Musculoskeletal Injury Profile of Circus Artists: A Systematic Review of the Literature

Abstract

BACKGROUND: The circus arts involve a high degree of acrobatic, athletic, and aesthetic ability with extreme physical demands placed on performers. An understanding of the injury profile is required to guide prevention. AIM: To provide the first systematic review to enhance understanding of circus-related injuries and to provide a foundation for future preventative intervention. METHODS: MEDLINE, Scopus, and Web of Science were searched from conception to March 2016 using key search terms relating to circus artists and injury. Studies were limited to English-language human studies and included all levels and ages of circus artists. Risk of bias was assessed using a novel seven-item checklist based on the STROBE statement. RESULTS: Eight studies of varying design, populations, outcomes, and quality were analysed. Results suggest that the injury rate is relatively low among professional circus artists at 7.37 to 9.27/1,000 artist exposures. The spine and ankle are frequently injured, and most injuries are to soft tissue structures. In the professional setting, injuries appear minor, resulting in few treatments, few missed or altered performances, and a low risk of re-injury. CONCLUSIONS: The spine and ankle should be targeted for preventative interventions in circus artists due to their high frequency of injury. The heterogeneity of studies included in this review highlights the need for consistency within future research, particularly in terms of injury definition and outcome measurements.