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Total and regional bone mineral content in Spanish professional ballet dancers.

Total body bone mineral content (TBBMC) and regional bone mineral content (BMC) was measured in the members of the Spanish National Dance Company (15 female, mean age 25.1 +/- 3.8 years, and 15 male, mean age 28.2 +/- 2.1 years) and in 30 controls (15 women, mean age 26.1 +/- 1.8 years, and 15 men, mean age 28.0 +/- 1.5 years). Ca, P, and Mg intake were greater in the group of ballet dancers than in controls analysis of variance (ANOVA, all P < 0.0001). BMC was similar in the group of ballet dancers and controls except in the trunk without pelvis (P < 0.001). Both male and female dancers weighed less than controls (P < 0.05). The BMC of the male dancers was less than that of male controls only in the trunk (P < 0.05) and in the trunk without pelvis (P < 0.005); BMC was lower in female dancers than in female controls only in the arms and in the trunk without pelvis (P < 0.05 and P < 0.005, respectively). TBBMC, adjusted for weight and age, was correlated partially with caloric intake (kcal/day) and with Ca, P, Mg, and Zn intake (g/day), and yielded significant differences between the dancers and controls only in P intake (P < 0.01), and between male dancers and male controls only in caloric intake and in Ca, P, and Zn intake (all P < 0.01, except for Ca, P < 0.05). The lower trunk bone mass observed in the female dancers is a risk factor for eventual osteoporosis.

Absorptiometry, Photon↗

Eating behavior of ballet dancers.

Ballet dancers are frequently regarded as having a higher risk of developing eating disorders (ED). This paper describes the eating habits and prevalence of ED in a group of female students from a dance academy in Rome, Italy. Participants were assessed with an array of measures conventionally employed (usually singly) in epidemiological studies of ED, namely: an anthropometrical-nutritional evaluation, the EAT, EDI, and BUT questionnaires, and the EDE interview. The 160 students who agreed to participate were evaluated anthropometrically, nutritionally and psychometrically and 83 underwent the EDE structured interview. Their calorie intake was insufficient in all age groups in terms of the nutritional standards required by their daily physical activity. EAT, EDI and BUT enhanced concerns about dieting, food intake control and body image. The significance of the correlations between calorie intake and the EAT Dieting and the EDI Perfectionism and Interceptive Awareness scores increased in function of age. Food, weight and body image concerns increased with age and length of time in the ballet environment The reduced calorie intake was not necessarily linked to the presence of psychopathological signs.

Adolescent↗

The injury panorama in a Swedish professional ballet company.

We performed a combined retro- and prospective study of injuries in a Swedish professional, classical ballet company during 5 consecutive years. There were 390 injuries incurred by 98 dancers over a 5-year period, i.e., 0.6 injuries/1000 dance hours. Most injuries were considered to be due to overuse. The median sick leave was 2.3 weeks per injury. The foot and ankle region is vulnerable in classical ballet dancers, and overuse injuries can result in long periods of sick leave. Of the dancers employed for more than 1 year 95% were suffered injuries during the study period. We found considerable differences in the injury profile between male and female and between younger and older dancers. Male dancers suffered more frequently from acute injuries to the knee joint. Traumatic injuries were seen most frequently in male soloists. Female dancers more often suffered overuse injuries, especially to the foot and ankle region. The younger dancers more often suffered traumatic injuries, for example, ankle sprain, and also stress fractures.

Adolescent↗

Deaths associated with MBDB misuse.

The use of phenethylamines in the dance scene is now well established. Apart from amphetamine, the commonest phenethylamine encountered in clinical and forensic settings is 3,4-methylenedioxymethamphetamine (MDMA) commonly known as ecstasy. Other phenethylamines, which have similar effects are encountered, such as 3,4-methylenedioxyethylamphetamine (MDEA) and their use has resulted in death. We report two deaths associated with another less commonly encountered member of the group, N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MBDB), also known as Methyl-J and Eden.

