BACKGROUND:Music performance anxiety (MPA) is common among musicians, affecting performance quality, well-being, and career continuity. Reliable and culturally adapted tools are essential for its assessment. The Mazzarolo Music Performance Anxiety Scale (M-MPAS) is a brief five-item measure of the intensity, frequency, and avoidance of performance-related anxiety, but no validated Brazilian version has been available. OBJECTIVE:To conduct a cross-cultural validation of the M-MPAS among professional and student musicians in the Brazilian context and evaluate the construct validity and reliability of the Brazilian version (M-MPAS-Br). METHODS:A cross-sectional methodological study was conducted with 243 musicians from orchestras, conservatories, and university programs in Rio de Janeiro. The adaptation followed international and COSMIN guidelines. The measurement properties evaluated were structural validity (exploratory and confirmatory factor analyses), internal consistency, test-retest reliability, and hypotheses testing for construct validity through correlations with the Kenny Music Performance Anxiety Inventory (K-MPAI) and the Short-Form 8 (SF-8). RESULTS:The M-MPAS-Br showed semantic and conceptual equivalence. A one-factor solution explained 74.9% of variance (CFI = 0.989, TLI = 0.978, RMSEA = 0.098, SRMR = 0.015). Internal consistency was α = 0.929 (95% CI [0.917-0.940]) and test-retest reliability ICC = 0.948 (95% CI [0.929-0.962]). Convergent validity with the K-MPAI (24 anxiety-related items) was ρ = 0.967, 95% CI [0.957-0.974], p < 0.001. Divergent validity showed weak correlations with the Physical Component Summary (PCS-T) (ρ = -0.211, p < 0.001) and moderate with the Mental Component Summary (MCS-T) (ρ = -0.462, p < 0.001). CONCLUSIONS:The M-MPAS-Br demonstrated excellent reliability, validity, and cultural adequacy, providing a brief and psychometrically robust tool for assessing MPA among Brazilian musicians. Its brevity supports its use as a screening instrument for the early identification of performance anxiety in clinical, educational, and large-scale research settings.
OBJECTIVES:Students in classical music performance in higher education frequently report playing-related musculoskeletal disorders (PRMDs) and psychological distress. Observational studies based on self-reported data suggest an association between these two health problems. This observation supports early multidimensional prevention. However, access to musician-specific health support remains limited. The aim of this study was to develop a consensus among experts, informed by input from music students and teachers (stakeholders), on the relevance/usefulness of Patient-Reported Outcome Measures (PROMs) and self-management strategies for music students, structured across four target domains: physical, psychocognitive, behavioral, and professional. A secondary aim was to identify relevant health-knowledge content and pedagogical modalities for prevention within the music curriculum. METHODS:A Delphi study was conducted according to the Guidance on Conducting and Reporting Delphi Studies (CREDES) guidelines. The Delphi survey items were derived from a previous scoping review, which identified 42 PROMs and 97 self-management strategies for pre¬professional and professional musicians, and from relevance/usefulness ratings provided by music students and teachers. In Round 1, experts rated each item's relevance/usefulness on 5-point Likert scales. In Round 2, retained items and refined additional proposals were re-rated; consensus was defined as ≥50% of experts ranking an item among the top 50% most relevant/useful within their individual set of rated items. RESULTS:Fourteen experts participated in Round 1 (4 clinicians, 2 researchers, 8 clinician-researchers) and 12 in Round 2. After two rounds, experts reached consensus on 10 PROMs, 30 self-management strategies (e.g., advice on physical exercise, individual work organization, and balance/postural control exercises), and 7 health-knowledge topics, spanning physical, psychocognitive, behavioral, and professional domains. Experts supported structured, curriculum-embedded delivery and formal academic credit at both Bachelor's and Master's levels. CONCLUSION:Numerous self-management strategies are considered relevant for improving health management in the daily lives of music students. The results highlight strong consensus in favor of incorporating PROMs-based health monitoring, health knowledge, and self-management strategies into higher-education music curricula to support music students' health management in daily life across physical, psychocognitive, behavioral, and professional domains.
