{
  "abstract": "Objectives This study investigates how growth and maturation-related factors are associated with growth and bone injury risk in elite-level ballet students.Methods 506 full-time dance students (preprofessional) were included in the study across a 7-year time period. A causal framework was outlined using a directed acyclic graph (DAG) to outline the investigatory approach. This was then used to inform a model-building process, which used a combination of generalised linear and polynomial mixed-effects models to identify relationships between growth-related and bone-related injury occurrence and percentage of adult height, growth rate, body mass index (BMI) percentile and change BMI, while controlling for year group.Results A significant positive relationship (p=0.0006) was observed between growth rate and growth injury occurrence, while a significant (quadratic p value=0.0019) inverted U-shaped relationship was observed between percentage of adult height and growth injury occurrence. Growth rate and percentage of adult height demonstrated similar associations with bone injury; however, substantially greater error was observed when analysing bone injury compared with growth-related injury. No relationships were observed between age-specific and sex-specific BMI percentile or change in BMI and either injury type.Conclusion Both growth rate and maturation stage (85%–95% of adult height) were associated with the risk of growth-related injury in dancers. The combination of these factors can be used to implement proactive injury-reduction strategies targeting growth-related injuries.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Sport, Allied Health and Performance Sciences, St Mary’s University—Strawberry Hill Campus, London, UK",
        "Healthcare, Royal Ballet School, London, UK"
      ],
      "name": "Niall MacSweeney"
    },
    {
      "affiliations": [
        "Healthcare, Royal Ballet School, London, UK",
        "Project RED-D, London, UK"
      ],
      "name": "Karen Sheriff"
    },
    {
      "affiliations": [
        "Data Science, GroupM, London, UK"
      ],
      "name": "Christopher Fitzpatrick"
    },
    {
      "affiliations": [
        "Department of Physical Exercise and Sports Science, University of Limerick, Limerick, Ireland"
      ],
      "name": "Daniel Dylan Cohen"
    },
    {
      "affiliations": [
        "School of Sport, Technology and Health Sciences, St Mary’s University—Strawberry Hill Campus, London, UK"
      ],
      "name": "Phil D B Price"
    },
    {
      "affiliations": [
        "School of Sport, Technology and Health Sciences, St Mary’s University—Strawberry Hill Campus, London, UK"
      ],
      "name": "Ryan Mahaffey"
    },
    {
      "affiliations": [
        "School of Sport, Technology and Health Sciences, St Mary’s University—Strawberry Hill Campus, London, UK",
        "Institute of Sport, Exercise and Health, University College London, London, UK"
      ],
      "name": "Charles Pedlar"
    },
    {
      "affiliations": [
        "School of Sport, Technology and Health Sciences, St Mary’s University—Strawberry Hill Campus, London, UK",
        "The Royal Ballet Healthcare, Royal Opera House, London, UK"
      ],
      "name": "Joseph William Shaw"
    }
  ],
  "title": "Adolescent maturation and injury risk in an elite ballet school: a 7-year cohort study of 506 students",
  "uid": "f54d1528-1195-5220-a5bc-a9e43457500d"
}