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ARTICLES DE PERIODIQUES

Preparation for flight : the physical profile of pre-professional and professional circus artists in the United States

Greenspan, Stephanie ; Stuckey, Melanie
2024

Background : established norms for fitness and performance measures are lacking in circus arts. These would assist healthcare professionals and coaches to screen for readiness to participate in training or performance, determine post-injury return to performance, and develop targeted conditioning programs.
Purpose : the purpose of this research was to establish norms for trunk and extremity physical exam and performance measures in circus artists by professional status, assigned sex at birth (ASAB), and age.
Study Design : descriptive laboratory study
Methods : Circus artists (n=201; ages 13-69y; 172 females ASAB, 29 males ASAB) from 10 cities across the United States underwent a baseline physical examination including shoulder, hip and trunk measures of passive (PROM) and active (AROM) range of motion, measures of flexibility (shoulder and hip), strength (manual muscle tests, grip strength), cardiovascular fitness (3 minute-step test), balance (single limb and handstand), and performance, (pull-ups, and the closed kinetic chain upper extremity stability test [CKCUEST]). ANOVAs were used to determine between group differences by age and T-tests to discern differences by ASAB or professional status.
Results : differences existed by professional status for shoulder external rotation PROM, hip PROM, hip flexibility, shoulder and abdominal strength, and cardiovascular fitness. Sex differences were seen in active scapular upward rotation, hip and shoulder PROM and flexibility, hip and grip strength, and for functional performance measures (pull-ups, CKCUEST). Differences by age were limited to active scapular upward rotation, shoulder PROM, flexibility and strength, cardiovascular fitness, and balance. Overall, professionals outperformed pre-professionals for lower abdominal strength, pull-ups, handstand
balance, cardiovascular fitness, hamstring, and straddle flexibility. Generally, males ASAB demonstrated greater shoulder flexibility and upper body functional strength while females ASAB had greater hip and lumbar flexibility and hip strength. No measures showed consistent declines with increasing age, though some showed differences between adolescents and adults.
Conclusion : these normative values for physical characteristics and functional performance in pre-professional and professional circus artists may be used to guide screening for readiness to participate in advanced training or performance, return to performance after injury, and the development of targeted strength and conditioning programs.
Background : established norms for fitness and performance measures are lacking in circus arts. These would assist healthcare professionals and coaches to screen for readiness to participate in training or performance, determine post-injury return to performance, and develop targeted conditioning programs.
Purpose : the purpose of this research was to establish norms for trunk and extremity physical exam and performance measures in circus ...

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Untangling risk factors including discipline-specific exposure for injuries in preprofessional and professional circus artists in the USA

Greenspan, Stephanie ; Stuckey, Melanie
BMJ Open Sport & Exercise Medicine, vol. 9 n°2, p. 1-10, 2023

Objective This prospective cohort study quantified injury patterns related to specific circus discipline exposure in preprofessional and professional circus artists.

Methods Circus artists (n=201; ages 13–69; 172 female, 29 male assigned sex at birth) were enrolled in 10 cities across the USA. Participants were followed for 1 year from enrolment, completing a weekly training log and undergoing a physical therapist evaluation for injuries. The circus-specific extension of the International Olympic Committee 2020 consensus on recording injury and illness in sports was used to analyse injury patterns.

Results The study completion rate was 77% (n=155). Data were analysed by participant subgroup (age, professional status, sex at birth). The highest injury rates in participant subgroups were for males (5.69/1000 exposures) and related to discipline subgroups, were in aerial with ground elements (5.93/1000 exposures) and aerial (4.26/1000 exposures). Adults had more injuries related to aerial, whereas adolescents had more related to ground disciplines (χ2 (2)=10.62, p=0.005) and non-time loss injuries (χ2 (1)=5.45, p=0.02). Females had a higher proportion of repetitive injuries (70% vs 55%) than males (χ2 (1) = 4.43, p=0.035). Individuals with an eating disorder history had more (p<0.004) injuries (mean 2.27±2.29) than those without (mean=1.48±0.96).

Conclusions This study showed that intrinsic factors (age, sex at birth and history of eating disorder) and extrinsic factors (circus discipline exposure) affect injury risk. We need to account for the intersectionality of these factors to address risk management at an individual and group level.
Objective This prospective cohort study quantified injury patterns related to specific circus discipline exposure in preprofessional and professional circus artists.

Methods Circus artists (n=201; ages 13–69; 172 female, 29 male assigned sex at birth) were enrolled in 10 cities across the USA. Participants were followed for 1 year from enrolment, completing a weekly training log and undergoing a physical therapist evaluation for injuries. The ...

