Incidence, Mechanisms, and Characteristics of Injuries in Pole Dancers: A Prospective Cohort Study.

OBJECTIVE: Pole dancing is a challenging physical activity. Prospective injury studies in pole dancing are lacking. The aim of this study was to describe the incidence, mechanisms, and characteristics of injuries in pole dancers. METHODS: A total of 66 pole dancers from 41 studios across Australia were prospectively followed over 12 months. An intake questionnaire was administered including items on pole dancers' demographics and training characteristics. Exposure was assessed using a daily online training diary. Self-reported injury data were collected via an incident report form and subsequently coded using the Orchard Sports Injury Classification System. Injuries occurring during pole-specific and pole-related activities were included in the analyses. RESULTS: The sample included 63 females and 3 males, mean age 32.3 ± 8.9 years and mean pole training experience 3.5 ± 2.8 years. 25 of 66 participants completed the full study. The 1-year incidence of all new injuries was 8.95/1,000 exposure hours (95% CI 6.94 - 10.96), 7.65/1,000 hrs (95% CI 5.79 - 9.51) for pole-specific injuries and 1.29/1,000 hrs (95% CI 0.53 - 2.06) for pole-related injuries. A total of 103 injuries occurred, 62.1% of which were sudden onset and 37.9% gradual onset. Mechanism of onset included 54.4% acute and 45.6% repetitive in nature. Shoulder (20.4%) and thigh (11.7%, majority ham¬string) were the most reported anatomic injury sites. Non-contact mechanisms accounted for the majority of injuries (57.3%). The most reported primary contributor to injury onset at the shoulder were manoeuvres characterised by loaded internal humeral rotation (33.3%), and at the hamstring were manoeuvres and postures involving front splits (100.0%). CONCLUSION: The findings indicate that pole dancers are at high risk for injuries. Future research is needed to understand the biomechani¬cal demand of manoeuvres and training characteristics of pole dancing (e.g., workload and recovery) to guide the development of preventative interventions, particularly targeted toward the shoulder and hamstring.

Dance Movement Therapy for Clients With a Personality Disorder: A Systematic Review and Thematic Synthesis.

Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners' expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients' experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.

Do hip and groin muscle strength and symptoms change throughout a football season in professional male football players? A prospective cohort study with repeated measures.

OBJECTIVES: Groin injuries are common in professional male football and result in significant complaints, time-loss and cost. We aimed to study: 1. Normal values of hip muscle strength and self-reported hip and groin function (Hip And Groin Outcome Score (HAGOS)). 2. Changes in these values throughout the season. 3. If previous (groin) injuries, leg dominance or league were associated with these outcome measures. DESIGN: Prospective cohort study. METHODS: 313 professional male football players (11 clubs) participated. Player characteristics and previous injuries were registered. Hip muscle strength (hand-held dynamometer) and HAGOS measurements were done at the start, middle and end of the season. RESULTS: Data from 217 players were analysed. Adduction strength (mean±standard deviation, Nm/Kg) was 3.40±0.72 (start), 3.30±0.65 (mid) and 3.39±0.74 (end) (p=0.186). Abduction strength was 3.45±0.67, 3.14±0.57 and 3.28±0.61 (p<0.001). Adduction/abduction ratio was 1.00±0.21, 1.07±0.22 and 1.05±0.23 (p<0.001). Statistically, the HAGOS-subscale 'Pain' (median [interquartile range]) deteriorated slightly during the season (p=0.005), especially from mid-season (97.5 [90.6-100.0]) to end-of-season (95.0 [87.5-100.0]) (p=0.003). Other subscale scores remained unchanged between time points; 85.7 (symptoms), 100.0 (daily living), 96.9 (sports and recreation) 100.0, (physical activities) and 90.0 (quality of life). Previous injuries were associated with lower HAGOS-scores. Dominant legs had higher abduction strength (p<0.001) and lower adduction/abduction ratio (p<0.001). No differences between leagues were found for hip muscle strength and HAGOS-scores. CONCLUSIONS: In Dutch male professional football players, hip muscle strength and HAGOS-scores remained relatively stable throughout the season. Pain increased slightly, which while statistically significant, was not clinically relevant.

