Bharatnatyam is a dynamic and energetic Indian classical dance form that has earned recognition across the globe. Dancers are engaged in aesthetic yet challenging poses frequently. Various dance poses are common like Kurma, Bhramari, Arimandi, Tandav, Nritta, Matsya, Kuttanam, Preukhanam and Muzhumandi position. It comprises of rhythmic stamping of the feet, jumps, twisting and turning with rotational movements, pirouettes and positions where knees are in contact with the floor which lead to injury to Hip, Knee, Ankle and foot, Shoulder, Knee, Back, Neck etc. The objective of the study is to assemble and synthesize the best available literature on musculoskeletal disorders in Bharatnatyam dancers. PUBMED, MEDLINE, Cochrane Library, ScienceDirect and Google Scholar, NIH Clinical Trials Database, Meta-Register of Controlled Trials and CRISP databases were searched. Indexed terms such as Bharatnatyam, dancer, pain, injuries, sprains and strains, musculoskeletal disorders, Back pain, Knee pain, Hip pain were used to search the databases. Level 1 through 4 evidence studies reporting prevalence of Musculoskeletal disorders Data from accepted studies were abstracted into evidence tables relating to the prevalence and associated factors, risk factors, diagnosis and pain in dancers and critically reviewed by STROBE checklist. Almost 19 different studies like systematic reviews, case control studies, randomized controlled trials, cross sectional studies were included. The best available evidence suggests that musculoskeletal disorders are an important health issue for dancers at all skill levels. The principal findings were high prevalence of Knee pain followed by Back, Ankle and foot pain and altered foot posture and overuse and lack of warm up sessions are the main cause for development of pain. Key words: Bharatnatyam Dancers, Musculoskeletal disorders, Pain, Injuries, sprains, strains, back pain, knee pain, Hip pain.

Background: These days, modern innovative technology plays a crucial part in our life. Touch screens has become the primary interaction method for smart phones due to their ability to combine input and output in a single interface. On the one hand, it has made our lives easier by allowing us to browse the internet, have essential conversations, and have a source of pleasure. Frequent use of technical devices without taking regular rest periods may result in cumulative trauma disorders to the neck, shoulders, hands and wrists. These disorders may occur because Smartphone, iPod etc. use typically requires thumb and finger interactions with the screen. Reports have shown that extended technology use accompanied by awkward wrist posture can lead to collective trauma disorders of the wrist joints, particularly when the wrist, hands, and fingers are overused. Repetitive static motion of the hands may also decrease blood supply and prevent nutrients from being delivered to muscles, thus leading to pain and muscle fatigue may result into poor hand function including reduced grip strength & poor dexterity. Children are attracted to smart phones because these devices can be used anywhere and contain games that are specifically matched to their ages. Numbers of studies have been done on Smartphone usage, hand writing performance & grip strength individually. However, the link between Smartphone addiction and grip strength and upper limb disability has been left unnoticed. Methodology: A cross sectional observational study was conducted to evaluate pencil grip type, hand dexterity & grip strength in children using technological devices for 2 or more hours a day dividing subjects into 2 groups. Group A: Children using technological devices for 2 or more hours a day. Group B: Children not using technological devices. Written consent was taken from the subjects and the subjects were made to understand the purpose of the study. Hand dexterity was evaluated using Functional Dexterity Test, Grip strength with hand held dynamometer & Pencil grip type was evaluated. Results: Data analysis was done using Graph Pad Prism 6. In Group A, Dynamic Tripod grasp was present in 19 subjects (61.29%) Five finger grasp in 0 subjects (0 %,), Thumb Wrap grasp in 1 subject (3.22%), Upright tripod grasp in 11 subject (35.48%).In Group B, Dynamic Tripod grasp was present in 26 subjects (83.87%) Five finger grasp in 0 subjects (0 %,), Thumb Wrap grasp in 1 subject (3.22%), Upright tripod grasp in 4 subjects (12.90%).The result showed significant difference for the functional dexterity test between Group A and Group B (t = 5.725 and p = 0.0001) & grip strength between Group A and Group B (t = 6.449 and p = 0.0001). Conclusion: Increased use of tech devices significantly affects Hand performance like Grip strength, Hand dexterity & Pencil grip pattern amongst children. Key words: Hand Dexterity, Grip Strength, Pencil Grip Type, Smart Phone Use, Functional Dexterity Test, Hand Writing Performance.