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Injury patterns in subgroups of circus artists by circus discipline : a pilot study

Greenspan, Stephanie
Orthopaedic Practice, vol. 34 n°3, p. 162-170, 2022

Background and Purpose: Circus injury research is limited. The purpose of this pilot cohort study was to describe injury frequency and characteristics related to specific circus discipline and similar sub-groups of artists based on discipline-specific physical stresses using the established IADMS injury surveillance guidelines and a novel classification for circus disciplines. Methods: Twenty-four circus artists [20 female mean (standard deviation) age 19.4 (7.7), 4 male 31.3 (2.5)] enrolled in the study. Participants were followed for one year. They submitted a weekly circus training log and circus-related injuries were assessed. Findings: Twenty-one participants completed the study (87.5%). Over the year, 47 total injuries were reported with an overall injury rate of 5/1000 exposures. Ground acrobatics was associated with 53.2% of all injuries. Clinical Relevance: Performing arts physical therapists should understand circus injury patterns and physical stresses related to different circus disciplines. Conclusion: Injury prevention strategies should initially focus on ground acrobatics.
Background and Purpose: Circus injury research is limited. The purpose of this pilot cohort study was to describe injury frequency and characteristics related to specific circus discipline and similar sub-groups of artists based on discipline-specific physical stresses using the established IADMS injury surveillance guidelines and a novel classification for circus disciplines. Methods: Twenty-four circus artists [20 female mean (standard ...

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Circus-specific extension of the International olympic committee 2020 consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport

Greenspan, Stephanie ; Munro, David ; Nicholas, Joanna ; Stubbe, Janine H. ; Stuckey, Melanie ; van Rijn, Rogier M.
BMJ Open Sport & Exercise Medicine, vol. 8 n°3, 23 pages, 2022

Indepth knowledge of injury and illness epidemiology in circus arts is lacking. Comparing results across studies is difficult due to inconsistent methods and definitions. In 2020, the International Olympic Committee (IOC) consensus group proposed a standard method for recording and reporting epidemiological data on injuries and illnesses in sports and stated that sport-specific extension statements are needed to capture the context of each sport. This is the circus-specific extension to be used with the IOC consensus statement. International circus arts researchers in injury and illness epidemiology and performing arts medicine formed a consensus working group. Consensus statement development included a review of literature, creation of an initial draft by the working group, feedback from external reviewers, integration of feedback into the second draft
and a consensus on the final document. This consensus statement contains circus-specific information on (1) injury definitions and characteristics; (2) measures of severity and exposure, with recommendations for calculating the incidence and prevalence; (3) a healthcare practitioner report form; (4) a self-report form capturing health complaints with training and performance exposure; and (5) a demographic, health history and circus experience intake questionnaire. This guideline facilitates comparing results across studies and enables combining data sets on injuries in circus arts. This guideline informs circus-specific injury prevention, rehabilitation, and risk management to improve the performance and health of circus artists.
Indepth knowledge of injury and illness epidemiology in circus arts is lacking. Comparing results across studies is difficult due to inconsistent methods and definitions. In 2020, the International Olympic Committee (IOC) consensus group proposed a standard method for recording and reporting epidemiological data on injuries and illnesses in sports and stated that sport-specific extension statements are needed to capture the context of each ...

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Injury frequency and characteristics in adolescent and adult circus artists

Greenspan, Stephanie
Medical problems of performing artists, vol.36 n°2, p. 103-107, 2021

BACKGROUND: Despite growing participation in circus arts, little is known about associated injuries. Understanding injury patterns is critical for developing interventions to decrease injury risk and guiding rehabilitation. OBJECTIVE: The purpose of this pilot prospective cohort study was to describe injury frequency and characteristics in adolescent and adult circus artists using a surveillance method derived from dance. METHODS: Participants
included 14 adolescent [mean age 14.7 yrs (1.3); 100% female] and 10 adult circus artists [mean age 30.7 yrs (3.1); 60% female]. Circus training exposure (single session of one circus discipline) and injuries were tracked for 1 year using a dance-derived injury surveillance guideline. A regression analysis was run using total session exposures, age (in years), and years of circus experience as predictor variables for injury rate. RESULTS: Twenty-one of 24 participants completed the study. Forty-seven injuries were reported (53.2% time loss; 46.8% non-time loss). Joint injuries were most common for both groups. The injury rate per 1,000 exposures was 3 (95%CI 0.6–8.7) for adolescents and 13 (95%CI 6.9–22.01) for adults. The overall regression was significant (F(3,13)=6.66, p=0.006). The only significant predictor was age (beta=0.82, p=0.003). Total session exposures and years of circus experience had betas close to 0 (–0.11 and –0.04, respectively). CONCLUSION: This pilot study comparing injuries in adolescent and adult circus artists found age but not exposure was predictive of injury risk. Use of a standardized injury surveillance guideline in circus, similar to the one used in this study, will provide greater insight into injury patterns by allowing between-study comparison.
BACKGROUND: Despite growing participation in circus arts, little is known about associated injuries. Understanding injury patterns is critical for developing interventions to decrease injury risk and guiding rehabilitation. OBJECTIVE: The purpose of this pilot prospective cohort study was to describe injury frequency and characteristics in adolescent and adult circus artists using a surveillance method derived from dance. METHODS: Parti...

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