Medical problems of performing artists最新文献

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.

Purpose: Musicians are labelled 'fine motor athletes' due to the significant demands of practice and performance. In response, sports medical concepts and expertise have been adapted and mobilized to address musicians' health considerations. However, understanding distinct differences between the sports and performing arts medical contexts is critical. Mismanagement of fatigue and acute fatigability are identified as key risk factors for deleterious symptoms and injuries in musicians. Acute fatigability in athletes and musicians have been assumed to occur similarly, although this has yet to be empirically demonstrated. This study aimed to evaluate acute muscular performance fatigability during piano performance of varied intensities.

Methods: Fourteen university pianists attended a single experimental session and performed three pieces of randomly ordered repertoire for 10 minutes each. Repertoire were self-selected to be physically easy (rating of perceived exertion [RPE] 9/20), somewhat hard (RPE 13/20), or hard (RPE 17/20). At baseline, after each repertoire performance, and following a concluding 10-minute silent sitting period, participants completed maximum voluntary contraction (MVC) grip and shoulder strength tests. Surface electromyographic (EMG) data were obtained from bilateral upper trapezius and forearm flexor and extensor muscles. Data were analyzed using uni- and multivariate repeated measures analyses of variance (ANOVAs).

Results: No evidence of muscular performance fatigability was found in study pianists at any intensity. Mean EMG amplitude and average median EMG frequency did not significantly vary during any repertoire performances or MVC tests (F≤1.72; p>0.09). Additionally, no changes in force or EMG parameters were found during any MVC tests (F≤1.19; p>0.31).

Conclusions: The absence of muscular performance fatigability during even the most intense piano performances suggests substantially differing mechanisms of fatigability and perceived exertion in pianists versus those commonly seen in sport athletes. Further research is needed to understand the mechanisms of acute fatigability in musicians and develop musician-specific management strategies.

Aims: Pain catastrophizing is characterized by a set of negative emotional and cognitive processes in response to pain, with a tendency to focus inordinately on the painful sensation, exaggerate the damage, and perceive feelings of helplessness. It is a psychological factor that can be treated to help people more effectively cope with pain. In this cross-sectional study, we explored the relationship between self-reported injuries, resilient behavior, and pain catastrophizing in dance students, with more than 3 years of study in public conservatories or private academies.

Methods: A sample of 147 dance students participated, 75.5% of whom were female with a mean age of 28.34 yrs (SD 11.42). Pain catastrophizing was assessed using the Pain Catastrophizing Scale, and resilience was assessed using the Resilience Scale.

Results: Students in the high resilience category reported lower scores on rumination and magnification, with a marginal difference in total catastrophizing and no difference in helplessness. Those who reported having suffered injuries during the last 3 years showed higher scores in total catastrophizing, rumination, and magnification, but not in helplessness. Those who reported mild injuries showed differences in pain catastrophizing, rumination, and magnification, while those with moderate and severe/very severe injuries only showed differences in magnification.

Conclusion: The individual nature of pain perception and coping strategies suggests that pain catastrophizing may be considered before dance performance and in those dancers who do not recover as expected after injury.

Background: Disordered eating (DE) behaviors are relatively common among high-level dancers, especially in classical ballet. At the same time, interventions aimed at reducing DE behaviors in this population are scarce.

Methods: An 8-week exploratory preventive intervention for DE behaviors was carried out in a high-level ballet school for 40 teenagers aged 12-15 years (77.5% female). Both risk factors (perfectionism) and potentially protective factors (self-esteem, self-compassion) for the development of DE behaviors were considered. The intervention was created specifically for this study and consisted of five cognitive behavior therapy (CBT) workshops and four nutrition workshops. Additional components included newsletters for pupils and educational sessions and social media interactions with staff and parents. The intervention comprised two phases (control and intervention periods), with students acting as their own controls. Standardized questionnaires were completed before and after both phases.

Results: Questionnaire results did not indicate any changes in reported perfectionism, self-esteem, or self-compassion, nor were symptoms of DE affected during either the control or intervention periods.

Conclusions: The intervention did not yield any discernible impact. However, it was affected by the onset of the COVID-19 pandemic, which limits our ability to draw conclusions about intervention effectiveness. Evaluations with pupils offer several considerations for future improvements.

Aims: To analyze headache and pain in the mandibular region as well as the self-perception of fatigue, difficulty and level of performance during instrumental practice when using a face mask. To analyze their influence in relation to the duration of practice.

Methods: Observational study through the completion of an online questionnaire among students and teachers in public conservatories in Spain.

Results: In 552 respondents (435 students, 117 teachers), the incidence of headache was 28.6%, being higher in musicians who used the face mask. Regarding jaw pain, 12.5% indicated that their pain increased since its use. However, the differences of pain in both regions and face mask use were not statistically significant. Nearly 40% of the participants indicated an increase in fatigue, tiredness and lowering of performance than before using the mask. Moreover, this percentage was between 66-74% when we analyzed the musicians who use it when playing, obtaining p<0.001 in all 3 variables. As for the duration of rehearsals, the only difference found is between jaw pain and hours/week of practice (p=0.036).

Conclusion: The use of the face mask significantly affected the self-perception of fatigue, as well as the difficulty and performance of instrumental practice, but was not related to the occurrence of headache and jaw pain in the musicians.