Characteristics and Extent of Mental Health Issues in Contemporary Dance Students.

AIMS: This study investigated the extent and characteristics of mental health issues in contemporary dance students, as clear insight into these health problems is lacking. METHODS: During one academic year, 134 dance and dance-teacher students were monitored on a monthly basis using the Performing artist and Athlete Health Monitor (PAHM). RESULTS: In total, 130 students were included in the analyses, comprising 81 dance students and 49 dance-teacher students. The response rate of the monthly questionnaires was 79.7%. Overall, 96.9% of the students reported at least one physical/mental health problem. The incidence proportion (IP) of all reported mental health issues for one academic year was 44.6% (n=58). Furthermore, 29.2% of the students reported a mental health issue as their most severe health problem, of whom 39.4% indicated a substantial mental health issue (i.e., problems leading to moderate, severe, or complete reductions in training volume or performance). The monthly IP of mental health issues ranged from 2.9 to 8.9% and 0 to 5.3% for substantial mental health issues. The most reported types of mental health issues were general anxiety (20.0%), stress due to external factors (18.3%), and constant tiredness (16.7%). Dance-teacher students of all study years and second-year students from both educational programs indicated significantly more mental health issues, while sex showed no significant differences. CONCLUSIONS: Contemporary dance students are at risk of mental health issues. Dance schools should pay special attention to stress, anxiety, and (constant) tiredness of their students. More research is needed to gain insight into specific characteristics and risk factors of mental health issues in dance students.

High prevalence of self-reported injuries and illnesses in talented female athletes.

BACKGROUND: A thorough knowledge of the epidemiology and severity of injuries and illness in youth female elite sports is lacking due to the methodological challenges involved in recording them. In this study, the prevalence and incidence of injuries and illness are assessed among youth female elite athletes. Instead of solely focusing on time-loss injuries, our study included all substantial and non-substantial health problems (ie, injuries, mental problems and illnesses). METHODS: Sixty young elite Dutch female athletes (age: 16.6 years (SD: 2.3), weight: 58.3 kg (SD: 15.1), height: 154.1 cm (SD: 44.2)) participating in soccer (n=23), basketball (n=22) and gymnastic (n=15) talent development programmes were prospectively followed during one season (September 2014 to April 2015). To collect health problem data, all athletes completed the Oslo Sports Trauma Research Center Questionnaire on Health Problems every other week. Main outcome measures were average prevalence of injury and incidence density of injury. RESULTS: At any given time, 47.9% of the athletes reported an injury (95% CI 43.6% to 52.6%) and 9.1% reported an illness (95% CI 5.1 to 19.0). The average injury incidence density was 8.6 per 1000 hours of athlete exposure. The average number of self-reported injuries per athlete per season was significantly higher in soccer athletes (4.3±2.7) than in basketball athletes (2.6±2.0) (p=0.03) and not significantly higher than in the gymnastic squad. The knee and the ankle were two of the most common injury locations for all squads. Knee injuries in basketball and soccer and heel injuries in the gymnastic squad had the highest impact on sports participation. CONCLUSION: High prevalence of self-reported injuries among talented female athletes suggests that future efforts towards their prevention are warranted.

Incidence and risk factors of injuries and their impact on academic success: A prospective study in PETE students.

Injuries can have a major impact on the physical performance and academic career of physical education teacher education (PETE) students. To investigate the injury problem, risk factors, and the impact of injuries on academic success, 252 PETE students were followed during their first semester. Risk factor analysis was conducted by means of logistic regression analysis with a differentiation for upper body, lower body, acute, overuse, and severe injuries. An incidence of 1.26 injuries/student/semester was found. Most injuries involved the lower body (61%), were new injuries (76%), occurred acutely (66%), and were sustained during curricular gymnastics (25%) or extracurricular soccer (28%). Significant risk factors for lower body acute injuries were age (OR=2.14; P=.01), previous injury (OR=2.23; P=.01), and an injury at the start of the year (OR=2.56; P=.02). For lower body overuse injuries, gender (OR=2.85; P=.02) and the interval shuttle run test score (OR=2.44; P=.04) were significant risk factors. Previous injury (OR=2.59; P=.04) and injury at the start of the year (upper body: OR=4.57; P=.02; lower body: OR=3.75; P<.01) were risk factors for severe injuries. Injury-related time loss was positively related to total academic success (r=.20; P=.02) and success in theoretical courses (r=.24; P=<.01). No association was found between time loss and academic success for sport courses.

