Hincapié Cesar A, Morton Emily J, Cassidy J David
Artists' Health Centre Research Program, Toronto Western Hospital, Toronto, ON, Canada.
Arch Phys Med Rehabil. 2008 Sep;89(9):1819-29. doi: 10.1016/j.apmr.2008.02.020.
To assemble and synthesize the best evidence on the epidemiology, diagnosis, prognosis, treatment, and prevention of musculoskeletal injuries and pain in dancers.
Medline, CINAHL, PsycINFO, Embase, and other electronic databases were searched from 1966 to 2004 using key words such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, and musculoskeletal diseases. In addition, the reference lists of relevant studies were examined, specialized journals were hand-searched, and the websites of major dance associations were scanned for relevant information.
Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best evidence synthesis method. After 1865 abstracts were screened, 103 articles were reviewed, and 32 (31%) of these were accepted as scientifically admissible (representing 29 unique studies).
Data from accepted studies were abstracted into evidence tables relating to the prevalence and associated factors, incidence and risk factors, diagnosis, treatment, economic costs, and prevention of musculoskeletal injuries and pain in dancers.
The scientifically admissible studies consisted of 15 (52%) cohort studies, 13 (45%) cross-sectional studies, and 1 (3%) validation study of a diagnostic assessment tool. There is a high prevalence and incidence of lower extremity and back injuries, with soft tissue and overuse injuries predominating. For example, lifetime prevalence estimates for injury in professional ballet dancers ranged between 40% and 84%, while the point prevalence of minor injury in a diverse group of university and professional ballet and modern dancers was 74%. Several potential risk factors for injury are suggested by the literature, but conclusive evidence for any of these is lacking. There is preliminary evidence that comprehensive injury prevention and management strategies may help decrease the incidence of future injury.
The dance medicine literature is young and heterogeneous, limiting our ability to draw consistent conclusions. Nonetheless, the best available evidence suggests that musculoskeletal injury is an important health issue for dancers at all skill levels. Better quality research is needed in this specialized area. Future research would benefit from clear and relevant research questions being addressed with appropriate study designs, use of conceptually valid and clinically meaningful case definitions of injury and pain, and better reporting of studies in line with current scientific standards.
收集并综合有关舞者肌肉骨骼损伤与疼痛的流行病学、诊断、预后、治疗及预防方面的最佳证据。
使用“舞蹈”“舞者”“跳舞”“运动损伤”“职业损伤”“扭伤和拉伤”以及“肌肉骨骼疾病”等关键词，对1966年至2004年期间的医学期刊数据库（Medline）、护理学与健康领域数据库（CINAHL）、心理学文摘数据库（PsycINFO）、医学与健康领域数据库（Embase）及其他电子数据库进行检索。此外，还查阅了相关研究的参考文献列表，手工检索了专业期刊，并浏览了主要舞蹈协会的网站以获取相关信息。
根据预先设定的标准筛选文献相关性，并采用最佳证据综合法对相关研究的科学价值进行严格评估。在筛选了1865篇摘要后，对103篇文章进行了评审，其中32篇（31%）被认定具有科学可接受性（代表29项独立研究）。
将纳入研究的数据提炼成证据表，内容涉及舞者肌肉骨骼损伤与疼痛的患病率及相关因素、发病率及危险因素、诊断、治疗、经济成本和预防等方面。
具有科学可接受性的研究包括15项（52%）队列研究、13项（45%）横断面研究以及1项（3%）诊断评估工具的验证研究。下肢和背部损伤的患病率和发病率较高，软组织损伤和过度使用损伤占主导。例如，职业芭蕾舞演员终身损伤患病率估计在40%至84%之间，而在一群来自大学、职业芭蕾舞团和现代舞团的舞者中，轻伤的时点患病率为74%。文献中提出了一些潜在的损伤危险因素，但尚无确凿证据支持其中任何一项。有初步证据表明，全面的损伤预防和管理策略可能有助于降低未来损伤的发生率。
舞蹈医学文献尚年轻且参差不齐，限制了我们得出一致结论的能力。尽管如此，现有最佳证据表明，肌肉骨骼损伤对于所有技能水平的舞者来说都是一个重要的健康问题。这一专业领域需要更高质量的研究。未来的研究若能提出清晰且相关的研究问题，并采用适当的研究设计，使用在概念上有效且具有临床意义的损伤和疼痛病例定义，并按照当前科学标准更好地报告研究结果，将会从中受益。
