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Prevalence and types of injuries in aerobic dancers.

A sample of 726 aerobic dancers was surveyed by questionnaire to document the prevalence, types, and severity of injuries experienced. Data were gathered on demographics, exercise behavior, and environmental conditions during a 1 week period. Most of the subjects (66%) engaged in aerobic dance classes at least every other day, with a mean exercise time of 195 minutes per week. Twenty-eight percent of the subjects had been exercising 1 to 2 years, and 26% had been exercising 2 years or longer. Forty-nine percent of the subjects reported a history of at least one injury related to aerobic dancing. Most of the injuries were to the shin (24.5%), lower back (12.9%), and ankle (12.2%). Among those subjects injured, 23% reportedly saw a physician because of their injury. The frequency with which subjects exercised was associated with a history of injury. Subjects who exercised fewer than four times per week reported fewer injuries (43%) than those who exercised four times per week (60%) or more (66%). This study is a first step toward providing data to help physicians counsel aerobic dancers regarding injury prevention.

Adolescent↗

Stress fractures in ballet dancers.

We surveyed 54 female dancers in two professional ballet companies. A total of 27 fractures were reported in 17 dancers. Metatarsal fractures were the most common (63%), followed by fractures of the tibia (22%) and spine (7%). Dancers who danced greater than 5 hours per day were significantly more likely to have a stress fracture than those dancing less than 5 hours per day. Dancers in the stress fracture group also had a significantly longer duration of amenorrhea than those in the group with no stress fractures. No significant difference was found between the dancers who had stress fractures and those who did not with regard to any of the other variables examined. These data suggest that prolonged amenorrheic intervals and heavy training schedules may predispose ballet dancers to stress fractures. Of the 17 dancers with stress fractures, only 1 had neither of these risk factors.

Adolescent↗

Degenerative joint disease in female ballet dancers.

The relationship between long-term ballet dancing and eventual arthrosis of the hip, ankle, subtalar, and first metatarsophalangeal joint was examined in 19 former professional female dancers, aged 50 to 70 years. The dancers were compared with pair-matched controls. All 38 women underwent medical history taking, clinical examination, and roentgenography of the joints studied. The roentgenographs were independently judged by two investigators and grouped according to a modified classification of Hermodsson. We found a statistically significant increase in roentgenologic arthrosis of the ankle, subtalar, and first metatarsophalangeal joints in the ballet group compared with the control group. There was no significant difference regarding degenerative changes of the hip joint. However, subjects in the dance group who had evidence of degenerative changes on roentgenographs had no clinical complaints. There was a statistically significant increase in hallux valgus deformity in the ballet group (P < 0.05). The dancers also showed a statistically significant increase in flexion, external rotation, and abduction of the hip joint, dorsal flexion of the first metatarsophalangeal joint, and inversion and eversion of subtalar joint. But the control group had statistically significant increased plantar flexion of the first metatarsophalangeal joint. The most important cause of the statistically significant increase of arthrosis of the ankle and first metatarsophalangeal joints must be explained by repetitive microtrauma.

Aged↗

Pedobarographic and musculoskeletal examination of collegiate dancers in relevé.

Twenty-one collegiate ballet pupils were evaluated via history/questionnaire, musculoskeletal assessment, and pedobarographs, focusing on factors (e.g., alignment of hip, knee, and foot) thought to affect the important and common second-position relevé in dance. In a blinded manner, three observers classified the pedobarographs (obtained by an independent examiner) according to force distribution through the foot. Most dancers bore weight through the toes and transmitted force on both the medial and central metatarsal heads, and some transmitted force through only one of these rays, but none transmitted force through the lateral ray alone. This analysis provides a baseline for future assessment of normal or abnormal dance maneuvers.

Adolescent↗

Anterior tibiotalar impingement syndromes in dancers.

Anterior tibiotalar impingement is caused by extension at the ankle. Repeated impingement causes two symptom-producing and potentially disabling syndromes. The most frequent is impingement exostoses which form on strong feet that offer resistance to impingement. This condition may be compatible with dancing for many years, but if symptoms warrant, surgery is a consideration. The other syndrome is found in young dancers with long, slender, flexible feet. These feet are weak and allow midfoot sag and plantar fascial stretch causing chronic foot strain. Such feet do not tolerate dancing without extensive retraining and surgery is of no help.

Dancing↗

Os trigonum syndrome: a clinical entity in ballet dancers.

