Injury Rates and Characteristics Associated with Participation in Organized Dance Education: A Systematic Review

Several studies and recent systematic reviews have investigated injury in dance settings and have largely focused on specific concert dance genres (i.e., ballet, contemporary) and elite levels (i.e., pre-professional, professional) of dance. Less is known about the health of those who participate in dance education settings, namely teachers and students from private dance studios. Given that these individuals constitute a large proportion of the dance community, greater clarity of risks in the dance training environment could benefit an underserved majority by informing the development of effective injury prevention strategies.
Objective: The primary objective was to describe injury rates and characteristics associated with participation in organized dance education settings.
Methods: Six electronic databases were searched to April 2021 (Medline, EMBASE, SportDiscus, CINAHL, SCOPUS, Cochrane). Selected studies met a priori inclusion criteria that required original data from dance teacher and student samples within formal dance education settings. All genres of dance were eligible. Studies were excluded if no injury outcomes or estimates of dance exposure were reported, if injuries occurred during rehearsal and performance, or if dance was used as a therapeutic intervention or exercise. Two reviewers independently assessed each paper for inclusion at abstract and full text screening stages. The quality of included studies was assessed using the Joanna Briggs Institute Level of Evidence tool.
Results: The initial database search identified 1,424 potentially relevant records, 26 were included and scored. Most studies (n = 22) focused on dance students only, three included only dance teachers, and one study included both. Among both dance students and teachers, the majority of injuries reported were overuse or chronic and involved the lower limb. For studies that reported injury rates (n = 14), estimates ranged from 0.8 to 4.7 injuries per 1,000 dance hours, 4.86 per 1,000 dancer-days, and 0.21 to 0.34 per 1,000 dance exposures.
Conclusions: Based on the current research, dance students and teachers experience a similar rate of injury to concert and professional dancers, and their injuries are most commonly overuse injuries involving the lower extremity. There have been few high-quality investigations of injury specific to the dance training environment. Therefore, consensus around the burden of injury in the dance education settings remains difficult. Future dance epidemiological investigations that examine the burden of injury among dance teachers and students, include operational injury and exposure definitions, and utilize prospective designs are warranted.