Ten-Year Epidemiology of Concussions in Cirque du Soleil Performers.

BACKGROUND

Sports concussion receives heavy attention from researchers. Conversely, research devoted to performing arts concussion is scant, despite a variety of head injury opportunities in artistic endeavors and environments. Circus is a high-energy, high-velocity performing art for which minimal concussion research is available.

PURPOSE: Assess via medical records the 10-year concussion incidence in Cirque du Soleil (CdS) performers and the variables surrounding their concussions.

STUDY

DESIGN

Descriptive epidemiology.

LEVEL OF EVIDENCE: Level 5.

METHODS

Data were extracted from CdS performers' medical records for 2010 to 2019: sex, age at injury, performance type, artistic discipline, mechanism of injury, performance context, and time-loss from full participation. Yearly artist-exposures for all CdS artists were identified. Data were analyzed for both resident and touring shows.

RESULTS

Over 10 years there were 2,733,073 exposures, with 354 concussions sustained among 296 performers. Acrobats were the most commonly concussed (82.8% of all concussions). There were 1.30 concussions per 10,000 artist-exposures. Repeat concussions accounted for 58 concussions (16.4%). Full return to performance occurred at a mean of 35.5 ± 100.3 days. The highest rate of concussions was in 2019 (1.93 per 10,000 artist-exposures); 2010 had the lowest (0.86 per 10,000 artist-exposures). More concussions occurred during performances than training sessions; nearly half (170 of 354) occurred during the first of 2 shows presented nightly. There was no significant difference in overall incidence between resident and touring performers. The most frequent concussion mechanisms were impact with apparatus/equipment (113 of 354) or with another artist (106 of 354).

CONCLUSION

The concussion incidence of CdS artists is noteworthy compared with sports concussions. Acrobats sustained the most concussions. Concussions occurred more frequently during performances than during training.

CLINICAL RELEVANCE: These new data on performing arts concussions highlight the prevalence and incidence of concussions in circus performers for healthcare professionals who care for them.