Musculoskeletal Injuries, Pelvic Floor Dysfunctions and Menstrual Irregularities in Norwegian Rhythmic Gymnasts and Dancers - Observational and Cluster Randomized Controlled Studies
Sponsor study identifier
interventional
205
1 country
1
Study Start
August 22, 2022
Actual (reported)Primary Completion
June 30, 2023
Actual (reported)Study Completion
June 30, 2023
Actual (reported)Overuse injuries are common among competitive Norwegian rhythmic gymnasts with a mean weekly prevalence of 37% \[95% CI: 36 - 39%\] and incidence of 4.2 new overuse injuries \[95% CI: 3.6 - 4.9\] per gymnast per year (Gram, M., Clarsen, B., \& Bø, K., 2021). The knees, lower back and hip/groin were the most common injury locations. It has been postulated that reduced physical capacity (e.g strength, flexibility, stability) in the knees, lower back and hip/groin can increase the risk of injuries in rhythmic gymnastics. In addition, more than 30% of the Norwegian rhythmic gymnasts experience urinary incontinence (UI), and 70% reported that UI negatively affected sports performance (Gram, M., \& Bø, K., 2020). Few of the rhythmic gymnasts had any knowledge about the pelvic floor. Hence, this assessor blinded cluster randomized controlled trial aims to find out whether the implementation of exercises targeting reduced physical capacity and pelvic floor dysfunction can prevent/reduce the prevalence of overuse injuries and UI.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
June 30, 2023
Actual (reported)Click on a node to explore related trials.
Some registry-reported names shown below are not yet linked in this graph.
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
August 16, 2022
Actual (reported)August 18, 2022
Actual (reported)August 22, 2022
Actual (reported)June 30, 2023
Actual (reported)June 30, 2023
Actual (reported)Reduction in prevalence of overuse injuries in the knees, lower back and hip/groin
The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2) is a valid questionnaire to assess prevalence and severity of injuries in different anatomical areas.
The gymnasts in both groups will answer the OSTRC-H2 at baseline (October 2022) and one time each month throughout the intervention period (last registration in June 2023)
Reduction in prevalence and bother of UI
The International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI-SF) is a reliable and valid questionnaire assessing prevalence, amount of leakage, bother and type of UI.
The gymnasts in both groups will answer the ICIQ-UI-SF one time at baseline (October 2022) and one time when the intervention period has ended (June 2023)
Self-experienced effect and progress related to overuse injuries in the knees, lower back and hip/groin
The gymnasts in the intervention group will answer the GRC on time when the intervention period has ended (June 2023)
Self-experienced effect and progress related to UI
The gymnasts in the intervention group will answer the GRC one time when the intervention period has ended (June 2023)
Exercises for knees, lower back and hip/groin in an expanded warm up program. In addition, the warm up program will include pelvic floor muscle training (PFMT). The warm up program will in total take approximately 12-15 minutes to conduct each training.
No intervention.
Rhythmic gymnastics clubs allocated to the intervention group will be visited by a physiotherapist (the PhD candidate), which will perform thorough teaching of coaches and gymnasts on how to perform the exercises in the expanded warm up program. During the same visit, before commencing PFMT, the gymnasts will have an individual session were a portable 2D ultrasound machine (GE Healthcare -Logiq e R7, GE\>12L-RS - 5-13 MHz Wideband Linear Probe) will be used to teach and assess ability to perform a correct PFM contraction. The probe is placed suprapubically and provides concurrent visible biofeedback of the PFM contraction. Adherence to the intervention will be registered weekly by the coach in a training diary and asked for as an additional question in the monthly OSTRC-H2 sent to the gymnasts. Reminders will be sent by phone to the coaches every week. To assure proper execution and motivation, the PhD candidate will perform one extra visit midterm.
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
Norwegian School of Sport Sciences
Oslo, 0863, Norway
Gram MCD, Clarsen B, Bo K. Injuries and illnesses among competitive Norwegian rhythmic gymnasts during preseason: a prospective cohort study of prevalence, incidence and risk factors. Br J Sports Med. 2021 Feb;55(4):231-236. doi: 10.1136/bjsports-2020-102315. Epub 2020 Aug 31.
Gram MCD, Bo K. High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance. Scand J Med Sci Sports. 2020 Jan;30(1):159-165. doi: 10.1111/sms.13548. Epub 2019 Sep 30.
Kari Bø, PhD
Norwegian School of Sport Sciences
205 participants (actual enrollment reported by the registry).
First Submitted
August 16, 2022
First Posted
Comparison Between Pelvic Muscle Training and Pilates Exercises for UI in Postmenopausal Women
Evaluation of a New Bladder Health Mobile Application in Pregnancy
Contact the study team to confirm eligibility.
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Thyssen HH, Clevin L, Olesen S, Lose G. Urinary incontinence in elite female athletes and dancers. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):15-7. doi: 10.1007/s001920200003.
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Ferreira, S., Ferreira, M., Carvalhais, A., Santos, P. C., Rocha, P., & Brochado, G. (2014). Reeducation of pelvic floor muscles in volleyball athletes. Revista da Associação Médica Brasileira, 60, 428-433.
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Gram MCD, Fagerland MW, Bo K. Pelvic floor muscle training by competitive rhythmic gymnasts at regular training sessions did not reduce urinary incontinence: a cluster-randomised trial. J Physiother. 2025 Apr;71(2):117-124. doi: 10.1016/j.jphys.2025.03.006. Epub 2025 Apr 1.
Gram MCD, Fagerland MW, Bo K. Efficacy of a Rhythmic Gymnastics-Specific Injury Prevention Program: An Assessor-Blinded Cluster-Randomized Controlled Trial. Scand J Med Sci Sports. 2025 Feb;35(2):e70022. doi: 10.1111/sms.70022.
August 18, 2022
Study Start
August 22, 2022
Actual (reported)Primary Completion
June 30, 2023
Actual (reported)Study Completion
June 30, 2023
Actual (reported)Last Updated
May 22, 2025
Record last verified: 2025-05
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