Steinberg Nili, Tenenbaum Shay, Zeev Aviva, Pantanowitz Michal, Waddington Gordon, Dar Gali, Siev-Ner Itzhak
Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel.
Department of Orthopedic Surgery, Chaim Sheba Medical Center Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
BMC Musculoskelet Disord. 2021 Feb 9;22(1):161. doi: 10.1186/s12891-021-04023-z.
Many young girls with generalized joint hypermobility (GJH) choose to participate in dance because their bodies are suited for this activity. Scoliosis tends to occur often in thin girls, who also are more likely to choose dance. Both anomalies (GJH and scoliosis) may be related to reduced abilities such as diminished strength and insufficient postural balance, with increased risk for musculoskeletal conditions. The main objectives of the present study were to determine the prevalence of dancers with GJH, the prevalence of dancers with scoliosis, and the prevalence of dancers with these two anomalies; and, to determine differences in physical abilities and the presence of patellofemoral pain (PFP) between young female dancers with and without such anomalies.
One hundred thirty-two female dancers, aged 12-14 years, were assessed for anthropometric parameters, GJH, scoliosis, knee muscle strength, postural balance, proprioception ability, and PFP.
GJH was identified in 54 dancers (40.9%) and scoliosis in 38 dancers (28.8%). Significant differences were found in the proportion of dancers with no anomalies (74 dancers, 56.1%) and dancers with both anomalies (34 dancers, 25.8%) (p < .001). Dancers with both anomalies had reduced dynamic postural balance in the anterior direction (p = .023), reduced proprioception ability (p < .001), and weaker knee extensors (p = .036) and flexors (p = .040) compared with dancers with no anomalies. Among dancers with both anomalies, 73.5% suffered bilateral PFP, 17.6% suffered unilateral PFP, and 8.8% had no PFP (p < .001).
A high prevalence of young girls participating in dance classes had GJH, as the increased joint flexibility probably provides them with some esthetic advantages. The high prevalence of scoliosis found in these young dancers might be attributed to their relatively low body mass, their delayed maturation, and the selection process of dancers. Dancers with both GJH and scoliosis had decreased muscle strength, reduced postural balance, reduced proprioception, with higher risk of PFP. The main clinical implications are the need to reduce the risk of PFP among dancers by developing appropriate strength and stabilizing exercises combined with proprioceptive and postural balance training, to improve the correct alignment of the hyperextended and hypermobile joints, and to improve their supporting muscle strength.
许多患有全身关节过度活动综合征（GJH）的年轻女孩选择参加舞蹈活动，因为她们的身体适合这项运动。脊柱侧弯往往在体型瘦的女孩中更常见，而这类女孩也更有可能选择舞蹈。这两种异常情况（GJH和脊柱侧弯）都可能与诸如力量减弱和姿势平衡不足等能力下降有关，从而增加了肌肉骨骼疾病的风险。本研究的主要目的是确定患有GJH的舞者的患病率、患有脊柱侧弯的舞者的患病率以及同时患有这两种异常情况的舞者的患病率；并确定有无此类异常情况的年轻女性舞者在身体能力和髌股疼痛（PFP）方面的差异。
对132名年龄在12至14岁的女性舞者进行了人体测量参数、GJH、脊柱侧弯、膝关节肌肉力量、姿势平衡、本体感觉能力和PFP的评估。
54名舞者（40.9%）被诊断出患有GJH，38名舞者（28.8%）患有脊柱侧弯。未患任何异常的舞者（74名，56.1%）和同时患有两种异常的舞者（34名，25.8%）的比例存在显著差异（p < 0.001）。与未患任何异常的舞者相比，同时患有两种异常的舞者向前动态姿势平衡能力下降（p = 0.023），本体感觉能力下降（p < 0.001），膝关节伸肌（p = 0.036）和屈肌（p = 0.040）力量较弱。在同时患有两种异常的舞者中，73.5%患有双侧PFP，17.6%患有单侧PFP，8.8%没有PFP（p < 0.001）。
参加舞蹈课程的年轻女孩中GJH的患病率较高，因为关节灵活性增加可能为她们提供了一些美学优势。在这些年轻舞者中发现的脊柱侧弯高患病率可能归因于她们相对较低的体重、发育延迟以及舞者的选拔过程。同时患有GJH和脊柱侧弯的舞者肌肉力量下降、姿势平衡能力降低、本体感觉减退，患PFP的风险更高。主要的临床意义在于需要通过开展适当的力量训练和稳定练习，并结合本体感觉和姿势平衡训练，来降低舞者患PFP的风险，改善过度伸展和过度活动关节的正确排列，并增强其支撑肌肉力量。
