Medical problems of performing artists最新文献

Objective: It is expected that in classical ballet dancers would be able to execute all the techniques symmetrically from the right as well as from the left side of the body. This study aimed to evaluate the symmetry of kinematic parameters of hip joints, knee joints, and foot progression angle of the left and right lower extremities (LE) in five classical ballet positions, as well as the symmetry of active and passive turnout and range of passive hip external rotation.

Methods: The experimental testing involved 12 female pre-professional ballet dancers. Three measurements of range of motion, made using a standard goniometer, were carried out to characterize the study group. Kinematic data of left and right LE in the five classical ballet positions were recorded using a motion capture system.

Results: The comparisons revealed significantly lower (p < 0.01) hip external rotation values by 9.8% (1st position), 5.4% (2nd position), and 8.5-11.8% (3rd position) for the right LE than the left LE. Moreover for 3rd, 4th and 5th positions, there was significantly higher (p < 0.05) hip external rotation values by 7.0%-27.2% in the back LE than the front LE. In 4th position there was asymmetry in foot progression angle with significantly lower values (p < 0.01) by 5.3% in the front LE (left) than the back LE (right). In case of goniometric measurements, the results showed significantly higher (p < 0.05) passive hip external rotation values by 10.8% for the right LE than the left LE.

Conclusion: The perfect ballet symmetry pursued by dancers is not in fact so ideal. The most astonishing result was the existence of statistically significant differences in hip external rotation in the case of the 1st and 2nd positions.

Objective: Low back pain (LBP) is relatively common among the musician population. Few studies have looked at the usefulness of a core stability exercise program in musicians suffering from LBP. The aim of this study was to investigate the effectiveness of a core stability exercise program on pain and improvement of function in musicians with LBP.

Methods: A total of 41 university-level instrumental musicians with nonspecific LBP who played piano, violin, or cello were randomly allocated to one of two groups in a randomized controlled trial. One person from the control group was lost to follow-up. Thus, 40 participants (23 females and 17 males) completed the study. The intervention group received education and a 12-week core stability exercise program. The control group only received an educational brochure. A visual analogue scale (VAS) and the Oswestry Disability Index (ODI) were used to determine the severity of pain and functional status, respectively. Data were collected by an independent, blinded evaluator at baseline and at 12 and 24 weeks after baseline.

Results: The intervention group showed a significant improvement in pain severity on the VAS and functional status on the ODI during all times of follow up, whereas the scores of pain and function worsened in the control group at 24 weeks. Between-group analysis showed significant difference in pain intensity at both weeks 12 and 24 of follow-up. However, for functional status, the difference was only significant after 12 weeks.

Conclusions: A structured core stability exercise program supplemented with an educational brochure was effective to manage LBP in musicians.

Background: Foot and ankle injuries are the most prevalent injuries in dance. The single leg heel-rise (SLHR) test is a simple tool to assess muscular endurance of the plantar flexors of the foot and is an increasingly popular manual muscle test in various areas of dance. Although the SLHR test has shown high reliability and validity in the medical field, no uniform description of this test exists in dance.

Objective: This systematic review aimed to identify parameters, outcome measures, purposes, and existing normative values of the SLHR test in the dance field.

Methods: Following the PRISMA guidelines, the electronic databases Scopus, PubMed, SPORTDiscus, EMBASE, CINAHL, and Cochrane were searched using a predefined search strategy up to June 2022. Studies were included if they reported screening, testing, or evaluation of either muscular endurance or strength of the calf muscle-tendon unit (MUT) in dancers using the SLHR test. The methodological quality of the studies was evaluated using a modified version of the Downs and Black Quality Index.

Results: A total of 180 studies were identified. Twelve studies comprising a total of 427 dancers met the inclusion criteria. Key testing parameters of the SLHR test varied widely or were not reported. The average quality rating of the reviewed studies was 12.9 (range 8 to 17) out of a possible 20 points.

Discussion: Although commonly used in test batteries, there are no standardized parameters of the SLHR test used in the dance field. Therefore, no generally applicable normative values could be established.

Conclusion: Key parameters such as the precise execution of the heel rises should be reported in testing protocols. For the SLHR test to be a useful tool in dance, further research on the influence of dance style, age, and injuries to the calf MTU on this test is needed.

Objective: The purpose of this study was to compare the impact of playing brass and wind instruments in seated versus standing positions on cardiovascular parameters in musicians. We hypothesized that heart rate (HR) and blood pressure (BP) would be higher while playing compared to resting, and would be higher in standing compared to seated positions.

Methods: Ten musicians completed two study visits. In both, resting, supine HR and BP were recorded, followed by 30 minutes of playing. In one visit, participants played seated, and in the other, played while standing. The order of these positions was randomized. BP and HR were recorded every 5 minutes during playing.

