Prevalence, Incidence, and Risk Factors of Musculoskeletal Injuries in Classical Ballet Dancers: A Systematic Review

Introduction: Classical ballet requires control, repetition and precise of movements, which increases the risk of musculoskeletal injuries when movements are executed incorrectly or under excessive load. This systematic review aimed to determine the prevalence and incidence of musculoskeletal injuries in classical ballet dancers and to identify the main affected body regions and associated risk factors. Methods: Systematic review study following PRISMA guidelines. Studies were selected from the databases Lilacs, Scielo, BVS, Medline, PubMed, and PEDro, using indexed terms (DeCS and MeSH). The research included observational studies reviews related to the analysis and risk of injuries in dancers of both sexes, published up to July 2023. Studies on other types of dance genres and clinical trials were excluded. The quality of the studies was assessed using the Joanna Briggs Institute Level of Evidence tool. Results: A total of 46 articles were analyzed, covering 7310 dancers (23% male, 66% female, and 11% without sex specification), aged between 8 and 47.5 years. Most studies focused on young dancers (15-24 years). The distribution of injuries by experience level was: amateur (10.9%), pre-professional (41.3%), professional (39.1%), unspecified (2.2%) and studies including more than one experience level (6.5%). Across the included studies, musculoskeletal injuries were predominantly located in the lower limbs, with the ankle and foot representing the most frequently affected regions based on the proportion of injuries reported within the study samples. The main risk factors were overload (n = 17), hypermobility (n = 10), and psychosocial conditions (n = 9). Conclusion: The high prevalence and incidence of injuries among dancers highlight the importance of implementing preventive measures based on accurate diagnoses and the identification of risk factors. The ankle is the most affected area, with overload being the main associated risk factor.