobility if both legs had greater than 10 ° knee hyperextension. Balance was measured via the composite anterior, posterolateral, and posteromedial Star Excursion Balance Test (SEBT) reach distances (normalized to leg length) in 15 female healthy collegiate dancers (18.3 + 0.5yrs, 165.5 + 6.9cm, 63.7 + 12.1kg). Point-biserial-correlation-coefficients examined relationships and a linear regression examined whether core endurance and hypermobility predicted balance (p<.05). Results LE hypermobility (Yes; n = 3, No; n = 12) and balance (87.2 + 8.3% leg length) were positively correlated r(14)=.67, (p=.01). However, core endurance (103.9 + 50.6 s) and balance were not correlated r(14)=.32, (p=.26). LE hypermobility status predicted 36.9% of the variance in balance scores (p=.01). Conclusion LE hypermobility, but not core muscle endurance may be related to balance in female collegiate dancers. While LE hypermobility status influenced balance in the female collegiate dancers, how this LE hypermobility status affects their longitudinal injury risk as their careers progress needs further study. Overall, the current findings suggest that rather than using isolated core endurance-centric training, clinicians may encourage dancers to use training programs that incorporate multiple muscles - in order to improve their balance, and possibly reduce their LE injury risk.
  • Assessment of maximum aerobic capacity and anaerobic threshold of elite ballet dancers

    Wyon, Matthew; Allen, N; Cloak, R; Beck, S; Davies, P; Clarke, F (Science & Medicine, 2016-01)
    An athlete’s cardiorespiratory profile, maximal aerobic capacity and anaerobic threshold, is affected by their training regimen and competition demands. The purpose of the present study is to ascertain whether there are company rank differences in maximal aerobic capacity and anaerobic threshold in elite classical ballet dancers. Seventy-four volunteers (M=34, F=40) were recruited from two full-time professional classical ballet companies. All participants completed a continuous incremental treadmill protocol with a 1 km.h-1 speed increase at the end of each 1-minute stage until termination criteria had been achieved (e.g. voluntary cessation, RER <1.15, heart rate ±5b.min-1 of estimated HRmax). Peak VO2 (5-breathe smooth) was recorded and anaerobic threshold calculated using ventilatory curve and ventilatory equivalents methods. Statistical analysis reported between-subject effects for gender (F1,67=35.18; p<0.001) and rank (F1,67=8.67; p<0.001); post hoc tests reported soloists (39.5 ±5.15 ml.kg-1.min-1) as having significantly lower VO2 peak than artists (45.9 ±5.75 ml.kg-1.min-1, p<0.001) and principal dancers (48.07 ±3.24 ml.kg-1.min-1, p<0.001). Significant differences in anaerobic threshold were reported for age (F1,67=7.68; p=0.008), rank (F1,67=3.56; p=0.034); post hoc tests reported artists (75.8 ±5.45%) having significantly lower %AT than soloists (80.9 ±5.71, p<0.01) and principals (84.1 ±4.84%, p<0.001). The observed differences in VO2 peak and anaerobic threshold between the ranks in ballet companies is probably due to their different rehearsal and performance demands.
  • Spinal posture in different DanceSport dance styles compared with track and field athletes.

    Kruusamäe, Helena; Maasalu, Katre; Wyon, Matthew; Jürimäe, Toivo; Mäestu, Jarek; Mooses, Martin; Jürimäe, Jaak (Lithuanian Medical Association, 2015-11)
    Background and objective: In DanceSport, athletes train for many years to develop a very specific posture. Presently there are few data as to whether these adaptations are habitual or cause permanent anatomical changes to the spine. The aim of the current study was to evaluate lumbar lordosis and thoracic kyphosis of the international level DanceSport dancers using track and field athletes as controls. Materials and methods: Thirty competitive DanceSport couples (15 men aged 23.4 6.6 years; 15 women aged 22.5 6.4 years) and 29 track and field athletes (16 mean aged 27 4.4 years and 13 women aged 22 4.1 years) volunteered. Twelve couples were Standard, 7 Latin American and 11 were Ten Dance couples. Thoracic kyphosis and lumbar lordosis angle were assessed in lateral view using a Vertebral Fracture Assessment scan. Results: DanceSport athletes had smaller S-shaped vertebral curvatures compared to track and field athletes. Male (5.7 4.78) and female dancers (8.7 5.98) had significantly smaller lumbar lordosis angle compared to their track and field counterparts (22.3 9.98 for men; 20.3 5.98 for women).Femaledancers(25.3 8.08)alsodemonstratedsignificantly smallerthoracickyphosis angle than female track and field (32.1 8.98) participants. It was further revealed that female Latin American dancers had significantly smaller lumbar lordosis values (3.7 3.18) compared with female Standard (10.7 6.18) and Ten Dance dancers (9.7 5.58). Conclusions: The results of the present study suggest that smaller S-shaped vertebral curvatures of DanceSport athletes compared with track and field athletes are permanent changes rather than habitual.
  • Methodological considerations for documenting the energy demand of dance activity: a review.