3,4-Methylenedioxyamphetamine↗

Echocardiographic mitral valve prolapse in ballet dancers: a function of leanness.

To determine the prevalence of mitral valve prolapse in ballet dancers by echocardiography and to establish which anthropometric measurements best predict the presence of mitral valve prolapse, we compared 44 professional dancers (22 men and 22 women) with 52 controls (24 men and 28 women). Forty-eight percent (21 of 44) of dancers had echocardiographic mitral valve prolapse compared with 10% (5 of 52) of controls (p less than 0.01). The dancers weighed less than the controls and had significantly smaller bony diameters and body circumferences. However, only ponderal index was predictive of mitral valve prolapse in both dancers and controls. Thus, echocardiographic mitral valve prolapse is associated with low body weight relative to height and neither to ballet dancing nor to a distinct body habitus. Echocardiographic mitral valve prolapse may represent a normal variant in the majority of asymptomatic, thin subjects without auscultatory findings.

Adult↗

Suprascapular nerve lesion as an occupational neuropathy in a semiprofessional dancer.

A 25-year-old semi-professional dancer developed painless, isolated weakness of external rotation of the right arm. Physical examination was otherwise normal. Electromyography showed selective partial denervation of the infraspinatus muscle. Stimulation of the suprascapular nerve at Erb's point demonstrated delayed conduction to the infraspinatus muscle. Clinical and electrophysiological findings implicated a distal lesion of the suprascapular nerve. Almost complete recovery of muscle function after 4 months of suspending the training program of Latin dances supports the view that the nerve injury occurred as an occupational neuropathy. It is assumed that repetitive, forceful movements of the arm with external rotation and abduction had induced compression of the nerve at the spinoglenoid notch.

Adult↗

Breakdancer's thumb--partial rupture of the ulnar collateral ligament with a fracture of the proximal phalanx of the thumb.

Breakdancing is an acrobatic dance that involves spinning on various parts of the body including the head, dorsal spine and hand. Three cases are reported of partial rupture of the ulnar collateral ligament (UCL) of the thumb, associated with a fracture of the base of the proximal phalanx which occurred as a result of torsional forces applied to the abducted and hyperextended thumb. It appears to be a distinct clinical entity. In all cases, open reduction was required and led to excellent functional recovery.

Adolescent↗

The implications of anorexia nervosa in a ballet school.

Features important in the diagnosis of anorexia nervosa were common in a sample of 100 ballet students. Defining a "case" of anorexia nervosa proved difficult. Follow-up one year later showed that seven girls who were designated "possible cases" had continued to dance and were considerably improved in their physical status without medical intervention.

Adolescent↗

Medical needs of performing arts students.

A questionnaire was administered to 71 college students enrolled in dance, drama, and musical theater programs to assess health care problems, injuries, risk-taking behaviors, and sources of care. Many desired help with depression, fatigue, and chronic bone or joint pain, although 37% identified no regular physician. Thirty-nine students reported 87 injuries involving the back, foot, ankle, and knee; 12% sustained injuries at least monthly; and 72% of injuries occurred in class. The incidence of eating disorders appears to be low, as assessed by indirect measures such as body weight, oligomenorrhea, diet pill or laxative use, and scores on a body image index. The 30-day prevalence of tobacco use was 26%; marijuana, 11%; and alcohol, 71%. This survey suggests that performing arts students have important unmet health care needs.

Adolescent↗

Aerobic exercise, subjective health and psychological well-being within age and gender subgroups.