Results: Systolic BP was not affected by playing (p = 0.09, eta2 = 0.046) or position (p = 0.35, eta2 = 0.024). Diastolic BP increased while playing (p < 0.0001, eta2 = 0.32), but did not differ between positions (p = 0.21, eta2 = 0.03). Mean arterial pressure (MAP) increased while playing (p < 0.0001, eta2 = 0.25), but did not differ between positions (p = 0.68, eta2 = 0.03). There was a significant time X position interaction for HR (p = 0.0001, eta2 = 0.037). Simple main effects analysis revealed that HR was higher while playing in the standing compared to the seated position at all but one time point.

Conclusion: Playing brass and wind instruments increases diastolic BP and MAP, regardless of playing position, while playing in the standing position induces a higher HR compared to the seated position.

The majority of current research on dance injuries has been on ballet, leaving a void in recent data on musculoskeletal injuries in Indian classical [IC] dance. The prevalence of injuries among IC dancers remains unclear, stressing the importance of injury epidemiology research for improved diagnosis, treatment, prevention, and injury burden reduction. Through a thorough examination of published literature, this study sought to critically evaluate existing research on the epidemiology of musculoskeletal pain and injury in IC dancers. Using Google Scholar and PubMed, a systematic evaluation of the online literature published in English was carried out from inception up to December 31, 2021 following PRISMA guidelines. For studies estimating injury prevalence, the Joanna Briggs Institute Prevalence Critical Appraisal Tool and the Risk of Bias Tool (RoBT) were used to evaluate the studies' quality. Of 3,917 studies identified, 6 studies, all cross-sectional, of low quality, with a high risk of bias, and featuring young Bharatanatyam and Kathak dancers, were determined to be admissible. Because of the studies' heterogeneity, severe study limitations, and methodological variability, a meta-analysis could not be carried out. The evidence from the current review is severely constrained, lacking generalizability to IC dancers as a whole and Bharatanatyam in particular. Since injury epidemiology is essential to the whole injury-prevention puzzle, there is a need for standardization in future research, particularly with active and prospective injury surveillance, injury assessment, and injury reporting.

Aims: Low back pain (LBP) is a common health problem in pre-professional dancers which could hamper the dancers' professional career. However, pre-professional dancers are not often studied, although they may have their own pain perceptions and coping strategies towards LBP. Considering the biopsychosocial nature of LBP, it is important to increase the understanding of these perceptions and coping strategies. The aim of this qualitative research study was to explore the dancers' perceptions about LBP and their coping strategies when they suffered from LBP.

Methods: Eighteen pre-professional dancers with and without LBP from different dance schools in Belgium were included in this study. Participants were invited for an in-depth online video interview. These in-depth interviews were based on a topic list. Afterwards, the interview transcripts were analyzed thematically.

Results: Two primary themes emerged from the data: 1) perceptions of LBP and 2) coping strategies which dancers applied when they suffered from LBP. The perceptions about LBP were related to two different themes: "it's all about the body" and "it's all about the psychosocial and contextual factors." In addition, the coping strategies were divided into "active coping strategies" and "passive coping strategies," whereas the most popular coping strategies were stretching exercises and passive coping strategies such as massages or heating cream.

Conclusion: Although LBP has clearly been shown to be a biopsychosocial phenomenon, this qualitative study showed that dancers mainly considered biomedical factors as contributing factors to LBP. Additionally, instead of relying on coping strategies aimed at directly improving pain or trying to treat LBP on the basis of a single-cause diagnosis, it is important to consider the biopsychosocial origin of LBP in the management plans.

Objective: This systematic review synthesizes the evidence of various interventions aiming to prevent muscu¬loskeletal complaints in professional musicians.

Methods: This study comprises a systematic review according to PRISMA guidelines. A database search was performed in Cochrane, Embase, and PubMed on 13 September 2022 without time and language restrictions. The search consisted of the following groups of keywords: preventive measures AND musculoskeletal AND musicians. Risk of bias was assessed with the PEDro and MINORs criteria. Two reviewers independently selected and assessed the quality of the studies.

Results: A total of 1,831 articles were screened and 20 articles were included in this review. There is a wide range of interventions aiming to reduce musculoskeletal complaints in musicians. Among the studied programs were interventions focused on strength, cardiovascular and general fitness, flexibility as well as educational interventions and combinations of these. On average, scientific quality was good, moderate, and low for randomized controlled trials (RCTs), comparative studies, and non-comparative studies, respectively. A significant beneficial effect of the evaluated intervention on either playing-related musculoskeletal disorders (PRMD) frequency or severity or (playing-related) pain frequency and intensity was reported in at least 12 of the 20 studies. In particular, interventions with a strength training program reported a beneficial effect on PRMD frequency and severity as well as pain intensity and interference on the short-term.

