Umbrella review of musculoskeletal injury burden in dancers: implication for practice and research

Dancers are susceptible to injury. Nevertheless, injury epidemiology research in dancers is inconsistent. Furthermore, ballet dancing has dominated the huge body of reviews analyzing the epidemiology of musculoskeletal injuries in a variety of artistic dance forms, making it challenging to acquire a thorough, comprehensive, and understandable reporting of the available data. The overview and reanalysis of dancers’ musculoskeletal pain and injury load across artistic dance forms. Systematic review of systematic reviews and meta-analysis A search was conducted online for literature written in English using PubMed and Google Scholar (2012–2021). The data gathered was then analyzed using predetermined qualifying criteria. 12 reviews were determined to be qualified, the majority of which had moderate to low confidence and raised concerns about bias based on JBI-URARI and ROBIS. The prevalence of dance-related musculoskeletal injuries ranged from 26% to 84% in any artistic dancers and 42% to 343% in ballet dancers. The incidence was less than 5 per 1000 dance hours in both groups, with lower extremities and back being the commonly reported sites. Reviews themselves stated that the quality of the reviews was often poor. Due to the study’s heterogeneity and methodological inconsistency, data pooling and meta-analysis were not possible. The current review emphasizes the gaps and restrictions in the dance epidemiology literature that make it challenging to quantify and report a single overall injury rate for dancers. These results underline the need for better primary investigations and evidence synthesis. As injury epidemiology is a critical component of the overall injury-prevention puzzle, there is a need for standardization in future research, particularly with active and prospective injury surveillance, injury classification, injury evaluation, and injury reporting. Systematic Review, Level III舞者群体极易遭受运动损伤。然而，目前针对舞者的损伤流行病学研究结论并不统一。此外，在分析多种艺术舞蹈形式肌肉骨骼损伤流行病学的大量综述文献中，芭蕾舞相关研究占据主导地位，这使得我们难以全面、完整且清晰地报告现有可用数据。 本研究旨在对各类艺术舞蹈形式下舞者的肌肉骨骼疼痛与损伤负担进行综述与再分析，属于针对系统综述（systematic review）与元分析（meta-analysis）的系统综述。 我们于2012年至2021年间，通过PubMed与Google Scholar两大数据库开展英文文献检索，随后依据预先设定的纳入标准对收集到的数据进行分析。最终共有12篇综述文献符合纳入标准，其中绝大多数研究的证据可信度为中等至偏低水平，且基于JBI-URARI与ROBIS偏倚风险评估工具显示存在偏倚风险。 在所有艺术舞蹈从业者中，与舞蹈相关的肌肉骨骼损伤患病率为26%~84%；芭蕾舞舞者的损伤患病率为42%~343%。两组人群的损伤发生率均低于每1000小时舞蹈时长5例，下肢与背部为最常受累的损伤部位。 纳入的综述文献自身均指出，相关研究的质量普遍偏低。由于纳入研究存在异质性与方法学不一致性，无法进行数据合并与元分析。 本次综述明确了舞蹈流行病学领域现存的研究缺口与局限性，这些问题导致难以量化并报告舞者的整体损伤率。上述结果凸显了开展更高质量的基础研究与证据整合工作的必要性。 鉴于损伤流行病学是整体损伤预防体系的关键组成部分，未来的研究亟需实现标准化，尤其是在主动前瞻性损伤监测、损伤分类、损伤评估与损伤报告等方面。 本研究属于系统综述（systematic review），证据等级为III级（Level III）。