CC BY-NC-ND 4.0 · Int J Sports Med 2023; 44(02): 108-116
DOI: 10.1055/a-1930-5376
Review

The Efficacy of Physical Fitness Training on Dance Injury: A Systematic Review

Yanan Dang
1   School of Sport, University of Wolverhampton, Walsall, United Kingdom of Great Britain and Northern Ireland
2   Faculty of Humanities, Beijing Dance Academy, China
,
Ruoling Chen
3   School of Health, University of Wolverhampton Faculty of Education Health and Wellbeing, Walsall, United Kingdom of Great Britain and Northern Ireland
,
Yannis Koutedakis
4   Sport Sciences, University of Thessaly, Trikala, Greece
,
Matthew Alexander Wyon
1   School of Sport, University of Wolverhampton, Walsall, United Kingdom of Great Britain and Northern Ireland
5   National Institute of Dance Medicine and Science, Birmingham, United Kingdom of Great Britain and Northern Ireland
› Author Affiliations
Funding This work was supported by the China Scholarship Council for their financial contribution (YD.).

Abstract

Greater levels of physical fitness have been linked to improved dance performance and decreased injury incidence. The aim was to review the efficacy of physical fitness training on dance injury. The electronic databases CINAHL, Cochrane Library, PubMed, Web of Science, MEDLINE, China National Knowledge Infrastructure were used to search peer-reviewed published articles in English or Chinese. Studies were scored using Strength of the Evidence for a Conclusion and a risk bias checklist. 10 studies met the inclusion criteria from an initial 2450 publications. These studies offered physical fitness training for professional (n=3) and pre-professional dancers (n=7), participant sample size ranged between 5 to 62, ages from 11 to 27 years, and most participants were females. Assessment scores were classified as Fair (n=1), Limited (n=7), and Expert Opinion Only (n=2) and risk of bias scores ranged from 22.7–68.2%. After physical fitness training, 80% of studies reported significant benefits in injury rate, the time between injuries, pain intensity, pain severity, missed dance activities and injury count. This review suggests that physical fitness training could have a beneficial effect on injury incidence in dance. The evidence is limited by the current study methodologies.