OBJECTIVES:This cross-sectional survey aimed to compare the 24-month injury prevalence between amateur and professional male breakdancers (also known as breakers or B-boys) in China and identify key injury characteristics associated with skill level. This study hypothesized that Chinese professional B-boys have a higher injury prevalence than amateurs and the injury characteristics differ in their association with technical movements and training condition. METHODS:A self-developed 27-item questionnaire covering three domains-basic information, training history, and injury characteristics-was distributed online to male breakers. Participants were classified into amateur (n=468) and professional (n=178) groups using a composite criterion combining self-assessed skill rank and cumulative train¬ing hours. Continuous variables were compared using Mann-Whitney U tests, and categorical variables using chi-square tests with Bonferroni correction for post-hoc pairwise comparisons. Generalized estimating equations (GEE) were applied to analyze injury factors while accounting for within-dancer clustering of multiple injuries. RESULTS:Among the 646 dancers, 584 (90.4%) reported at least one injury, with no significant difference in injury prevalence between the amateur and professional groups (89.3% vs 93.3%, P=0.445). A total of 1,000 injury cases were documented. The most frequently injured sites were the wrist, knee, shoulder, and waist, with shoulder injuries significantly more common in professional dancers (21.3% vs 14.6%, P=0.031). Self-reported contributing factors included insufficient warm-up, fatigue, and perceived deficiencies in basic skills. Over 80% of dancers lacked professional medical support. Exploratory chi-square tests revealed that shoulder, knee, and wrist injuries were related with technical movements; however, these patterns were unadjusted for exposure time and therefore reflect only injury distribution, not movement-specific risk. CONCLUSIONS:Injury prevalence was similarly high in amateur and professional B-boys, with no significant between-group differences. Commonly injured sites and self-reported contributing factors, together with the lack of medical support, highlight the priorities for prevention. The movement-injury patterns warrant further investigation in future prospective studies.
Muscle fatigue and smaller hand spans are considered important risk factors of injuries for pianists. The objective of the present study was to assess the effect of keyboard size and hand anthropometry on perceived exertion and the evolution of upper-limb muscle fatigue in 20 expert pianists performing a repetitive piano task, while controlling for performance parameters. Muscle fatigue was assessed using surface electromyography (EMG), including a high-density EMG grid placed on the right posterior forearm and wireless EMG sensors on the right upper-limb muscles. The myoelectric manifestation of fatigue was quantified using variations in the median EMG frequency at different time intervals throughout the task. All upper-limb muscles exhibited fatigue. Smaller hand size was found to be a contributing factor to increased perceived exertion and muscle fatigue in finger/wrist extensor muscles. When pianists with smaller hands played on a smaller keyboard (DS6.0 keyboard), perceived exertion decreased, the radial area of finger/wrist extensors showed fewer signs of fatigue, and playing speed (tempo) was faster toward the end of the task. The DS6.0 keyboard can help reduce muscle fatigue in pianists with smaller hands. However, as hand-size and keyboard-size effects were localized in different areas of the posterior forearm, the DS6.0 keyboard might reduce but not fully mitigate hand-size disparities between pianists.
BACKGROUND:Temporomandibular disorders (TMDs) comprise a heterogeneous group of conditions affecting the temporomandibular joints, masticatory muscles, and related structures, and may influence both quality of life and professional performance. Professional musicians represent an occupational group exposed to combined physical and psychosocial demands that may increase vulnerability to temporomandibular symptoms. OBJECTIVE:To determine the prevalence of temporomandibular symptom reporting and its association with socio-demographic and occupational factors, as well as health-related quality of life, among Portuguese professional orchestral musicians. METHODS:A cross-sectional study was conducted involving 271 professional musicians from Portuguese orchestras. Data were collected using a self-administered questionnaire incorporating the Fonseca Anamnestic Index (FAI) and the SF-12v2 Health Survey, alongside sociodemographic and occupational variables. Descriptive statistics, chi-square tests, Student's t-tests, Mann-Whitney U tests, and multiple logistic regression analyses were performed with a significance level of p < 0.05. RESULTS:Temporomandibular symptoms were identified in 61.6% of participants. Female musicians showed a significantly higher prevalence than males (77.4% vs 48.3%, p < 0.001). Younger musicians (18-29 years) presented the highest prevalence, whereas those aged over 50 years showed the lowest frequency. Part-time employment was associated with increased odds of symptom reporting (OR = 2.15, 95% CI: 1.07-4.31). No significant associations were observed with education level, instrument category, or weekly practice time. Musicians reporting temporomandibular symptoms demonstrated significantly lower physical and mental health scores on the SF-12v2 (p < 0.01). CONCLUSION:Temporomandibular symptoms are highly prevalent among professional orchestral musicians and are associated with demographic and occupational factors, as well as reduced health-related quality of life. These findings highlight the importance of preventive and multidisciplinary approaches addressing the occupational demands of orchestral performance.