A new clinical test for measurement of lower limb specific range of motion in football players: Design, reliability and reference findings in non-injured players and those with long-standing adductor-related groin pain.

OBJECTIVE: The association between groin pain and range of motion is poorly understood. The aim of this study was to develop a test to measure sport specific range of motion (SSROM) of the lower limb, to evaluate its reliability and describe findings in non-injured (NI) and injured football players. DESIGN: Case-controlled. SETTING: 6 Dutch elite clubs, 6 amateur clubs and a sports medicine practice. PARTICIPANTS: 103 NI elite and 83 NI amateurs and 57 football players with unilateral adductor-related groin pain. MAIN OUTCOME MEASURES: Sport specific hip extension, adduction, abduction, internal and external rotation of both legs were examined with inclinometers. Test-retest reliability (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. Non-injured players were compared with the injured group. RESULTS: Intra and inter tester ICCs were acceptable and ranged from 0.90 to 0.98 and 0.50-0.88. SEM ranged from 1.3 to 9.2° and MDC from 3.7 to 25.6° for single directions and total SSROM. Both non-injured elite and amateur players had very similar total SSROM in non-dominant and dominant legs (188-190, SD ± 25). Injured players had significant (p < 0.05) total SSROM deficits with 187(SD ± 31)° on the healthy and 135(SD ± 29)° on the injured side. CONCLUSION: The SSROM test shows acceptable reliability. Loss of SSROM is found on the injured side in football players with unilateral adductor-related groin pain. Whether this is the cause or effect of groin pain cannot be stated due to the study design. Whether restoration of SSROM in injured players leads to improved outcomes should be investigated in new studies.

Sports injuries and illnesses during the European Youth Olympic Festival 2013.

BACKGROUND: The European Youth Olympic Festival (EYOF) is a biennial sporting event of nine Olympic Summer Sports for talented athletes, aged 13-18 years, from all over Europe. OBJECTIVE: To analyse the injuries and illnesses that occurred during the multisport event (14-19 July 2013), with the long-term aim of enabling international sports federations, the National Olympic Committees, and the European Olympic Committee to improve protection of athletes' health in youth. METHODS: Daily occurrence or non-occurrence of injuries and illnesses was recorded by using the IOC injury and illness surveillance system for multisport events. All National Olympic Committee physicians and healthcare providers and physicians of the Local Organizing Committee were invited to participate. RESULTS: In total, 2272 athletes from 49 countries took part in the EYOF 2013. During the five competition days of EYOF, 207 injuries and 46 illnesses were reported, resulting in an incidence of 91.1 injuries and 20.2 illnesses per 1000 athletes. Almost 10% of the athletes sustained at least one injury or illness. CONCLUSIONS: This study is the first multisport surveillance study on injuries and illnesses during the EYOF or any other summer Games organised for youth elite athletes. The data form the basis for further research on risk factors and injury mechanisms for this cohort. This research is needed to gain more knowledge and finally to implement effective injury and illness prevention measures.

Differences in injury risk and characteristics between Dutch amateur and professional soccer players.

