Ballet dancers have a high prevalence of injuries to the lower extremity. Many studies have investigated the relationship between dance injury and risk factors. However, risk factors for lower-extremity injury comparing recreational- and elite-level ballet dancers are scarce.
To systematically review available original studies to assess risk factors for lower-extremity injury in female ballet dancers between recreational and elite ballet dancers.
Five online databases [Web of Science, PubMed, OVID (Medline), EBSCO, and ProQuest] were searched systematically.
Included studies had an analytic study design published in the past 11 years and investigated an association between potential risk factors and lower-extremity injury in female ballet dancers.
Assessed independently by 2 reviewers using the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine.
Seventeen studies were included. Alignment was a risk factor for lower-extremity injury in both recreational and elite ballet dancers. In elite ballet dancers, poor lumbopelvic movement control, inappropriate transversus abdominis contraction, decreased lower-extremity strength, and poor aerobic fitness were risk factors for lower-extremity injury. In recreational ballet dancers, hypermobility of the hip and ankle and longer training hours were risk factors for lower-extremity injury. Mean DB score was 15.94 (SD 1.57). The majority of studies were retrospective cohort studies or had poor follow-up, with 7 level 2b studies, 6 level 3b studies (cross-sectional), and 4 level 1b studies (prospective cohort with good follow-up).
Alignment was identified as a common risk factor for recreational and elite ballet dancers. Other risk factors differed between recreational ballet dancers and elite ballet dancers. Future studies are warranted to use a prospective study design, identify dance level–specific risk factors, and implement evidence-based prevention strategies.
*Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia;
†The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts;
‡Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts; and
§Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
Corresponding Author: Jessica Biernacki, MD, Melbourne Medical School, University of Melbourne, Parkville 3010, VIC, Australia (firstname.lastname@example.org).
The authors report no financial or conflicts of interest.
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Received July 07, 2017
Accepted October 13, 2018