{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:25:41Z","timestamp":1784262341321,"version":"3.55.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sports Health: A Multidisciplinary Approach"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Assess via medical records the 10-year concussion incidence in Cirque du Soleil (CdS) performers and the variables surrounding their concussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level 5.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were extracted from CdS performers\u2019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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 \u00b1 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>These new data on performing arts concussions highlight the prevalence and incidence of concussions in circus performers for healthcare professionals who care for them.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19417381251373057","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:48:47Z","timestamp":1758797327000},"page":"427-435","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Ten-Year Epidemiology of Concussions in Cirque du Soleil Performers"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2519-576X","authenticated-orcid":false,"given":"Jeffrey A.","family":"Russell","sequence":"first","affiliation":[{"name":"Ohio University, Department of Athletic Training, College of Health Sciences and Professions, Athens, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7768-8186","authenticated-orcid":false,"given":"Mychelle","family":"Berry","sequence":"additional","affiliation":[{"name":"Ohio University, Department of Athletic Training, College of Health Sciences and Professions, Athens, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Richardson","sequence":"additional","affiliation":[{"name":"Cirque du Soleil Performance Medicine, Las Vegas, Nevada"},{"name":"Henderson Silver Knights Sports Medicine, Henderson, Nevada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6308-2387","authenticated-orcid":false,"given":"Janet E.","family":"Simon","sequence":"additional","affiliation":[{"name":"Ohio University, Department of Athletic Training, College of Health Sciences and Professions, Athens, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-019-01052-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.21091\/mppa.2019.1004"},{"key":"e_1_3_2_4_2","unstructured":"Cirque du Soleil. About Cirque du Soleil entertainment group. https:\/\/www.cirquedusoleil.com\/press\/kits\/corporate\/about-cirque. Accessed June 17 2025."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-51.3.05"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513499230"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.21091\/mppa.2021.2013"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2023-001551"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/sports8050065"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508323644"},{"issue":"18","key":"e_1_3_2_11_2","first-page":"1009","article-title":"A CHecklist for statistical Assessment of Medical Papers (the CHAMP statement): explanation and elaboration","volume":"55","author":"Mansournia MA","year":"2021","unstructured":"Mansournia MA, Collins GS, Nielsen RO, et al. A CHecklist for statistical Assessment of Medical Papers (the CHAMP statement): explanation and elaboration. 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