Thirteen Swedish National classic ballet dancers were surgically treated for an "os trigonum syndrome."Their main symptom was an impingement pain in the hind foot while actively plantarflexing the ankle during ballet dancing. The surgical procedure included excision of an os trigonum or a prominent lateral posterior process of the talus, together with division of the flexor hallucis tendon sheath if it was thickened. This procedure was safe and resulted in return of the dancers to the same level of ballet dancing within 5 to 10 weeks.

Adolescent↗

Reducing HIV infections at circuit parties: from description to explanation and principles of intervention design.

Circuit parties are weekend-long, erotically charged, drug-prevalent dance events attended by up to 25,000 self-identified gay and bisexual men who socialize and dance nonstop, sometimes for 24 hours or longer. Although these parties started originally as part of the gay community's response to raise HIV/AIDS awareness and to build community and cultural identity, they may have become a site for transmitting HIV across geographical regions and socioeconomic groups of gay and bisexual men. This article reviews the descriptive published studies on circuit parties. The authors use these studies and the literature on drug use and high-risk sexual behavior in gay and bisexual communities, along with sociological and social psychological research, to propose a causal model of why circuit parties may contribute to unsafe sexual practices that increase HIV infection risk. The authors abstract 5 prevention messages relevant to circuit parties and review intervention studies in nonparty settings for insight into how to reduce risky sexual behavior within circuit events. These intervention studies help to identify 5 context-specific groups that can effectively carry the prevention messages. The 5-by-5 matrix represents a first stage in developing a causal model for reducing HIV infections, along with evaluable principles of intervention, at circuit parties.

Bisexuality↗

Long-term recreational gymnastics, estrogen use, and selected risk factors for osteoporotic fractures.

The purpose of this cross-sectional study was to examine whether long-term participation in recreational gymnastics or folk dancing or estrogen replacement therapy (ERT) is associated with mechanically more competent bones and improved muscular strength and body balance. One hundred and seventeen healthy, female postmenopausal recreational gymnasts (mean age 62.1 [SD 4.7] years) and 116 sedentary controls (mean age 61.5 [4.6] years) were enrolled in the study. Bone mineral content (BMC) of the distal radius, femoral neck, and trochanter were measured with dual-energy X-ray absorptiometry. BMC of the midshaft and distal tibia and trabecular density (TrD) of the distal tibia were measured with peripheral computed quantitative tomography. Maximal isometric strength, muscular power, cardiorespiratory fitness, and body balance of the participants were also assessed. The cardiorespiratory fitness, muscular strength, and dynamic balance of the recreational gymnasts and folk dancers combined were significantly better than those of the controls, the average group difference ranging from 7.5% (95% confidence interval 5.0-9.9%) in dynamic balance to 12.8% (6.6-19. 4%) in dynamic muscular power. ERT was not associated with the fitness indicators, muscular power, or balance, but was significantly associated with the BMC at all the measured bone sites, the mean group difference between estrogen users and nonusers ranging from 6.5% (3.7-9.3%) for the tibial shaft to 11.8% (6.4-17. 0%) for the distal radius. Recreational gymnastics, in turn, was significantly associated with higher BMC at the tibia only, the mean group difference being 3.9% (0.9-6.9%) for the tibial shaft and 7.7% (3.7-11.9%) for the distal tibia. Recreational gymnastics was also associated with higher TrD at the distal tibia (5.2%; 1.2-9.2%), whereas estrogen usage did not show such association. The results indicate that ERT seems especially effective in preventing postmenopausal bone loss, whereas recreational gymnastics and folk dancing improve muscular performance and body balance in addition to increased bone mass and bone size in the tibia. All these factors are essential in prevention of fall-related fractures of the elderly.

Absorptiometry, Photon↗

Psychoanalysis, creativity, and hope: forward edge strivings in the life and work of choreographer Paul Taylor.

Psychoanalysis and creativity are not interchangeable enterprises; however, both creativity and psychoanalysis promise the hope of transformation. But hope may be fragile. Healthy aspects of self may hide and diminish hope to protect it against invasion from toxic pathological patterns. Hope may be rekindled by an empathically responsive environment and the reengagement of healthy forward edge strivings. Psychoanalysis illustrates creativity as a conduit for hope. Modern dance choreographer Paul Taylor's 1988 autobiography, Private Domain, describes Taylor's hope and strivings through creative engagement. Unfortunately, when Taylor's body inevitably falters after years of performing, he is unprepared psychologically to cope successfully. Taylor's sense of self begins to fragment and his forward edge strivings to decay. Eventually, Taylor collapses on stage from drug addiction and illness; his performing career crashes to an end. Taylor must search for his forward edge strivings with hope. Psychoanalysis illuminates Taylor's journey to find hope, motivation, meaningful intention, and transformation through creativity and dance-making.

