Association Between Bone Maturation, Menstrual Cycle, Hypermobility, Scoliosis, and Low Back Pain in Pre-Professional Female Adolescent Dancers.

Abstract

Many adult dancers suffer from low back pain (LBP), which interferes with their movement strategies. A group that merits further attention are adolescent dancers as high levels of physical activity are associated with a higher risk to develop LBP. The aims of this cross-sectional study were (i) to investigate if delayed bone maturation and aberrant menstrual cycle were present in pre-professional female adolescent dancers and (ii) whether these ailments or other physical impairments could be related to LBP. Bone maturation, menstrual cycle, hypermobility, scoliosis, and LBP. Eligible female dancers were recruited among dancers aged 14-18 yrs in a secondary school specialized in dance. One-way ANOVA was used for the variables to determine significant differences between groups and the repeated measures ANOVA test was used to determine the significant differences within groups. Significance level was determined at 0.05. Fifteen out of 50 dancers reported a history of LBP. Significant differences were observed between calendar age and skeletal age in adolescent dancers (p<0.05). A considerable proportion of dancers showed delayed bone maturation (32%) or an aberrant menstrual cycle (53%), but this was not related to LBP (p>0.05). Scoliosis and generalized joint hypermobility were also not related to LBP (p>0.05). However, dancers with a history of LBP started dancing 2 years earlier (p<0.01), had significantly less hip internal rotation (p<0.05), and showed asymmetrical hip ROM (p<0.05). Based on the results of current study, delayed bone maturation and menstrual cycle disorders are common in pre-professional female dancers, but this was not related to LBP. Additionally, out of 27 variables, only starting dance activities under age 6 years old, showing hip asymmetry, and showing less internal hip rotation may be contributing factors for the development of LBP in pre-professional dancers.