This study is the first to investigate the prevalence of pelvic floor dysfunctions in female athletes who practice aerial disciplines. Aerial disciplines, originating from the circus, encompass a range of acrobatic elements such as aerial fabric, hoop, trapeze, net, and pole. While traditionally limited to acrobats and circus performers, there has been a surge in interest from individuals engaging in these athletic pursuits, leading to their widespread popularity. Pole and aerial dance, renowned within aerial disciplines, are distinguished by their airborne practice and demand rigorous training emphasizing physical strength, agility, and joint flexibility. Despite extensive research on pelvic floor dysfunction in high-impact sports such as volleyball, basketball,gymnastic and CrossFit, there remains a gap in the literature pertaining to female athletes participating in aerial disciplines. Therefore, this study aims to provide estimates of the prevalence of pelvic floor dysfunctions in pole dance and aerial fabric. Strength training has been found to be a risk factor for stress urinary incontinence in studies evaluating women in CrossFit (73%)1, powerlifting (43.9%)2, and weightlifting (41.7%)3, considering that aerial disciplines are strength sports, we expect to find a prevalence similar to the other sports investigated.

A web-based questionnaire incorporating three sections from the International Consultation on Incontinence Questionnaire (ICIQ) (i.e., ICIQ-UI-SF for urinary incontinence, ICIQ-OAB for urgency/frequency syndrome, and ICIQ-FLUTSsex for sexual symptoms) was administered to adult female subjects affiliated to sports clubs, pole dance establishments, and aerial dance federations nationwide. The prevalence was calculated, and descriptive statistics was used to present the data.

Four hundred and ninety-nine females were included in this study. One hundred and sixty-eight (34.1%) participants frequented aerial fabric, 270 (54.9%) practiced pole dancing, and 54 (11.3%) performed both disciplines. Regarding the total sample, 106 (21.5%) of the participants reported urine leakage at least once a week; of these, most (96.2%) were small in quantity. For the sample practicing aerial fabric, 27 out of 168 subjects (16.1%) reported a small amount of urine loss at least once a week. Finally, regarding the sample that practiced pole dancing, 68 subjects out of 270 (25.2%) reported urine loss at least once a week.

Approximately one-fifth of participants who practiced pole dancing and/or aerial fabric reported leakage of urine at least once a week, even if it was minor. Considering the two different samples, the prevalence was higher in pole dance practitioners than in aerial fabric practitioners, probably our hypothesis is that in pole dance the impact on the ground and the resulting ground reaction forces are more frequent than in aerial dance.

although there is no data in the literature relating to pelvic floor dysfunctions in these disciplines, the study showed a significant prevalence of iu, greater in pole dance athletes. our hypothesis is that in pole dance there is greater contact with the ground and greater load forces from the ground.
the present observational study deserves further investigation through incidence studies and possible clinical studies to verify whether any changes in training methods, as well as evaluation and education by pelvic floor professionals, can improve the condition of athletes suffering from incontinence urinary and promote prevention

1.	Elks W, Jaramillo-Huff A, Barnes KL, Petersen TR, Komesu YM. The Stress Urinary Incontinence in CrossFit (SUCCeSS) study. Female Pelvic Med Reconstr Surg 26: 101–106, 2020.
2.	Wikander L, Kirshbaum MN, Waheed N, Gahreman DE. Urinary incontinence in competitive women powerlifters: A cross-sectional survey. Sports Med Open 7: 89–11, 2021.
3.	Skaug KL, Engh ME, Frawley H, Bø K. Prevalence of pelvic floor dysfunction, bother and risk factors and knowledge of the pelvic floor muscles in Norwegian male and female powerlifters and Olympic weightlifters. J Strength Cond Res 36: 2800–2807, 2022.