Conclusion: This systematic review highlights the heterogeneity in interventions aiming to prevent musculoskeletal complaints in musicians. Strength training might have a positive short-term effect on reducing musculoskeletal complaints. There is a need for further research to improve the quality of evidence as well as long-term outcomes of injury prevention programs.

Objective: There are no universally accepted requirements or uniform protocols to determine when dancers can safely commence dancing en pointe (shod relevé). The purpose of this study was to examine dancer-specific biomechanics of adolescent pointe dancers and explore factors that may help determine pointe readiness.

Methods: Dancers (n=26; median age 14 yrs [IQR=13-16]) were stratified into two groups based on the ability to stand on the pointe shoe box as per a plumb line (Group 1: on the box; Group 2: not on the box) during parallel, shod relevé. Measurements included unshod weight-bearing range of motion (ROM) of ankle plantarflexion (PF) and first metatarsophalangeal (MTP) extension and shod posture assessment during first position elevé (rising into relevé with turned out, straight legs). Qualisys 3D motion capture and AMTITM force plates recorded dancers performing 10-15 repetitions of first position elevé. Comparison of three kinematic and three kinetic variables aimed to describe group differences during unshod and shod conditions. Wilcoxon signed-rank test assumed no difference between groups with a Bonferroni correction (p<0.0083).

Results: During unshod parallel relevé, ROM was different between groups for first MTP extension (deg; MedGroup1: 90°, IQR 80°-90°; MedGroup 2: 70°, IQR: 70°-80°, p<0.0001) but no statistical difference in ankle PF (deg; p=0.0098). There were no differences in C7 displacement (m; p=0.5055), ankle PF moment (p=0.1484), or hip mediolateral and anteroposterior moments (p=0.8785 and 0.8785, respectively) during shod first position relevé, indicating that both groups tend to engage the same dominant muscle groups (trunk extensors, ankle dorsiflexors, hip flexors, and hip abductors) during elevé.

Conclusion: Dancers in Group 1 demonstrated greater first MTP extension during unshod relevé compared to dancers in Group 2. Weight-bearing ROM could be a valuable tool in predicting pointe readiness of adolescent ballet dancers.

Objective: In professional dance, the injury rate is extremely high and dancers have a great chance to experience at least one injury during their careers. Since the #metoo campaign, many abuse cases showed up in the dance industry, resulting in media coverage. Results indicate that dancers had a significantly higher distribution of post-traumatic stress disorder (PTSD) compared to the broad population. In this study, we investigate pathological dissociation, quantify chronic musculoskeletal conditions and evaluate abusive experiences.

Methods: Questionnaire-based dataset filled out online by Hungarian professional dancers (n = 168). The statistical analysis contains descriptive results, risk assessment, Kaplan Meier curve, and hazard ratios.

Result: Dancers scored in the pathological dissociation values, reported several cases of emotional and physical abuse, and were represented by elevated chronic musculoskeletal conditions. We found a statistically significant relationship between abusive experiences and musculoskeletal conditions, so as with dissociation.

Conclusion: We conclude that emotional abuse might be one of the factors in a multifactorial model that plays a role in the pathomechanism of chronic pain, inflammation, and tendinopathy. It is important to raise awareness about the importance of emotional factors of pedagogy and the working atmosphere among professional dancers since it might have a role in higher injury rates.

Aims: In classical ballet, dancers may wear flat shoes and pointe shoes. To consider the kinematic changes between flat shoes and pointe shoes to prevent injuries, it is essential to focus on the fundamental ballet movement of standing on pointe. This study aimed to clarify the differences in the center of pressure (COP) displacement and lower limb muscle activity during the descending phase of a relevé when wearing pointe shoes versus flat shoes.

Methods: Ten amateur ballet dancers volunteered for this study and performed a reléve wearing flat shoes and pointe shoes. We measured the COP displacement by using a footplate and electromyographies of the tibialis anterior, soleus, lateral gastrocnemius, and peroneus longus muscles during the relevé descending phase. These data were compared using a paired t-test or Wilcoxon signed-rank sum test.

Results: The COP significantly shifted to the lateral side when dancers were wearing pointe shoes compared to wearing flat shoes (p<0.05). The muscle activity of the tibialis anterior and soleus muscles was significantly higher by 5.7% and 5.3%, respectively, when ballet dancers were wearing pointe shoes compared to flat shoes (p<0.05). However, there were no differences in both lateral gastrocnemius and peroneus longus.

Conclusion: Greater muscle activities in the tibialis anterior and soleus muscles when wearing pointe shoes than when wearing flat shoes were associated with a larger lateral displacement of the COP. To control the COP displacement during the descending phase of a relevé, the muscle activity of the peroneus longus, which is antagonist of tibialis anterior muscle, and soleus muscles should be increased.