Aspirations, Psychological↗

Prevention of hip and knee injuries in ballet dancers.

Hip problems form about 10% (7.0 to 14.2%) of most published series of ballet injuries. The abnormally large range of external rotation needed for a perfect turnout is primarily due to soft tissue adaptation, more readily achieved in the young dancer. Insufficient range of motion at the hip throws considerable stress on the other lower limb segments. The snapping hip syndrome is common (43.8% of hip problems), with about one-third associated with pain. A tight iliotibial band may contribute to this, and balanced flexibility requires special attention to abductor stretching. The external clicking hip must be distinguished from the internal clicking hip, which is associated with the joint and psoas tendon. Stress fractures of the hip are easily overlooked and, if undetected, they may progress to a complete fracture. Knee problems account for 14.0 to 20% of complaints, and over 50% of these are peri- or retropatellar problems. This includes synovial plica, medial chondromalacia, lateral patella facet syndrome, subluxing patella and the fat pad syndrome. Specific diagnosis leads to specific treatment and the best chance of cure. Mild hyperextension of the knee may be aesthetically desirable, but excessive range leads to symptoms in the posterior capsule and poor control. Young dancers with a tendency to very lax joint structures should be identified early and protected from overstretching. In the author's series, meniscal lesions did not appear to be as big a problem as reported elsewhere in the literature. Ballerinas appear to have less leg strength than other groups of athletes, having only 77% of the weight-predicted norms. The introduction of strength training for male and female dancers may reduce injuries and improve balance, but it requires an intensive educational programme to dispense with the many myths. There are several references to the development of early arthritis but, while relatively common in the foot, symptomatic arthrosis in ballet dancers' hips and knees is not more prevalent than in the general population. The young age at which serious dance training begins, the long and rigorous hours of practice, the thin ballet slipper, dancing en pointe and unusual dietary regimens may all contribute to injury patterns in varying degrees.

Dancing↗

Comparison of two methods of improving dynamic balance of mentally retarded children.

To compare the effectiveness of a creative dance and a movement exploration program in relation to balance performance 26 mildly and moderately mentally retarded boys and girls (ages 8 to 13 years) were randomly assigned to one of the programs. Mean ages of the subjects in the dance and movement exploration groups were 10.5 yr. and 11.1 yr., respectively. Each group received 24 lessons of 30 min. each, in the 8-wk. program. Pre- and posttest distance on six balance-beam tasks and stabilometer performance subjected to multivariate analysis of covariance indicated no significant differences.

Child↗

Self-reports on the Eating Disorder Inventory by female aerobic instructors.

This study examined the possibility of eating disorders in 30 female aerobic dance instructors. All subjects completed a biographical questionnaire and the Eating Disorder Inventory. The results showed that the aerobic instructors yielded scores which were comparable to similarly aged female weight lifters but tended to be lower than those of women distance runners (also of similar age). Interestingly, 23% (n = 7) of the subjects reported a previous history of bulimia and 17% (n = 5) reported a previous history of anorexia. Thus, 40% of the instructors indicated a previous experience with eating disorders. Based on all 30 participants, the mean scores associated with Body Dissatisfaction, Drive for Thinness, Ineffectiveness, and Perfectionism were quite comparable to those previously established for anorexic groups. In addition, a relatively high percentage of the sample yielded scores which were actually greater than mean values associated with anorexia patients on nine of the 11 subscales. Based on these results, a number of the aerobic dance instructors possessed scores suggesting behaviors and attitudes consistent with female athletes whose sports emphasize leanness and comparable to those who have eating disorders.

Adult↗

Associations between turnout and lower extremity injuries in classical ballet dancers.