This research examines relationships between different forms of aerobic exercise (swim, walk, jog, dance) and two measures of health: subjective health and psychological well-being. We hypothesize that the relationship between aerobic exercise and subjective health/well-being will be notably stronger for older than younger persons and females than males. This prediction is based on Homans' exchange theory of investments and rewards. Since social norms concerning aerobic exercise are likely to be weaker among older (than younger) persons and among women than men, older persons and women who do exercise are making special investments and should expect greater rewards (good health). The concept of 'exercise norms' implies social comparisons with others. Accordingly, age comparative data were analyzed to see if older persons who exercise see themselves as more active than their age peers than do younger persons. Data come from a national probability sample of 3025 adults (National Survey of Personal Health Practices and Consequences). As predicted, exercise was much more strongly related to subjective health and well-being among older than younger respondents. In the main, the gender hypothesis was not supported.

Adult↗

Multi-joint coordination in ballet dancers.

In upright posture, we analyzed the multi-joint coordination during drawing ellipses with the foot in a horizontal plane in classical ballet dancers (Elite) and gymnasts who had no dance training (Novice). In both groups, the stability of the head and the trunk was similar. Furthermore, a comparatively simple synergy inter-relating the movements in the hip, knee and ankle joints, was revealed by the kinematic analysis. However, novices made larger errors in the eccentricity and orientation of ellipses than ballet dancers. Ankle angular excursions were smaller in novices than in dancers whereas hip angular excursions were larger. This study illustrates some rules underlying the ability of the nervous system to integrate multiple degrees of freedom of the body to master body balance while producing complex leg movement trajectories. This study offers a dynamical approach of the problem of redundancy.

Anthropometry↗

Contribution of neck proprioception to subjective vertical perception among experts in physical activities and untrained women.

The purpose of this study was to investigate the influence of physical training on subjective vertical perception with the different head positions in order to explore the involving of the neck proprioception. Visual field dependence was assessed using a rod and frame test on women practising judo or dance (international level) or no specific physical activity. Tests were performed with head upright or tilted head to disturb the Z-axis egocentric reference frame. A cluster analysis determined the distribution of visual field independent (VFI) and visual field dependent (VFD) participants. The first result showed no head position effect for the group of judoists (6 degrees +/-5 degrees ; 7 degrees +/-5 degrees ) and dancers (4 degrees +/-2 degrees ; 5 degrees +/-3 degrees ) but a significant effect for untrained participants (5 degrees +/-2 degrees ; 7 degrees +/-3 degrees ): their visual vertical perception was more disturbed with tilted head than with head upright. A variability exists among experts and would necessitate further analysis. The second result showed no influence of the head position for all VFD participants, whereas for VFI participants significant difference between upright and tilted head appeared both for experts (3 degrees +/-1 degrees ; 4 degrees +/-2 degrees ) and untrained participants (3 degrees +/-1 degrees ; 5 degrees +/-2 degrees ). In this research, whatever physical activity level, the VFI participants would mainly use the Z-axis reference frame and rely on proprioceptive information. VFD among experts and VFI among untrained participants suggest that proprioceptive reference frame of neck may not provide alone according the groups an appropriate postural control.

Adult↗

Common musculoskeletal problems in the performing artist.

In this chapter we touched on a wide variety of unique musculoskeletal conditions in the musician and dancer. We outlined generalized methods of evaluation that stress the importance of the interdisciplinary approach in this highly specialized patient population and stressed the importance of specific involvement of the music or dance instructor in evaluation and management. We sought to emphasize the need to refer to specialized care early when in doubt of diagnosis or when usual first-line treatments fail. We gave examples of specific injury patterns common in these subgroups and suggestions for early management. Finally, we described some general principals for prevention of musculoskeletal injury in this group. A physician treating the performing artist must always keep in mind that in this unique patient population, their occupation is not only a means of earning a living, it is their passion. Artists make great sacrifice both physically and mentally to bring the world such immeasurable beauty. It is our responsibility to care for them in the most comprehensive and compassionate manner possible while informing them as honestly as possible about their treatment options.

Biomechanical Phenomena↗

Effects of a health-promotion program on cardiovascular risk factors, health behaviors, and life satisfaction in institutionalized elderly women.