Literature on renowned classical ballet dancers and educators highlights the importance of breathing in dancing. The purpose of this case study was to explore the feasibility of investigating the underexplored relationship between breathing and dance movements. The participant, a 25-year-old female professional classical ballet dancer, performed ballet choreography requiring significant stamina and pointe technique. Her breathing sounds and video footage were recorded simultaneously using two smartphones. The timings of breathing and kinematic events were identified in the two segments. In both segments, the respiratory rate was approximately 60 breaths/minute, suggesting that breathing may be finely controlled in ballet. In the first segment, breathing occurred at a steady rhythm, and no clear coupling between breathing and movement phases was observed. In the second segment, the rhythms of turns and breathing appeared to be coupled, suggesting possible coordination between breathing and movement. These exploratory findings provide a basis for future research on breathing during ballet performance.
The problem of occupational injuries and pain among musicians continues to receive wide attention. However, the limitations of survey tools have limited hindered the in-depth development of occupational health research on musicians across different regions to a certain extent. The aim of this study was to translate the Performance-Related Pain in Musicians Questionnaire (PPAM) into Simplified Chinese (PPAM-C) and to conduct the cultural adaptation and initial validation of the PPAM-C for music students. The reliability and validity of the questionnaire were tested with Chinese music students. A total of 610 valid questionnaires were collected (students' mean age 19.4 yrs, SD 1.146); females accounted for 69.7%. The respondents represented a variety of primary musical instrument types. Exploratory factor analysis (EFA) supported a three-factor structure consistent with the original version: pain intensity, pain interference in general activities, and pain interference in performance. The sample fit was good (KMO = 0.851; Bartlett's test of sphericity, p <0.001). The communalities and eigenvalues showed the robustness of the factor structure. The internal consistency (Cronbach's α = 0.786-0.937) of the subscales was good. The PPAM-C showed significant moderate to high correlations with the relevant domains of the Simplified Chinese versions of the Brief Pain Inventory (BPI), QuickDASH, and SF-36 scales, which confirmed its good convergent validity. The results of demographic analysis further showed that the questionnaire was applicable to music students of different ages, genders, and primary musical instruments. In conclusion, the PPAM-C exhibits excellent psychometric properties and is a reliable tool for assessing pain and its impact on music students' general and performance-related activities in the Chinese context.
OBJECTIVES: Psychological stress concerns many musicians and poses a risk for their mental and physical health. However, there are thus far no instruments that measure psychological stress of musicians in particular. We aimed to fill this gap by developing a questionnaire designed specifically to detect components that increase psychological strain in musicians. METHODS: The L & uuml;becker Inventar f & uuml;r psychischen Stress bei Musizierenden (L & uuml;beck Inventory on Musicians' Psychological Stress, LIMIT) was developed through consultation with experts from the field. Subsequently, the factorial structure was examined on a sample of N = 602 musicians. Multiple factor extraction methods were compared using model fit criteria to determine an adequate/representative number of factors and items. Reliability and validity of the questionnaire were tested. RESULTS: The Kaiser-Meyer-Olkin criterion revealed an excellent sampling adequacy (0.945). Excluding non-fitting items, the final LIMIT is composed of 34 items loading on four factors: "self-efficacy," "depression," "time-management," and "pressure." The scale reached an excellent reliability (Cronbach's a = 0.938) and fulfilled validation criteria. CONCLUSIONS: The LIMIT can be a useful screening tool for assessing musician-specific psychological strain, enabling musicians and practitioners to identify stress at an early stage and to seek out support in good time. An English validation is in progress. Med Probl Perform Art 2025;40(4):97-113.
The Japanese Performing Arts Medicine Association (JPAMA) has officially launched. This marks the realization of a vision first articulated by Dr. Naotaka Sakai in this journal in 2017. Although JPAMA was established in 2022, it initially comprised only doctors and dentists. In 2025, a third kind of academic conference was scheduled, for not only medical professionals but also basic researchers, music educators, musicians, and dancers. By structuring JPAMA as a tripartite organization-—comprising the Performing Arts Medicine group, Performing Arts Therapy group, and Performing Arts Science group—-it enabled medical professionals to engage in more specialized discourse. This new tripartite structure offers a potential model for the future development of performing arts medicine societies.
