Ten-Year Epidemiology of Concussions in Cirque du Soleil Performers

Abstract

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.