STUDY DESIGN: Descriptive correlational study. OBJECTIVES: To determine relationships between aspects of turnout and injury history in preprofessional classical ballet dancers, and to determine the clinical utility of various methods used to assess turnout. BACKGROUND: In Australia 50% of professional dancers currently have persistent or recurrent injuries, with 36% of these injuries commencing before 18 years of age (preprofessional level). Overuse or nontraumatic dance injuries are often attributed to faults in technique, with poor turnout and inappropriate compensatory strategies consistently cited as the main cause. METHODS AND MEASURES: Twenty-nine dancers (24 female), aged 15 to 22 years, were recruited from a preprofessional classical ballet program. Measurements were taken of passive and active hip external rotation (ER) range of motion (ROM) in supine, and functional turnout angles in standing. Three turnout variables were derived: active ER lag, compensated turnout, and static-dynamic turnout difference. Injury history over the previous 2 years was ascertained by interview. Pearson product moment and Spearman rank correlation coefficients were used to determine associations between turnout variables and injury history. RESULTS: All dancers reported a history of injury, with 93.1% reporting a history of nontraumatic injuries and 41.4% reporting a history of traumatic injuries. Number and severity of nontraumatic injuries were associated with reduced functional turnout (r or rho>0.38; P<.04), but not with hip ER ROM. Number and severity of traumatic injuries were not associated with turnout. No correlation was found between hip ER ROM and functional turnout. CONCLUSIONS: Functional measures of turnout are more relevant than hip ER ROM to prevalence of nontraumatic dance injuries. Control of turnout in classical ballet dancers should be assessed dynamically and in functional positions.

Adolescent↗

Spectral analysis of adult dancers' sways: sex and interaction vision-proprioception.

In subjects of both sexes with or without dance training, dependence on vision and proprioception for postural control was studied by destabilizing these cues on a free seesaw. Fast Fourier transform processing allowed spectral frequency analysis of the platform sways recorded by an accelerometer. Two frequency bands of the total spectral energy were used: the lower (0 - 2 Hz) and the higher (2 - 20 Hz) frequency bands. Dancers were significantly less dependent on vision but use more proprioception than untrained subjects. Professional dance training appears to shift sensorimotor dominance from vision to proprioception, and this evolution seems more marked for males than females. Female and male dancers had similar dynamic performances, but for males, the better neuromuscular coordination may be associated with biomechanical factors.

Adult↗

Gender and limb differences in healthy elite dancers: passé kinematics.

Symmetry of skill development is emphasized in dance training, and many movements are well learned by both genders. The authors conducted a 2-dimensional kinematic analysis of a complex dance movement, the passé, in 12 healthy professional male and female dancers to determine whether there are differences between genders or limbs during the performance of that task. Only peak hip angular displacement differed in men and women. No differences were found between limbs in any of the dependent variables. Dancers displayed consistent temporal and spatial proximal-to-distal sequencing of movement coordination. Despite an indication of limb preference, as defined by gesture or stance limb, there were no differences in proficiency.

Adolescent↗

Career hazards for the dancer.

Most dance injuries are of the overuse variety. Their gradual onset, coupled with the intense competition for professional positions, often results in injuries being ignored and thus seen late in their course. While treatment of the specific injury is of paramount concern, maintenance of the extremes of flexibility, strength, and conditioning necessary to dance professionally is an equally important treatment element.

Accidents, Occupational↗

Low-energy anterior hip dislocation in a dancer.

In this article, we report the case of a healthy young woman who sustained an anterior hip dislocation while participating in a noncontact activity (ballet dancing). The patient's atraumatic dislocation failed closed reduction secondary to interposition of anterior capsule and rectus femoris muscle. Open reduction using a Smith-Petersen approach was concentric and stable. Postinjury femoral nerve neuropraxia resolved within 6 weeks. At 2-year follow-up, the patient was without complications of the injury-including avascular necrosis and posttraumatic arthritis. She returned to dancing and is now asymptomatic.

Adolescent↗

[Health peculiarities among georgian national ballet dancers].

Dancers performing classical, characteristic and national dances represent one of those activities that cause stress of nervous-muscular and psycho-emotional systems, locomotion apparatus induced by physical efforts. Intensive physical and psycho - emotional stress during the dancing process causes misbalance between physiological possibilities of the body and its capability of prompt adaptation, thus creating conditions for developing pathologies. Among male dancers of Georgian national ballet most frequently occur professional diseases such as: arthrosis and traumatic meniscites of knee joints, arthrosis of talocrural joint, epicondylitis of shoulder bone, chronic lumboiliac sacriplex radiculitis, and osteochondrosis of cervical part of the spine; among female dancers osteochodrosis of neck and chronic lumboiliac radiculitis were mainly observed. Increased level of neurasthenic syndrome among dancers of Georgian national ballet occurred in the form of hypertonic type vegetative-vascular dystonia. That stemmed from peculiarities of dancers work and permits to ascribe this pathology to the group of work-related diseases. To this group should be ascribed as well podagra arthritis of a foot stemmed from: a) systematic micro-traumas resulting in dystrophic changes and b) special regimen of nutrition.

Adult↗