OBJECTIVE:Performance-related musculoskeletal disorders (PRMDs) are common among orchestral musicians, with string players, including cellists, at high risk due to their unique playing posture and forceful movements. Despite frequent reports of pain, especially in the upper back, shoulders, and hands, specific tissue pathologies in cellists remain underexplored. This study investigates ultrasound findings in cellists with PRMDs and their clinical implications. METHODS:This retrospective case series study, conducted at a musician clinic in a tertiary medical center from January 2019 to September 2023, included cellists diagnosed with PRMDs. Exclusion criteria included traumatic accidents and rheumatological conditions. Data collected according to the CARE guidelines included demographics, PRMD severity, discomfort localization, ultrasound imaging findings, and treatment modalities (e.g., postural training, manual therapy, and injections). The null hypothesis was rejected at a < 0.05. Statistical analysis was performed using SPSS (ver. 27.0). RESULTS:Fifty-one cellists were included. The majority were students (70.6%), with Stage 4 PRMDs being the most common (60.7%). Common discomfort regions included the left scapulae/shoulder (33.3%), left hand (25.4%), and right scapulae/shoulder (19.6%). Ultrasound revealed the left serratus anterior superior bundle (21.5%) and left levator scapula (15.6%) as the most affected sites. 98% of participants resumed playing within 3 months after the interventions, with reported functional improvement and pain reduction. Treatment included physical therapy, instrument adjustment, ultrasound-guided regenerative injection (hypertonic dextrose and/or platelet-rich plasma), and a postural retraining program. CONCLUSION:This study provides the first ultrasound-based analysis of PRMDs in cellists. Key lesions were identified in the left serratus anterior superior bundle and levator scapulae. Ultrasound-guided regenerative injections and postural retraining effectively treated cellists, with 98% returning to playing within 3 months.
OBJECTIVES:Psychological stress concerns many musicians and poses a risk for their mental and physical health. However, there are thus far no instruments that measure psychological stress of musicians in particular. We aimed to fill this gap by developing a questionnaire designed specifically to detect components that increase psychological strain in musicians. METHODS:The Lübecker Inventar für psychischen Stress bei Musizierenden (Lübeck Inventory on Musicians' Psychological Stress, LIMIT) was developed through consultation with experts from the field. Subsequently, the factorial structure was examined on a sample of N = 602 musicians. Multiple factor extraction methods were compared using model fit criteria to determine an adequate/representative number of factors and items. Reliability and validity of the questionnaire were tested. RESULTS:The Kaiser-Meyer-Olkin criterion revealed an excellent sampling adequacy (0.945). Excluding non-fitting items, the final LIMIT is composed of 34 items loading on four factors: "self-efficacy," "depression," "time-management," and "pressure." The scale reached an excellent reliability (Cronbach's a = 0.938) and fulfilled validation criteria. CONCLUSIONS:The LIMIT can be a useful screening tool for assessing musician-specific psychological strain, enabling musicians and practitioners to identify stress at an early stage and to seek out support in good time. An English validation is in progress.
INTRODUCTION:Playing wind instruments may promote neck, arm, or shoulder pain, as well as temporomandibular pain. The cervical and orofacial regions are associated, due to their proximity and the influence they both have on body posture. In wind musicians, the mouth is responsible for producing the sound. Any alteration in the characteristics of the orofacial system can affect the embouchure when playing a wind instrument. AIM:To observe demographic and physical characteristics in the cervicomandibular region in a sample of university wind students. METHODS:An observational descriptive cross-sectional study was carried out with wind students in the two higher conservatories of the region of Galicia, Spain. We studied the posture of the head and neck, the range of cervical movement and mouth opening, the presence of trigger points in the upper trapezius and masseter, as well as their algometry and electromyographic value. RESULTS:30 woodwind and 19 brass students were evaluated, 51% of whom were female. A tendency towards a forward position of the head and protraction of the shoulders was observed, maintaining horizontality in the frontal plane in both the head and shoulders. Cervical movements were diminished, while the mouth opening was greater than standard. In this sample, a relatively high prevalence of trigger points in the upper trapezius was observed, while the masseters showed greater sensitivity to pain and greater activation during trapezius contraction. CONCLUSIONS:Musicians in this study presented an anteriorized position of the head and shoulders in the sagittal plane, with a decrease in cervical range of motion particularly in the transverse plane.
