title: Injuries and musculoskeletal pain among Norwegian group fitness instructors.
abstract: OBJECTIVE
  To examine the prevalence and factors associated with instruction-related injuries and musculoskeletal pain among group fitness instructors.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  Online survey.
  
  
  METHODS
  Group fitness instructors from three fitness centre companies in Norway (n = 1473). Assessment of independent variables: questions regarding duration of working as a group fitness instructor, weekly instruction and exercise loading and modality, instruction-related injuries, musculoskeletal pain, use of alcohol, tobacco, snuff, menstrual dysfunction and disordered eating (Eating Disorder Inventory, EDI). The respondents were divided into high instruction loading (HIL), ≥5 h/w with instruction; and low instruction loading (LIL), <5 h/w with instruction).
  
  
  RESULTS
  The response rate was 57% (n = 837). Mean total loading (instruction and exercise) was 11.8 h/w and 6.3 h/w in the HIL and LIL groups (p < .001), respectively. The prevalence of acute (9% vs. 6%, p < .05), overuse (38% vs. 24%, p < .001) and both acute and overuse injuries (25% vs. 10%, p < .001) was higher in the HIL than in the LIL group (OR: 3.9, CI: 2.7, 5.5). The most prevalent injury locations were ankle and lower leg. The most frequent location for musculoskeletal pain was the shoulder/neck region. Factors associated with injury were instruction loading (h/w), years working as an instructor and EDI score. A high total EDI score predicted musculoskeletal pain.
  
  
  CONCLUSIONS
  The high prevalence of injuries and musculoskeletal pain suggests a need for prevention strategies in the fitness industry. There is a need for limits regarding weekly instruction loading, especially for classes with high metabolic and/or mechanical loading.
authors.affiliation: a Department of Sport and Outdoor Life Studies , Telemark University College , Bø i Telemark , Norway.
authors.forename: Solfrid
authors.initials: S
authors.lastname: Bratland-Sanda
authors.affiliation: b Oslo Sport Trauma Research Center, Department of Sports Medicine , Norwegian School of Sport Sciences , Oslo , Norway.
authors.forename: Jorunn
authors.initials: J
authors.lastname: Sundgot-Borgen
authors.affiliation: b Oslo Sport Trauma Research Center, Department of Sports Medicine , Norwegian School of Sport Sciences , Oslo , Norway.
authors.forename: Grethe
authors.initials: G
authors.lastname: Myklebust
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D005260:Female; D020446:Fitness Centers / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D009141:Musculoskeletal System / Q000293:injuries; D009664:Norway / Q000453:epidemiology; D010809:Physical Fitness / Q000502:physiology; D015995:Prevalence; D012307:Risk Factors; D013178:Sports Medicine / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000706:statistics & numerical data
keywords: Muscle injuries; disordered eating; fitness; general sports trauma; nutrition