Injury Characteristics and Physical Therapy Management Strategies for Circus Artists: A Scoping Review

Background: Circus arts are gaining popularity across the globe and lifespan. Despite growing participation rates, there is limited high-quality evidence describing the physical therapy evaluation and management of injury within this population. The purpose of this scoping review was to identify and summarize evidence related to the injury characteristics and management of circus artists. Methods: With a research librarian, computerized searches were developed and performed using online databases (PubMed, CINAHL, Scopus, SPORTDiscus and Cochrane), gray literature and non-medical databases. Two authors independently voted on article inclusion with a third author blinded to previous voting used in case of conflict. Concept mapping identified five primary themes related to circus injuries and physical therapy treatment. Data was extracted from each article based on content relevant to the classification. Results: In total, 1095 titles were retrieved from electronic searches, of which 49 studies were included. Overall, 20 studies related to injury characteristics, 10 to risk factors, 9 to each psychosocial variables and interventions, and 8 to screening. Acrobats with required ground elements were the most commonly injured discipline, particularly at the shoulder, ankle and spine. Intrinsic and extrinsic risk factors were identified and numerous psychosocial and lifestyle contributing factors were reported. Literature guiding treatment is limited. Conclusions: This scoping review mapped and synthesized evidence related to the evaluation and management of circus artist injuries. While injury patterns and characteristics are generally understood, the treatment of this population is poorly described. Clear gaps in screening, injury prevention strategies, and interventions for this group were identified.