OBJECTIVE: The aesthetic demands require adaptations in posture that serve both functional efficiency and artistic purposes, but the relationship between spinopelvic alignment and center of pressure (COP) displacement in ballet dancers is understudied. Exploring the differences in these parameters between ballet-trained and untrained individuals could help determine whether the posture of dancers, adapted to aesthetic demands, is also efficient from a kinematic perspective. In this study, we compared postural sway characteristics and segmental kinematics between ballet dancers and non-dancers during three different standing positions with progressively increasing heel elevation (normal, 1/4 pointe, and demi-pointe). Additionally, this study sought to clarify the relationship between the spinopelvic and lower limb kinematics and the oscillations in the COP of the body. METHODS: This study was designed as a comparative cross-sectional study. The study involved 11 ballet dancers and 10 nondancers. Variables such as COP path length, mean angular position, and coefficient of variance (CV) of the spinal-pelvis system (midthoracic, thoracolumbar, and lumbopelvic regions) and lower limb joints (hip, knee, and ankle) were measured. For variables with normal distribution, a two-way repeated-measures ANOVA was conducted to detect group and task effects, with post-hoc Tukey’s HSD tests for significant interactions. Additionally, the relationships among COP path length, angular position, and CV were analyzed using correlation coefficients. RESULTS: Dancers demonstrated significantly shorter COP path length in demi-pointe (701.3 vs 902.2 mm, p<0.05) and greater ankle plantar flexion in both elevated positions (1/4 pointe: –13.3° vs –7.2°, p<0.05; demi-pointe: –44.7° vs –22.5°, p0<0.01) compared to nondancers. With increasing heel height, the number of segments showing a significantly higher CV compared with normal standing increased in both groups. In the demi-pointe posture, dancers exhibited a correlation between COP path length and hip and knee angles (p<0.05) and nondancers showed correlations between COP path length and CV of the midthoracic (p<0.01), thoracolumbar (p<0.05), knee (p<0.01), and ankle (p<0.01). CONCLUSION: Dancers exhibited better balance, as indicated by a shorter COP path, particularly in the demi-pointe position, compared to nondancers. While no significant differences were found in spinopelvic kinematics between groups, these were associated with COP path length in nondancers during demi-pointe owing to within-group variations, unlike in dancers.
BACKGROUND: Violinists and violists are prone to musculoskeletal pain due to repetitive movements, sustained postures, and long hours of practice. While performance-related musculoskeletal disorders are well documented internationally, little is known about their prevalence and psychosocial correlates among Brazilian professional musicians. OBJECTIVES: To (1) describe the prevalence, intensity, and interference of musculoskeletal pain across 12-month, 4-week, and 7-day time frames, together with perceived quality of working life; (2) examine correlations between pain, psychological distress, and work-related quality of life; and (3) test whether pain severity was independently associated with psychological distress and work-related quality of life in multivariate regression models adjusting for demographic and professional covariates. METHODS: In this cross-sectional study, 122 musicians from 10 orchestras completed validated questionnaires, including the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-Br), the Depression Anxiety and Stress Scale (DASS-21), and the abbreviated Quality of Work Life Questionnaire (QWLQ-bref). Statistical analyses comprised descriptive statistics, Spearman correlations, and multivariate linear and logistic regression models adjusting for age, sex, and years of professional experience. RESULTS: Nearly all participants (95.1%) reported having experienced musculoskeletal pain affecting their playing, with the shoulders (44.2%), wrists (36.5%), scapulas (21.2%), and cervical region (21.2%) most affected. Although overall quality of working life was rated satisfactory, 13.1% reported moderate to severe psychological distress, particularly stress symptoms. Higher pain interference was consistently associated with greater psychological distress (b = +0.30, p = 0.013) and lower work-related quality of life (b = –0.28, p = 0.015). Pain intensity alone was not a significant independent predictor when controlling for covariates. CONCLUSIONS: Musculoskeletal pain is highly prevalent among Brazilian violinists and violists and is closely linked to psychological distress and reduced work-related quality of life. These findings highlight the need for comprehensive strategies addressing both physical and psychosocial aspects of musicians’ health.