OBJECTIVES: To compare the incidence and characteristics of injuries between Dutch amateur and professional male soccer players during one entire competition season. DESIGN: A prospective two-cohort design. METHODS: During the 2009-2010 season, 456 Dutch male amateur soccer players and 217 professional players were prospectively followed. Information on injuries and individual exposure to all soccer activities were recorded in both cohorts. Injuries were recorded using the time-loss definition. RESULTS: In total, 424 injuries were recorded among 274 of the amateur players (60.1% injured players) and 286 injuries were sustained by 136 (62.7% injured players) of the professional players (p=0.52). Compared to the professionals, the injury incidence during training sessions was higher among amateurs (p=0.01), but the injury incidence among professionals was higher during matches (p<0.001). Professional players also had a higher incidence of minimal injuries (p<0.001), whereas the incidence of moderate and severe injuries was higher for amateurs (all p<0.001). Lastly, professional players sustained more overuse injuries (p=0.02), whereas amateurs reported more recurrent injuries (p<0.001). CONCLUSIONS: The above-mentioned differences in injury rates between amateur and professional players in the Netherlands might be explained by the difference in the level at which they play, since factors like the availability of medical support and/or the team size may influence the injury risk and characteristics.

Patients' experiences with quality of hospital care: the Consumer Quality Index Cataract Questionnaire.

BACKGROUND: Patients' feedback is of great importance in health care policy decisions. The Consumer Quality Index Cataract Questionnaire (CQI Cataract) was used to measure patients' experiences with quality of care after a cataract operation. This study aims to evaluate the reliability and the dimensional structure of this questionnaire and assesses its ability to measure differences between hospitals in patients' experiences with quality of care. METHODS: Survey data of 4,635 respondents were available. An exploratory factor analysis was performed to evaluate the construct validity of the questionnaire and item-correlations and inter-factor correlations were calculated. Secondly, Cronbach's alpha coefficients were calculated to assess the internal consistency of the scales. Thirdly, to evaluate the ability of the questionnaire to discriminate between hospitals, multilevel analyses were performed with patients hierarchically nested within hospitals. RESULTS: Exploratory factor analysis resulted in 14 quality of care items subdivided over three factors (i.e. communication with ophthalmologist, communication with nurses, and communication about medication). Cronbach's alpha coefficients of 0.89, 0.76 and 0.79 indicated good internal consistency. Multilevel analyses showed that the questionnaire was able to measure differences in patients' experiences with hospital care regarding communication with ophthalmologist and communication about medication. In addition, there was variation between hospitals regarding ophthalmologist ratings, hospital ratings and one dichotomous information item. CONCLUSION: These findings suggest that the CQI Cataract is a reliable and valid instrument. This instrument can be used to measure patients' experiences with three domains of hospital care after a cataract operation and is able to assess differences in evaluated care between hospitals.

Exercise participation and self-rated health: do common genes explain the association?

The purpose of this study is to investigate whether there is an association between exercise participation and self-rated health and whether this association can be explained by common genes and/or common environmental influences. In a sample of 5,140 Dutch adult twins and their non-twin siblings from 2,831 families, exercise participation (sedentaries, light or moderate, vigorous exercisers) and self-rated health were assessed by survey. To investigate the etiology of the association, bivariate genetic models using structural equation modeling were applied to the data. The correlation between exercise participation and self-rated health is significant but modest (r = 0.20). Exercise participation and self-rated health are both heritable (around 50% of the variance of both phenotypes is explained by genetic factors). The genetic factors influencing exercise participation and self-rated health partially overlap (r = 0.36) and this overlap fully explains their phenotypic correlation. We conclude that the association between exercise and self-rated health can be explained by genes predisposing to both exercise participation and self-rated health. These genes may directly influence both phenotypes (pleiotropy). Alternatively, genes that affect exercise or self-rated health may indirectly influence the other phenotype through a causal relationship. We propose that identification of the genes that cause differences in exercise behavior will help resolve the issue of causality.

The association between exercise participation and well-being: a co-twin study.