    Beck, Sarah; Redding, Emma; Wyon, Matthew (Frontiers, 2015)
    Previous research has explored the intensity of dance class, rehearsal, and performance and attempted to document the body's physiological adaptation to these activities. Dance activity is frequently described as: complex, diverse, non-steady state, intermittent, of moderate to high intensity, and with notable differences between training and performance intensities and durations. Many limitations are noted in the methodologies of previous studies creating barriers to consensual conclusion. The present study therefore aims to examine the previous body of literature and in doing so, seeks to highlight important methodological considerations for future research in this area to strengthen our knowledge base. Four recommendations are made for future research. Firstly, research should continue to be dance genre specific, with detailed accounts of technical and stylistic elements of the movement vocabulary examined given wherever possible. Secondly, a greater breadth of performance repertoire, within and between genres, needs to be closely examined. Thirdly, a greater focus on threshold measurements is recommended due to the documented complex interplay between aerobic and anaerobic energy systems. Lastly, it is important for research to begin to combine temporal data relating to work and rest periods with real-time measurement of metabolic data in work and rest, in order to be able to quantify demand more accurately.
  • Body mass index, nutritional knowledge, and eating behaviors in elite student and professional ballet dancers.

    Wyon, Matthew; Hutchings, Kate M; Wells, Abigail; Nevill, Alan M (Wolters Kluwer Health, 2014-09)
    Objective: It is recognized that there is a high esthetic demand in ballet, and this has implications on dancers' body mass index (BMI) and eating behaviors. The objective of this study was to examine the association between BMI, eating attitudes, and nutritional knowledge of elite student and professional ballet dancers. Design: Observational design. Setting: Institutional. Participants: One hundred eighty-nine participants from an elite full-time dance school (M = 53, F = 86) and from an elite ballet company (M = 16, F = 25) volunteered for the study. There were no exclusion criteria. Interventions: Anthropometric data (height and mass), General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitude Test—26 (EAT-26) were collected from each participant. Main Outcome Measures: Univariate analysis of variance was used to examine differences in gender and group for BMI, GNKQ, and EAT-26. Regression analyses were applied to examine interactions between BMI, GNKQ, and EAT-26. Results: Professional dancers had significantly greater BMI than student dancers (P < 0.001), and males had significantly higher BMI scores than females (P < 0.05). Food knowledge increased with age (P < 0.001) with no gender difference. Student dancers had a significant interaction between year group and gender because of significantly higher EAT-26 scores for females in years 10 and 12. Regression analysis of the subcategories (gender and group) reported a number of significant relationships between BMI, GNKQ, and EAT-26. Conclusions: The findings suggest that dancers with disordered eating also display lower levels of nutritional knowledge, and this may have an impact on BMI. Female students' eating attitudes and BMI should especially be monitored during periods of adolescent development.
  • The effect of moderate glycemic energy bar consumption on blood glucose and mood in dancers.