OBJECTIVE:Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered care (PCC). The purpose of this study was to explore healthcare providers (HCPs) who MB artists have access to and the artists' perceptions of PCC. METHODS:We used a cross-sectional, web-based survey to explore which providers MB artists had access to. In total, 751 MB artists (age 20±8 yrs) completed the survey. Respondents who reported no access or were unsure were prompted to complete an open-ended response describing what they would do if an injury or illness occurred. Participants who had access to an athletic trainer (AT) completed the Global Perceptions of Athletic Trainer Patient-Centered Care Tool (GPATPCC; a=0.90; 15 items [1 reverse-scored]; 4-point Likert scale [1=strongly disagree, 4=strongly agree, 0=unsure]; score=average). Participants with access to other HCPs completed the Consultation and Relational Empathy tool (CARE; a=0.97; 10 items; 5-point Likert scale [1=poor, 5=excellent]; score=sum). Scores for the tools were standardized (z-score), and a Mann-Whitney U test determined PCC differences between those with access to ATs and those with access to other HCPs. RESULTS:Overall, 42.5% of MB artists had access to a HCP. The MB artists with access to ATs expressed satisfaction (mean 3.05±0.67) on the GPATPCC tool. Participants who completed the CARE tool expressed they were satisfied (mean 39.59±8.78). However, 57.5% of MB artists reported having no access or being unsure, who commonly relied upon communicated with MB leadership (33.8%) when injured. No significant differences were identified between ATs and other HCP ratings of PCC (U=4615, z=-0.36 p=0.719). CONCLUSION:Over half of MB artists reported a lack of access or a lack of familiarity with what HCPs are available. Those with access to HCPs were satisfied with the care they received. Continued efforts should be focused on improving MB artists' access to HCPs.
BACKGROUND:In ballet, a single movement can be developed into multiple variations by changing factors such as direction or magnitude. Similarly, the Dance-Specific Graded Rehabilitation Program (DSGRP) is built on the progression of three factors: (1) movement (relevés, heel raises; explosive relevés [EXrelevé], heel raises with the intention to jump but not actually jumping; and sautés, small jumps), (2) leg support (double-leg and single-leg), and (3) barre support (two hands, one hand, and no hands). However, these factors are yet to be fully analyzed biomechanically. OBJECTIVE:This study aimed to investigate the influence of movement, leg support, and barre support on mechanical load and impact characteristics of a dance-specific heel raise to jump progression. METHODS:Eighteen healthy dancers performed the stages of the progression in a semi-randomized order. Mechanical load was quantified by peak vertical ground reaction force (vGRF) and illustrated by weight-bearing profiles. Impact characteristics relating to force-time dynamics were quantified by the rate of force attenuation (RFA) during takeoff and the rate of force development (RFD) during landing. Linear mixed models assessed the significance and incremental contributions of each factor for peak vGRF, RFA, and RFD, while weight-bearing profiles were analyzed descriptively. RESULTS:Results revealed increasing load and impact characteristics with movement type and leg support, though negligible influence of barre support. Incre¬mental increases were quantified for the first time in a dance-specific context. CONCLUSION:Findings support the inclusion of EXrelevés as an intermediary movement between relevés and sautés. Barre support did not influence vertical kinetics, suggesting the need to explore its potential role in transverse plane stabilization. The reported increments suggest the following progression for optimal loading: double-leg relevés, double-leg EXrelevé, single-leg relevé, single-leg EXrelevé, double-leg sauté, and single-leg sauté. Incremental effects of observed factors inform optimal sequencing for training and rehabilitation progressions in dance.
Marching performers spend a significant amount of time on their feet practicing precise movements. Presumably, individuals choose footwear to practice in that is comfortable and suits their individual needs. However, when it comes to competition, there are a limited number of footwear options available, and they are not specialized to the individual. The purpose of this letter is to advocate for more research and the continued evolution of competitive footwear design for marching arts.
