Background Within the community of professional dancers flexible joints are highly regarded for esthetic reasons and often required in order to perform complex dance routines. From a clinical perspective generalized joint hypermobility (GHM) is also associated with pain, fatigue, loss of function and psychological distress. When GHM is associated with complaints the condition is referred to as Hypermobility Syndrome (HMS). Past research has shown that GHM and HMS are prevalent within the population of dancers, however it remains unknown what the impact of GHM in professional dancers is and whether affects dancers differently.
Objectives To study the impact of GHM in young adult female dancers on functional ability, physical fitness, musculoskeletal complaints and psychological distress.
Methods 36 female dancers were recruited from the Amsterdam School of Arts and compared to 36, age matched controls (mean age: 20, range: 17-27). BMI, functional ability (6MWT), physical fitness (muscle strength, estimated V02max), musculoskeletal complaints (pain (VAS), fatigue (CIS)) were measured as well as psychological distress (HADS). The presence of GHM was scored according to the Beighton score (GHM present when ≥4). Statistical analysis was performed by MANCOVA, in which group allocation (dancer vs control) and presence GHM (Yes/No) were used as fixed factors, corrected for BMI and physical activity level.
Results For the whole population (N=72), MANCOVA revealed significant effects for the factor group and for GHM. Pairwise comparisons showed that dancers have higher levels of physical fitness: V02max (p=.02), 6MWT (p=.00). When regarding complaints, dancers showed higher levels of fatigue (p=.00) and psychological distress (p=.00). GHM was found to have a significant negative effect on physical fitness: lower functional ability (p=.00), muscle strength (p=.00) and V02max (p=.04). As well as higher pain intensity (p≥.05), fatigue (p=.00) and psychological distress (p=.04). When combining both factors only functional ability was found to be significant (p=.03), whereas other outcomes did not.
Conclusions The current study indicates that dancers have greater physical fitness but also experience more fatigue and psychological distress. In both groups GHM was also found to be a negative factor in performance and presenting complaints. The presence of GHM in highly trained and disciplined dancers caused their physical capabilities to be comparable to normal individuals without GHM that do follow a less physical straining educational program. Caregivers and professionals within the professional dance education should not only monitor on the physical capabilities but also take the psychological strain into account. Especially for individuals with GHM who seem to be more vulnerable. Why a mechanical variable like GHM is related to psychological distress is unknown, this warrants further investigation.
Grahame R, Jenkins JM. Joint hypermobility: asset or liability? A study of joint mobility in ballet dancers. Ann Rheum Dis 1972;31:109-11.
Day H, Koutedakis Y, Wyon MA. Hypermobility and dance: A review. Int J Sports Med 2011;32:485-9.
McCormack M, Briggs J, Hakim A, Grahame R. Joint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers. J Rheumatol 2004;31:173-8.
Disclosure of Interest None Declared