Injuries and adolescent ballet dancers: current evidence, epidemiology, and intervention

Abstract

Background: It has been consistently reported in the literature that adolescent dancers have a high injury prevalence. Most injuries are reported as overuse onset and the most affected body region is the lower limb. Growth and maturation have been reported as non-modifiable whereas poor motor performance in power and strength as modifiable risk factors. Methods: A systematic review was conducted to evaluate the association of growth, maturation and overuse injuries in aesthetic sports/disciplines. This was followed by a prospective cross­ sectional study to assess the relationship of injury incidence and primarily countermovement­ jump (CMJ), a valid indicator of motor performance, and secondarily gender differences and maturity status. Three randomized controlled trials (RCT) were conducted to assess 1) the feasibility of a trial in a vocational environment, 2) to conduct power and sample calculation and 3) to assess the effects a neuromuscular injury prevention intervention on countermovement-jump, reactive strength-index (RSI), isometric mid-thigh pull (IMTP) and inter-limb asymmetry (ASYM) in adolescent ballet dancers. Results: The results from the systematic review were inconclusive, due to the heterogeneity of the studies, the research design, and sample size. The cross-sectional study revealed no association between injury incidence and CMJ; and there was no statistically significant gender or maturity status differences in injury incidence. The RCT results demonstrated no statistically significant between-group differences in the mean scores of all the measured parameters. Both groups revealed potentially clinically meaningful difference, between pre and post intervention scores in CMJ and IMTP. No harm was observed, however, less injuries were reported for the intervention group during the duration of the trial. Conclusion: The results of this investigation indicate no association of CMJ and injury incidence, and no gender or maturity status differences in injury incidence were observed. The RCT results indicate no significant between-group post intervention differences in all the assessed parameters. The observations about the potentially clinically meaningful results in power and strength, may warrant further investigation in this area of study. Research in injuries and dance is particularly important, given the high prevalence, suggesting that more work is needed in this field to ameliorate the detrimental effects of injury in this population.