Supplementary Material



Publication History

Received: 22 March 2022

Accepted: 23 August 2022

Accepted Manuscript online:
24 August 2022

Article published online:
04 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Allen N, Ribbans W, Nevill AM. et al. Musculoskeletal injuries in dance: a systematic review. Int J Phys Med Rehabil 2014; 3: 1-8 DOI: 10.4172/2329-9096.1000252.
  • 2 Hincapié CA, Morton EJ, Cassidy JD.. Musculoskeletal injuries and pain in dancers: a systematic review. Arch Phys Med Rehabil 2008; 89: 1819-1829 DOI: 10.1016/j.apmr.2008.02.020.
  • 3 Smith PJ, Gerrie BJ, Varner KE. et al. Incidence and prevalence of musculoskeletal injury in ballet: a systematic review. Orthop J Sports Med 2015; 3: 2325967115592621 DOI: 10.1177/2325967115592621.
  • 4 Swain CT, Bradshaw EJ, Ekegren CL. et al. The epidemiology of low back pain and injury in dance: a systematic review. J Orthop Sports Phys Ther 2019; 49: 239-252
  • 5 Vassallo AJ, Trevor BL, Mota L. et al. Injury rates and characteristics in recreational, elite student and professional dancers: A systematic review. J Sports Sci 2019; 37: 1113-1122 DOI: 10.1080/02640414.2018.1544538.
  • 6 Biernacki JL, Stracciolini A, Fraser J. et al. Risk factors for lower-extremity injuries in female ballet dancers: a systematic review. Clin J Sport Med 2021; 31: e64-e79
  • 7 Henn E, Smith T, Ambegaonkar J. et al. Low back pain and injury in ballet, modern, and hip-hop dancers: a systematic literature review. Int J Sports Phys Ther 2020; 15: 671-687 DOI: 10.26603/ijspt202001.
  • 8 Bowerman EA, Whatman C, Harris N. et al. A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers. J Dance Med Sci 2015; 19: 51-56
  • 9 van Seters C, van Rijn RM, van Middelkoop M. et al. Risk factors for lower-extremity injuries among contemporary dance students. Clin J Sport Med 2020; 30: 60-66
  • 10 Dang Y, Koutedakis Y, Wyon M.. Fit to Dance Survey: elements of lifestyle and injury incidence in Chinese dancers. Med Probl Perform Art 2020; 35: 10-18 DOI: 10.21091/mppa.2020.1002.
  • 11 Kenny S, Whittaker J, Emery C.. Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review. Br J Sports Med 2016; 50: 997-1003 DOI: 10.1136/bjsports-2015-095121.
  • 12 Laws H.. Fit to Dance 2 – Report of the Second National Inquiry into dancers’ Health and Injury in the UK. London: Newgate Press;; 2005
  • 13 Riding-McCabe T, Ambegaonkar J, Redding E. et al. Fit to Dance Survey: a comparison with DanceSport injuries. Med Probl Perform Art 2014; 29: 102-110 DOI: 10.21091/mppa.2014.2021.
  • 14 Koutedakis Y, Cross V, Sharp N.. The effects of strength training in male ballet dancers. Impulse 1996; 4: 210-219
  • 15 Koutedakis Y, Khalouha M, Pacy P. et al. Thigh peak torques and lower-body injuries in dancers. J Dance Med Sci 1997; 1: 12-15
  • 16 Swain C, Redding E.. Trunk muscle endurance and low back pain in female dance students. J Dance Med Sci 2014; 18: 62-66
  • 17 Koutedakis Y, Jamurtas A.. The dancer as a performing athlete: physiological considerations. Sports Med 2004; 34: 651-661 DOI: 10.2165/00007256-200434100-00003.
  • 18 Angioi M, Metsios G, Koutedakis Y. et al. Physical fitness and severity of injuries in contemporary dance. Med Probl Perform Art 2009; 24: 26-29
  • 19 Twitchett E, Brodrick A, Nevill AM. et al. Does physical fitness affect injury occurrence and time loss due to injury in elite vocational ballet students? . J Dance Med Sci 2010; 14: 26-31
  • 20 Campoy FAS, de Oliveira Coelho LR, Bastos FN. et al. Investigation of risk factors and characteristics of dance injuries. Clin J Sport Med 2011; 21: 493-498
  • 21 Angioi M, Metsios G, Twitchett E. et al. Effects of supplemental training on fitness and aesthetic competence parameters in contemporary dance: a randomised controlled trial. Med Probl Perform Art 2012; 27: 3-8
  • 22 Twitchett E, Angioi M, Koutedakis Y. et al. Do increases in selected fitness parameters affect the aesthetic aspects of classical ballet performance. Med Probl Perform Art 2011; 26: 35-38
  • 23 Koutedakis Y, Hukam H, Metsios G. et al. The effects of three months of aerobic and strength training on selected performance and fitness-related parameters in modern dance students. J Strength Cond Res 2007; 21: 808-812 DOI: 10.1519/R-20856.1.
  • 24 Ambegaonkar JP, Chong L, Joshi P.. Supplemental training in dance: a systematic review. Phys Med Rehabil Clin N Am 2021; 32: 117-135 DOI: 10.1016/j.pmr.2020.09.006.
  • 25 Page MJ, Moher D, McKenzie JE.. Introduction to PRISMA 2020 and implications for research synthesis methodologists. Res Synth Methods 2022; 13: 156-163
  • 26 Howick J, Chalmers I, Glasziou P et al. The 2011 Oxford CEBM Levels of Evidence (Introductory Document). Oxford Centre for Evidence-Based Medicine. Available from https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence
  • 27 Schünemann H, Brożek J, Guyatt G et al. GRADE Handbook: Handbook for Grading the Quality of Evidence and the Strength of Recommendations Using the GRADE Approach, 2013. Available from https://gdt.gradepro.org/app/handbook/handbook.html