PURPOSE:The health concerns of drag queens remain understudied. This paper examines the physical health and healthcare access of drag queens and reflects on ways to holistically promote their well-being. METHODS:Professional drag queens in the United States underwent the Dance/USA Task Force on Dancer Health Annual Post-Hire Health Screen, which assesses medical history, musculoskeletal metrics, and cardiovascular fitness. To discuss healthcare needs, this paper draws from the authors' expertise in physiatry, dermatology, gender studies, mental health, and medical anthropology. RESULTS:Seven performers chose to participate in the study, with 6 participants participating in both the history and physical examination portions. While 3 (50%) had excellent cardiovascular fitness, 2 had below aver¬age or very poor results. None of the performers met the Beighton criteria for hypermobility. Bilateral hip flexion tightness was seen in 5 (83%) of performers, while 100% had tightness in bilateral hip internal rotation. The weakest muscle groups included lower abdominals and hip extensors bilaterally, left weaker than right. Four out of 7 reported a current or prior musculoskeletal injury. Three of 7 have health insurance, 4 felt they would benefit from psychology counseling, and 4 reported binge drinking at least three times in the past year. Four out of 7 were overdue (>24 months) for visiting their primary care physician. CONCLUSIONS:Drag queens may be at risk for musculoskeletal injuries and strength asymmetries, dermatologic issues, and psychosocial harms. An urgent need exists for a comprehensive understanding of drag queen health to promote the well-being of understudied LGBTQIA+ populations.
OBJECTIVE:To investigate via video review the intra-rater and inter-rater reliability of three pointe-readiness tests: the topple test, airplane test, and sauté test. METHODS:Ten ballet-trained pre-professional and professional dancers were videotaped performing the topple test, airplane test, and sauté test from the front and side views. The videos, written instructions, and rater score sheets were provided to the raters via individually linked electronic access over four sessions, with a washout period of 2 weeks between sessions. The videos were reviewed at slow speed and at real-time speed, with two sessions at each speed, assigned in random order. Raters received a training session prior to the start of their first session. Intraclass correlation coefficients were calculated for intra-rater and inter-rater reliability for all raters for each test and for the total score of the three tests. RESULTS:Twenty-two raters assessed the 10 dancers. Intra-rater reliability was good between session 1 and session 2 for the real-time speed (ICC range = 0.83-0.88), good for the slow speed (ICC = 0.83-0.85), good to excellent for the average of real-time vs slow speed (ICC = 0.88-0.94), and excellent for session 1 vs session 2 (ICC = 0.93-0.96). Inter-rater reliability was good to excellent for the first real-time speed (ICC = 0.88-0.94), for the first slow speed (ICC = 0.85-0.96), and for the first session regardless of speed (ICC = 0.88-0.96). CONCLUSION:The criteria for the pointe-readiness tests are acceptable. Raters with and without a dance background were able to conduct the movement assessments with good to excellent intra-rater and inter-rater reliability in real-time review. LEVEL OF EVIDENCE:III.
BACKGROUND:In dance, injuries are significant factors that can bring an active dance career to an end. A patient-reported outcomes questionnaire with established validity and reliability is useful for determining and evaluating the functional status of dancers before or after injuries. However, no valid and reliable survey is available in Turkish to assess dancers' functionality levels. The objective of this study was to translate, culturally adapt, and validate the characteristics of the Turkish version of the Dance Functional Outcome Survey (DFOS-TR) in adult dancers. METHODS:The DFOS-TR underwent forward translation, reconciliation, backward translation, and thorough review by an expert committee to ensure optimal alignment with the original English DFOS. A sample of 113 dancers (55 injured and 58 healthy) voluntarily participated in the research. Construct validity was assessed by comparing DFOS-TR to SF-36 using Pearson correlations; exploratory factor analysis and internal consistency were conducted; and sensitivity was evaluated through the generation of receiver operating characteristic curves and calculation of the area under the curve (AUC). Test-retest reliability was assessed by examining 26 dancers over a 15-day period, employing intraclass correlation (ICC). Various methods were employed, including ICC, standard error of measurement (SEM), minimal detectable change at the 95% confidence interval (MDC95), and standardized response mean (SRM). DFOS-TR scores were compared using paired samples t-test and two-way repeated measures ANOVA (p<0.05). The scores of injured dancers were examined to identify any floor or ceiling effects. RESULTS:The DFOS-TR demonstrated very high test-retest reliability (ICC=0.84). Single-factor loading in exploratory factor analysis confirmed the scale's unidimensionality and high internal consistency (a=0.79), A positive moderate correlation was found between SF-36 physical component and DFOS-TR total score (r=0.44; p=0.046) and activities of daily living (ADL) subscore (r=0.58; p=0.006). Cut-off value of 85.5 for DFOS-TR total score yielded in 87.3% sensitivity and 36.2% specificity. The scale did not exhibit ceiling or floor effects among the injured dancers, indicating robust measurement properties. CONCLUSION:The DFOS-TR can be used as a reliable, internally consistent, and effective measurement tool for Turkish-speaking dancers in health as well as during and after lumbar or lower extremity injuries.