OBJECTIVE: We investigated the association between leisure time exercise participation and well-being (i.e., life satisfaction and happiness) and examined the causality underlying this association. METHOD: The association between exercise participation and well-being was assessed in around 8000 subjects, (age range 18-65 years) from The Netherlands Twin Registry (NTR). Causality was tested with the co-twin control method in 162 monozygotic (MZ) twin pairs, 174 dizygotic (DZ) twin and sibling pairs, and 2842 unrelated individuals. RESULTS: Exercisers were more satisfied with their life and happier than non-exercisers at all ages. The odds ratio for life satisfaction given exercise participation was significantly higher than unity in unrelated pairs, and a trend was visible in DZ pairs. In MZ pairs, the odds ratio was close to unity. The pattern of odds ratios for happiness given exercise participation was similar. CONCLUSION: Exercise participation is associated with higher levels of life satisfaction and happiness. This association is non-causal and appears to be mediated by genetic factors that influence both exercise behavior and well-being.

Regular exercise, anxiety, depression and personality: a population-based study.

OBJECTIVES: To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age. METHODS: The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from The Netherlands Twin Registry (1991-2002). Exercise participation, anxiety, depression and personality were assessed with self-report questionnaires. RESULTS: The overall prevalence of exercise participation (with a minimum of 60 min weekly at 4 METs (Metabolic Energy Expenditure Index)) in our sample was 51.4%. Exercise participation strongly declined with age from about 70% in young adolescents to 30% in older adults. Among adolescents, males exercised more, whereas, among older adults, females exercised more. Exercisers were on average less anxious (-0.18 SD), depressed (-0.29 SD) and neurotic (-0.14 SD), more extraverted (+0.32 SD) and were higher in dimensions of sensation seeking (from+0.25 SD to+0.47 SD) than non-exercisers. These differences were modest in size, but very consistent across gender and age. CONCLUSIONS: This study corroborates and extends previous findings: regular exercise is cross-sectionally associated with lower neuroticism, anxiety and depression and higher extraversion and sensation seeking in the population.

Heritability of life satisfaction in adults: a twin-family study.

BACKGROUND: Subjective well-being (SWB) can be partitioned into the components life satisfaction and affect. Research on factors influencing these components of well-being has mainly focused on environmental characteristics. The aim of this study was to investigate the relative contribution of genes and environment to individual differences in life satisfaction in a large sample of Dutch twins and their singleton siblings. METHOD: Life satisfaction of 5668 subjects registered with The Netherlands Twin Registry (NTR) was measured with a Dutch version of the self-reported Satisfaction with Life Scale. An extended twin design was used to obtain correlations in life satisfaction scores for monozygotic twins, dizygotic twins and sibling pairs and to estimate the contribution of genes and environment to the variation in life satisfaction. RESULTS: No differences between males and females were found in the mean level of life satisfaction. Broad-sense heritability was 38%. Non-additive genetic factors explained all or most of the genetic influences. The remaining 62% of the variance in life satisfaction could be attributed to unique environmental factors, both persistent and transitory, plus measurement error. CONCLUSIONS: Individual differences in life satisfaction are determined in part by genetic factors that are largely or entirely non-additive in nature.

Familial clustering in burnout: a twin-family study.

BACKGROUND: Research on risk factors for burnout has mainly focused on circumstances at work and on personal characteristics. The aim of this study was to investigate whether burnout clusters within families and, if so, whether this is due to genetic influences or to environmental factors shared by family members. Finally, we tried to identify specific risk factors for burnout. METHOD: In 2707 twins, 736 of their siblings and 575 of their spouses from a population-based twin-family sample, burnout was measured using a self-report questionnaire. Correlations in burnout scores were obtained for monozygotic and dizygotic twin pairs and sibling pairs conditional on the pairs' sex. Correlations for twins and their spouses were derived conditional on the length of the relationship. RESULTS: In the final model, correlations of the monozygotic and dizygotic twin pairs and sibling pairs were significantly different from zero, but not significantly different from each other. The correlation was estimated at 0.22. The correlation between spouses was also significant. This was mainly due to the group with a relationship longer than 5 years in which the correlation was 0.24. Burnout scores were higher in subjects whose parents had a high level of education. CONCLUSIONS: There is familial clustering for burnout due to environmental factors shared by family members, explaining 22 % of the variance. Genetic factors do not seem to be of importance. The significant correlation between spouses supports the conclusion that common environment plays a role in burnout. A high parental education is one of the familial risk factors.