  • 28 (Academy) AoNaD. Grade Definitions and Chart Strength of the Evidence for a Conclusion. In; 2021: www.andeal.org
  • 29 Kmet LM, Lee RC, Cook LS.. Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. Edmonton: Alberta Heritage Foundation for Medical Research (AHFMR). AHFMR - HTA Initiative #13.. 2004
  • 30 Long KL, Milidonis MK, Wildermuth VL. et al. The impact of dance-specific neuromuscular conditioning and injury prevention training on motor control, stability, balance, function and injury in professional ballet dancers: a mixed-methods quasi-experimental study. Int J Sports Phys Ther 2021; 16: 404-417 DOI: 10.26603/001c.21150.
  • 31 Viktoria KB, Brigitta S, Gabriella K. et al. Application and examination of the efficiency of a core stability training program among dancers. Eur J Integr Med 2016; 8: 3-7 DOI: 10.1016/j.eujim.2016.11.004.
  • 32 Welsh TM, Jones GP, Lucker KD. et al. Back strengthening for dancers a within-subject experimental analysis. J Dance Med Sci 1998; 2: 141-148
  • 33 Beckmann Kline J, Krauss JR, Maher SF. et al. Core strength training using a combination of home exercises and a dynamic sling system for the management of low back pain in pre-professional ballet dancers a case series. J Dance Med Sci 2013; 17: 24-33 DOI: 10.12678/1089-313X.17.1.24.
  • 34 Kim G, Kim H, Kim WK. et al. Effect of stretching-based rehabilitation on pain, flexibility and muscle strength in dancers with hamstring injury: a single-blind, prospective, randomized clinical trial. J Sports Med Phys Fitness 2018; 58: 1287-1295 DOI: 10.23736/s0022-4707.17.07554-5.
  • 35 Xiangxian CYaC. Exercise prescription for DanceSports ankle injury: an intervention study. Journal of Chuzhou University 2011; 13: 70-72
  • 36 Vera AM, Barrera BD, Peterson LE. et al. An injury prevention program for professional ballet: a randomized controlled investigation. Orthop J Sports Med 2020; 8: 12 DOI: 10.1177/2325967120937643.
  • 37 Allen N, Nevill AM, Brooks JHM. et al. The effect of a comprehensive injury audit program on injury incidence in ballet: a 3-year prospective study. Clin J Sport Med 2013; 23: 373-378 DOI: 10.1097/JSM.0b013e3182887f32.
  • 38 Roussel NA, Vissers D, Kuppens K. et al. Effect of a physical conditioning versus health promotion intervention in dancers: A randomized controlled trial. Man Ther 2014; 19: 562-568 DOI: 10.1016/j.math.2014.05.008.
  • 39 Mistiaen W, Roussel NA, Vissers D. et al. Effects of aerobic endurance, muscle strength, and motor control exercise on physical fitness and musculoskeletal injury rate in preprofessional dancers: an uncontrolled trial. J Manipulative Physiol Ther 2012; 35: 381-389 DOI: 10.1016/j.jmpt.2012.04.014.
  • 40 Kenny SJ, Palacios-Derflingher L, Whittaker JL. et al. The influence of injury definition on injury burden in preprofessional ballet and contemporary dancers. J Orthop Sports Phys Ther 2018; 48: 185-193
  • 41 Stephens N, Nevill A, Wyon M.. Injury incidence and severity in pre-professional musical theatre dancers: a 5-year prospective study. Int J Sports Med 2021; 42: 1222-1227 DOI: 10.1055/a-1393-6151.
  • 42 Wyon MA, Abt G, Redding E. et al. Oxygen uptake during modern dance class, rehearsal, and performance. J Strength Cond Res 2004; 18: 646-649
  • 43 Schantz P, Åstrand P-O.. Physiological characteristics of classical ballet. Med Sci Sports Exerc 1984; 16: 472-476
  • 44 McCabe TR, Ambegaonkar JP, Redding E. et al. Fit to dance survey: a comparison with dancesport injuries. Med Probl Perform Art 2014; 29: 102-110 DOI: 10.21091/mppa.2014.2021.
  • 45 Dang Y, Koutedakis Y, Chen R. et al. Prevalence and risk factors of dance injury during COVID-19: a cross-sectional study from university students in china. Front Psychol 2021; 12: 759413
  • 46 Kozai AC, Twitchett E, Morgan S. et al. Workload intensity and rest periods in professional ballet: Connotations for injury. Int J Sports Med 2020; 41: 373-379
  • 47 Angioi M, Metsios G, Twitchett EA. et al. Effects of supplemental training on fitness and aesthetic competence parameters in contemporary dance: a randomised controlled trial. Med Probl Perform Art 2012; 27: 3-8
  • 48 Twitchett EA, Angioi M, Koutedakis Y. et al. Do increases in selected fitness parameters affect the aesthetic aspects of classical ballet performance?. Med Probl Perform Art 2011; 26: 35-38
  • 49 Nowacki RM, Air ME, Rietveld AB.. Use and effectiveness of orthotics in hyperpronated dancers. J Dance Med Sci 2013; 17: 3-10 DOI: 10.12678/1089-313x.17.1.3.
  • 50 van Rijn RM, Stubbe JH.. Characteristics, properties, and associations of self-assessed pain questionnaires a literature review and prospective cohort study among dance students. Med Probl Perform Art 2020; 35: 103-109 DOI: 10.21091/mppa.2020.2016.
  • 51 Ekegren CL, Gabbe BJ, Finch CF.. Sports injury surveillance systems: a review of methods and data quality. Sports Med 2016; 46: 49-65