Although the benefits of exercise are well documented, the risk of injury as a result of exercise is also documented. The undertaking of exercise in the form of sport or dance carries a risk of injury. This risk is increased in the professional ranks where increased intensity of exercise coupled with greater exposure periods are noted. Two published systematic reviews of the literature pertaining to musculoskeletal injuries and pain in dancers (up to 2008) indicated that there are still major scientific limitations and biases in the literature reviewed and indicated the need for explicit criteria on injury definition and methods of injury reporting. The reviews did comment on the evidence that musculoskeletal injury is an important issue for all dancers and that there is preliminary evidence that comprehensive injury prevention and management strategies may reduce injuries. The purpose of this single cohort observational study was to document injury incidence and severity in professional ballet dancers over three years including any changes as a result of changes within their medical management. While it is recognised that a randomised control trial would be advocated for an interventional study, due to the demands of this high performance environment this was not feasible. As such, steps were taken to improve the reporting of findings through the utilisation of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. To date there are two publications in peer reviewed journals as a result of the data collected in this study. In the absence of international consensus on injury data collection in dance the methodology employed in this study was consistent with the International Consensus Statements on injury data collection from sport. Although the incidence of injuries in Year 1 was lower than that in other sports, the results were higher than other studies that have been reported in dance. The reason for this may be due to the use of a more encompassing injury definition. In response to the data and details obtained through the injury audit process changes in the comprehensive medical management of the dancers were implemented. The pre-participation screening was extended and the individual conditioning programmes were structured using the developed Hybrid Intervention Model. The result of the injury auditing indicated a significant reduction in injury incidence in the Year 2, with a further reduction in Year 3. These findings support the results of the systematic reviews in that there is growing evidence that comprehensive injury prevention and management strategies may reduce injuries in dance and that in the absence of stronger evidence there is a strong recommendation for those charged with caring for professional dancers to implement comprehensive medical management programmes.

Dance has attracted little scientific interest on the effects of physical fitness improvements on performance and injury severity, particularly with respect to contemporary dance. The main aims of the current work were: a) to observe the physical demands of dance performance; b) to develop a reliable dance-specific performance tool; c) to assess the association between selected physical fitness parameters and performance in contemporary dance by using a new reliable method (AC test); d) to assess selected physical fitness parameters in relation to injury severity in contemporary dance; e) to study the effects of increased fitness parameters on performance through a randomized controlled trial. A total of 50 performances, performed by 20 dancers, were monitored by using a portable accelerometers (SWA armbands) and heart rate monitors while 45 performances in DVDs were video analysed. Six dancers and two dance teachers were recruited to test a newly developed performance tool. A sample made of 41 dancers were recruited and assessed for aerobic fitness (DAFT), lower body muscular power (jump height test), upper body muscular endurance (press-ups test), flexibility (active and passive hip ROM), body composition (skinfolds), performance (n=17) and injury severity (n=16). In order to investigate the effects of the supplementary fitness training on performance, 24 of the total 41 dancers, were randomly assigned to either an intervention (n=12) or control (n=12) group. The intervention group undertook a specifically designed exercise-training programme (circuit and WBV training) lasting six weeks. Both groups were re-tested for physical fitness levels and performance at the end of the intervention period. Results revealed that performance intensities varied from light to moderate while these were observed with the use of pliés and jumps as well as lifting other dancers. Based on the seven most frequently used criteria by selected pre-professional contemporary dance institutions and companies, a novel performance tool (AC tool) was developed with an inter-rater reliability of r=0.96. There was a significant correlation between aesthetic competence (AC) scores and jump ability (r=0.55) and press-ups (r=0.55), respectively. Stepwise backward multiple regression analysis revealed that the best predictor of AC was press-ups (R2=0.30, p=0.03, 95% confidence intervals=0.11–1.34). Univariate analyses also revealed that the interaction of press-ups and jump ability improved the prediction power of AC (R2=0.44, p=0.004, 95% confidence intervals=0.009–0.04). Pearson’s correlation coefficients detected significant negative correlations between the mean score recorded for injury severity (expressed as TDO) and lower body muscular power (r=-0.66; p=0.014); backward regression analysis also revealed that, from all studied parameters, the strongest predictor of TDO was lower body muscular power (p=0.014). For the intervention group repeated measures ANOVA revealed significant increases (pre vs. post) in aerobic fitness (p<0.05), lower body muscular power (p<0.05), upper body muscular endurance (p<0.05) and performance (p<0.05). Linear regression analyses indicated that the only significant predictor of AC was aerobic capacity (F=7.641; p=0.03); the interaction of press-ups and aerobic capacity (F=6.297; p=0.036), and lower body muscular power with aerobic capacity (F=5.543; p=0.05) demonstrated an improved prediction power. These results show that the observed contemporary dance performance is an intermittent type of activity of moderate intensity. Given the reliability of the AC tool, it is concluded that upper body muscular endurance and jump ability best predict AC of contemporary dancers. Reduced lower body muscular power is associated with increased severity of injuries. Finally, supplementary exercise training significantly increases lower body muscular power, upper body muscular endurance and aerobic fitness, which in turn are beneficial to improve AC of contemporary dancers.

The subject of dance and injury has become an increasingly important area of study for sports medicine, education, and dance studies. However, the majority of current research focuses on professional dancers or pre-professional dancers in a conservatory training context. The research typically overlooks dancers in a university setting who pursue baccalaureate-level dance programs. This small-scale research study therefore focuses on collegiate dancers in their first year of study in a liberal arts dance program. As this population often sustains injuries, the thesis project seeks to examine the management of injury strategies and to create injury prevention guidelines for the liberal arts dance department, its dance classes, and a hypothetical syllabus for a first-year injury prevention course. The research methodology adopts three approaches: a survey of the incoming freshman dance class at Temple University; a detailed study of six previously or currently injured dance students through interview; and a critical assessment of the research on dance injury. The injury prevention guidelines developed from the student injury surveys, interviews, and assessments will focus on basic, yet essential, information regarding injury management and misconceptions, and the guidelines will prepare collegiate-level dancers for future injury challenges they may face. / Dance