    Brown, Derrick; Wyon, Matthew (Science & Medicine, 2014-03)
    Ingesting quality carbohydrates has been shown to be essential for dancers. Given that most dance classes take place in the morning, it has been recommended that dancers eat a well-balanced breakfast containing carbohydrates, fats, and protein as a means of fuelling this activity. The aim of this study was to determine the effect of a moderate glycemic index energy (MGI) bar or a fasting condition on dancers' blood glucose levels and perceived pleasure-displeasure response during the first dance class of the day. In a randomized counterbalanced design, 10 female preprofessional dance students took their regular scheduled contemporary dance class, on four separate occasions. On each occasion, they consumed either a commercially prepared carbohydrate (CHO)-dense energy bar (47.3 g CHO) or water (FAST). Plasma glucose responses and pleasure-displeasure affect were measured before and at two time points during the class. Dancers who consumed the MGI bar had significantly greater peak blood glucose levels at all time points than those who fasted (p<0.05). Regarding affective state measures, participants who had breakfast had significantly greater pleasure scores than those who only ingested water(p<0.05). In conclusion, results suggest that CHO with an MGI value positively impacts blood glucose concentrations during a dance class. Further, we conclude that skipping breakfast can have an unfavorable effect on the pleasure-displeasure state of dancers. These findings highlight the impact of breakfast on how one feels, as well as the physiological and metabolic benefits of CHO as an exogenous energy source in dancers.
  • Fit to dance survey: a comparison with dancesport injuries.

    Riding McCabe, Teri; Ambegaonkar, Jatin P; Redding, Emma; Wyon, Matthew (Science & Medicine, 2014-06)
    The Fit to Dance survey has been conducted twice previously, in 1993 and 2002, without dancesport participants. The purpose of this present online survey was to supplement a comparison of dancesport against the earlier results. The current study had a greater percentage of male respondents than previous studies (43% vs 24% and 26%). The dancesport participants were older (28% at 40+ yrs vs 3% and 1%) and more likely to have normal (69% vs 57%) to overweight BMI (18% vs 2%). Dancesport participants spent more time in various non-dancing conditioning activities than previous surveys (5.2 ± 3.9 hrs SD vs 1.9 ± 2.5 and 2.2 ± 2.7). Muscles and joints were the most common type of injury in all the surveys. The knee was the top injury site in this survey, with lower back in previous surveys. The main perceived cause of injury was repetitive movements, whereas fatigue and overwork were cited in the previous surveys. Physiotherapists were the most common type of medical professionals from whom the dancers sought treatment for their injuries in all surveys. The first survey included recommendations that the present survey results agree with, including: dancers should be physically fit, dancers should warm up and cool down, dancers should never have to work in unsuitable environments, and dancers should receive immediate high-quality treatment for injuries.
  • An international study on dietary supplementation use in dancers.

    Brown, Derrick; Wyon, Matthew (Science & Medicine, 2014-12)
    Little is known of the prevalence and motives of dietary supplement use amongst dancers from different cultures. Investigating supplement use, presumed effects, and other factors may be crucial for improving educational and nutritional advice provided for this cohort. Therefore, this study investigated the use of dietary supplements in 334 dancers from 53 countries, who completed a digitally based 35-question survey detailing demographic information and the use of dietary supplementation. Supplement use was prevalent amongst this international cohort, with 48% reporting regular supplement use. Major motives for supplement use were to improve health, boost immunity, and reduce fatigue. Forty-five percent believed that dancing increased the need for supplementation, whilst 30% recognized that there were risks associated with nutritional supplementation. The most frequently consumed supplements were vitamin C (60%), multivitamins (67%), and caffeine (72%). A smaller group of participants declared the use of whey protein (21%) or creatine (14%). Supplements were mainly obtained from pharmacies, supermarkets, and health-food stores. Dancers recognized their lack of knowledge in dietary supplement use and relied on peer recommendations instead of sound evidence-based advice from acknowledged nutrition or health care professionals. This study demonstrates that dietary supplement use is internationally prevalent amongst dancers. Continued efforts are warranted with regard to information dissemination.
  • Prevalence of low bone mineral density in female dancers.