This study applied a 3-month health-promotion program to institutionalized elderly people to examine changes in cardiovascular risk factors, health behaviors, and life satisfaction. Twenty-one elderly women with an average age of 77 years participated in the program consisting of cardiovascular risk assessments, Korean traditional dance movements (KTDMs), and health education/counseling. Paired t-tests revealed that the participants exhibited significant reductions in total risk score, improvements in health behaviors and life satisfaction at the end of the program. However, the positive effects tend to decrease at 3 months after the program ended. In conclusion, the health-promotion program using KTDM exercises was safely applicable and beneficial to institutionalized elderly women.

Aged↗

Bone mineral density in professional ballet dancers.

We studied the effect of physical training on the bone mineral content and soft tissue composition in 42 professional ballet dancers (17 men and 25 women). Twenty-eight of them were still actively performing and 14 had retired from professional dancing. Forty-two healthy age- and sex-matched volunteers served as controls. The bone mineral density (BMD) (g/cm2) in total body, spine, hip, arms, legs, and the proximal tibia metaphysis was measured with a Lunar DPX apparatus and the BMD of the distal forearm was measured with single-photon absorptiometry (SPA). Twelve of the now retired dancers had earlier been measured with SPA in the tibia condyle during their active career in 1975. There was no significant difference in BMD values between dancers and controls with the exception of a lower BMD in the head of the male dancers and a lower BMD in the arms of female dancers. After correcting for difference in body mass index (BMI), using analysis of covariance we found significant higher BMD in the lower extremities of female dancers and in the hip of male dancers. No correlation was found between the SPA measurements from 1975 and the corresponding measurements 15 years later. The dancers were on average 9 kg lighter but of the same height as the controls. The dancers had lower body mass index and fat content but their lean body mass was the same as the controls.

Absorptiometry, Photon↗

Multiple subdural hematomas associated with breakdancing.

A 17-year-old, previously healthy, male breakdancer presented with a three-month history of crescendo headache and newly identified papilledema. The patient was found to have four separate, unilateral extracranial collections. At surgery, three were subdural hematomas, and one was a probable arachnoid cyst containing a hematoma. These were removed, and the patient made an uneventful recovery with no neurosurgical sequelae. The possibility of serious head injury must be considered when evaluating headache in youngsters who engage in this new and apparently popular dance form.

Adolescent↗

Visual contribution to self-induced body sway frequencies and visual perception of male professional dancers.

We studied the degree of dependence on vision, for postural control and for perception, among male adult dancers and untrained subjects. First, body sways were analyzed on a free seesaw platform. Fast Fourier transform processing allowed spectral frequency analysis of the platform sways recorded by an accelerometer. Secondly, a visual dependence test, the rod and frame test (RFT) was used. Professional dancers were significantly more stable and less dependent on vision for postural control and for perception than untrained subjects. Presumably, professional dance training strengthens the accuracy of proprioceptive inputs and shifts sensorimotor dominance from vision to proprioception. For the dancers, there was interaction between the RFT visual dependence and the visual control of posture: the less visual-dependent they were for the RFT, the more stable they were in dynamic balance conditions.

Adolescent↗

Balance training to maintain mobility and prevent disability.

Balance is important for the safe performance of many activities that allow older people to remain independent in their community. Housework, cooking, shopping, and travel generally require the ability to stand, reach, turn, and bend down and pick up objects from the floor. Multiple interacting factors are implicated in the deterioration of balance. Several strategies have been tested to improve balance and reduce falls. Home-based individualized training that attempted to improve identified deficits reduced falls and improved physical performance and stabilized or reduced disability. Home-based exercise programs that included low-intensity strength and balance training have improved balance and reduced fall rates by about 40% compared to controls. Class-based exercise programs in senior centers or exercise centers have improved balance and physical performance, and some have reduced falls. Programs such as tai chi and social dance look promising and should be further investigated.

Accidental Falls↗