    Amorim, Tânia; Wyon, Matthew; Maia, José; Machado, José Carlos; Marques, Franklim; Metsios, George S; Flouris, Andreas D; Koutedakis, Yiannis (Springer, 2015-02)
    BACKGROUND AND OBJECTIVE: While some authors report that dancers have reduced bone mineral density (BMD) and increased risk of osteoporosis, others have stressed the positive effects of dance training on developing healthy BMD. Given the existing controversy, the aim of this systematic review was to examine the best evidence-based information available in relation to female dancers. METHODS: Four databases (Web of Science, PubMed, EBSCO, Scopus) and two dance science journals (Journal of Dance Medicine and Science and Medical Problems of Performing Artists) were searched for relevant material using the keywords "dance", "ballet", "BMD", "bone density", "osteoporosis" and "female athlete triad syndrome". A total of 257 abstracts were screened using selected inclusion (studies involving bone measurements in dancers) and exclusion (editorials, opinion papers, chapters in books, narrative reviews and non-English language papers) criteria according to PRISMA guidelines. Following the above screening, a total of 108 abstracts were identified as potentially relevant. After the exclusion of conference proceedings, review papers, studies focusing only in male dancers and studies in which dancers' information were combined with other athletes, the eligible papers were subsequently assessed using the GRADE system and grouped according to: (1) prevalence of low BMD and associated factors, (2) incidence of low BMD and risk factors, (3) prevention/treatment of low BMD in dancers, and (4) other studies. RESULTS: Of the 257 abstracts that were initially screened, only 35 studies were finally considered. Only one of these 35 was of high quality, while the remaining 34 were of relatively low quality. Seven studies reported prevalence of low BMD and associated factors, 10 reported associated factors with no prevalence data, while one reported prevalence with no associated factors data. One study cited risk factors, while another one elaborated on the treatment of low BMD in dancers. The remaining 15 studies were classified as "other studies". CONCLUSIONS: It remains unclear whether low BMD is prevalent in female dancers. The present review highlights the need for high-quality BMD research in this area.
  • Musculoskeletal Injuries in Dance: A Systematic Review

    Ribbans WJ,; Allen N; Nevill, Alan M.; Wyon, Matthew (Graphy Publications, 2014)
    Background: Within sport, mitigation of risk of injury through the use of comprehensive specialist sports medicine provision is commonplace. Dance participation, through its athletic nature can also introduce risk of injury, but unlike sport, is not always recognised that specialist medicinal provision will assist in the mitigation of that risk. Objectives: This systematic review has two objectives: to examine the extent of injury in dance participation; and the impact that specialist dance medicine provision has on overall dance injury incidence. Data sources: The review was undertaken using the Medline electronic databases using MeSH terms relating to the framing question. Study Eligibility Criteria and Participants: The study was based on ballet or any forms of artistic dance that had as its focus musculoskeletal injuries, or screening for injury prevention or interventions to reduce musculoskeletal injury. Interventions: The use of specialist dance medicine provision programmes including in-house medical teams, screening and exercise programmes Study appraisal and synthesis methods: As the literature relating to dance injury comprised of observational studies, the GRADE system was utilised. Results: The results of this systematic review reflect those of two previous systematic reviews in that little progress has been made in terms of quality of papers in recent years. On overall injury incidence of 1.33/1000hrs and a reduction in injury from 2.46/1000hrs to 0.84/1000hrs due to the impact of specialist dance medicine provision was calculated. Limitations: PubMed was not utilised as the search required medical subheadings and therefore the exclusion of unpublished work/thesis, poster presentations and abstracts along with chapters from books may reduce the total number of studies available from which evidence and recommendations can be drawn Conclusions and implications of key findings: An overall recommendation was made that, in the absence of stronger evidence, those involved with organising participation in dance consider the value of specialist medical provision. In addition, due to the low level of evidence reviewed, a call for consensus on injury data collection in dance is made to improve the quality of evidence in dance injury literature.
  • Vitamin D status in professional ballet dancers: winter vs. summer.

    Wolman, Roger; Wyon, Matthew; Koutedakis, Yiannis; Nevill, Alan M; Eastell, Richard; Allen, Nick (Elsevier, 2013-09)
    Objective: Serum 25-hydroxyvitamin D is produced by the exposure of the skin to sunlight. Therefore athletes who train indoors, such as dancers, are vulnerable to vitamin D deficiency. The purpose of the study was to evaluate the serum 25-hydroxyvitamin D status in UK professional dancers during periods of reduced and increased sunlight exposure (i.e., winter vs. summer), and to assess the impact on bone metabolism and risk of injury. Design: Cohort study. Methods: 19 elite classical ballet dancers (age 26±8.86 yr; height 1.66±8.84 m; mass 54.3±10.47 kg) were monitored over a 6 month period for 25-hydroxyvitamin D, PTH and blood serum bone turnover markers (CTX and PINP) along with injury data. Repeated measure ANOVA and Wilcoxon and Chi-square analyses were used and significance was set at p≤0.05. Results: Significant changes were noted between the winter andsummertest dates for 25-hydroxyvitamin D (14.9 ng/ml vs. 23.9 ng/ml; p < 0.001), PTH (38.7 pg/ml vs. 26.3 pg/ml; p < 0.001) and PINP (89.9 ng/ml vs. 67.6 ng/ml; p < 0.01). The oral contraceptive had a significant effect on serum 25-hydroxyvitamin D, PTH and CTX. Soft tissue injuries were significantly lower in summer compared to winter period (winter = 24, summer = 13; p < 0.05). Conclusions: Professional ballerinas characterized by a high incidence of low serum 25-hydroxyvitamin D levels which improve marginally in the summer. These dancers also demonstrate a higher injury incidence in the winter. Oral contraception seems to increase serum 25-hydroxyvitamin D levels and has a positive effect on bone metabolism.
  • Bilateral differences in peak force, power, and maximum plié depth during multiple grande jetés.

    Wyon, Matthew; Harris, Julie; Brown, Derrick; Clark, Frances (Science & Medicine, 2013-03)
    A lateral bias has been previously reported in dance training. The aim of this study was to investigate whether there are any bilateral differences in peak forces, power, and maximum knee flexion during a sequence of three grand jetés and how they relate to leg dominance. A randomised observational design was selected for the study. Volunteers consisted of 20 female dancers in the last year of pre-professional training. All volunteers completed three different tests to determine leg dominance prior to completing a three grande jeté sequence. The lead leg for the jump sequence was randomised. Peak take-off power, relative landing force (BW), and maximum knee flexion angles were measured using a Myotest accelerometer and integrated goniometer. Results indicated that 90% of dancers reported right leg dominance. A significant difference was noted in peak take-off power among the jumps (p<0.01); post hoc test indicated jump 3 was significantly greater than jump 1. Mean maximum take-off knee angles increased over the three-jump sequence with the left leg having a significantly deeper plié than the right (p<0.01). Landing data showed an increase in peak force and a decrease in maximum knee angles across the jump sequence. The present data indicate different bilateral strategies during take-off and landing during grand jetés in female dancers resulting in increased forces during the jumps on the non-dominant side. These differences need to be addressed by incorporating appropriate modifications in training methodology that eliminates the observed bilateral differences.
  • A Bibliographic Review of Medicine and Science Research in DanceSport

    Wyon, Matthew; Riding-McCabe, T; Ambegaonkar, J; Redding, E (Science & Medicine, 2013-06)
    DanceSport is the competitive form of ballroom dancing, and even though it has more participants worldwide than ballet and modern dance, there is less peer-reviewed research. A review was conducted to identify all relevant literature to help researchers and clinicians gain an enhanced understanding of dancesport. Eight databases were searched, with 34 articles found in topics including participation motives, psychology, exercise physiology, fitness training, injuries and injury prevention, biomechanics, menstrual dysfunction, and substance use. Our results indicate that researchers have been inconsistently recording and reporting anthropometric and dancesport data; for example, 31 studies separated participants by gender, 21 included the competition classification of dancers, 19 reported which style of dancesport participants competed in, and 13 described the participants as a dance couple. Common injuries affected the neck, shoulder, spine, knee, lower leg, and foot. Dancesport is in the very heavy to extremely heavy category in energy expenditure (mean heart rate: male 175.2 ± 10.7, female 178.6 ± 8.6 bpm) and utilizes both aerobic and anaerobic energy systems. Alpha-beta and heart rate variability intervention techniques are reported to successfully enhance performance in dancers. Dancesport participants also appear less likely to smoke cigarettes, but have little knowledge about anti-doping rules. During events, professionals danced farther (30 m) and faster (0.3 m/sec) than junior dancers. Female competitors were more likely to be eumenorrheic. Dancesport is a physically and mentally demanding competitive sport, but there is a need to standardize measurements in future studies to allow comparison.

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