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This study aims to evaluate intrinsic risk factors (muscle strength, joint range of motion, static and dynamic balance) that may lead to ankle injuries in ballet dancers and to examine the relationship between these factors and ankle injuries experienced in the last 12 months. By comparing ballet dancers who have suffered injuries requiring physical therapy or forcing them to take a break from dancing for more than one week in the past year with uninjured ballet dancers and a control group, the findings aim to contribute scientifically to the development of individualized rehabilitation programs and the safe and effective planning of return-to-stage processes. Furthermore, it is believed that these data may support the reduction of time and financial losses among dancers.
This study aims to evaluate intrinsic risk factors that may lead to ankle injuries in ballet dancers. Ankle injury risk factors are divided into two categories: intrinsic and extrinsic. Extrinsic risk factors are external to the individual, such as surface type, shoe wear, and type of athletic activity (training and competition) that may affect the athlete's performance. Intrinsic risk factors include age, gender, strength, joint range of motion, balance, and motor control, which affect the athlete's ability to perform sports-related activities. The study will be conducted with a total of 45 participants, including 30 participants aged 18 and over who reside in Izmir and are professional ballet dancers, and 15 control participants who have no previous dance experience. Of the 30 professional ballet dancers, 15 will be selected from dancers who have suffered an ankle injury requiring physical therapy or forcing them to take at least a one-week break from the stage within the last year. The other 15 ballet dancers will be those who have not experienced any problems due to an ankle injury within the last year. Participants will be asked whether they have suffered an injury requiring medical attention in the ankle region within the last 12 months; the data obtained will be correlated with various biomechanical measurements. Each participant will perform a standard warm-up program before the tests.
The four main parameters to be evaluated in the study are as follows:
The primary objective of the study is to determine the relationship between a history of ankle injury and these intrinsic parameters. It also aims to compare the control group with ballet dancers who have not suffered an ankle injury in the last year in terms of these intrinsic parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ballet dancers without ankle injury | Ankle muscle isokinetic strength, joint range of motion, and dynamic and static balance will be measured in ballet dancers who have not taken a break from dancing in the last 12 months. | ||
| Ballet dancers with ankle injury | The isokinetic strength of the ankle muscles, joint range of motion, and dynamic and static balance of ballet dancers who have taken at least a week off from dancing due to an ankle injury within the last 12 months will be measured. | ||
| Control | The ankle isokinetic muscle strength, joint range of motion, dynamic and static balance of healthy male and female volunteers over the age of 18 without ankle injuries will be measured. |
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| Measure | Description | Time Frame |
|---|---|---|
| Ankle muscle strength | Isokinetic peak torque of the ankle muscles will be assessed using an isokinetic dynamometer (Isomed 2000). Plantar flexion / dorsiflexion (PF/DF): measured at 30°/s and 120°/s angular velocities, in both concentric and eccentric modes. Inversion / eversion (INV/EV): measured at 60°/s and 90°/s angular velocities, in both concentric and eccentric modes. Units: Newton-meters (Nm). | baseline(single assessment session; Day 1) |
| Dynamic Balance Ability | Dynamic balance: Y-Balance Test (Lower Quarter). Reach distances in the anterior, posteromedial, and posterolateral directions will be normalized to leg length. A composite score will be calculated. Units: Reach distances (ANT, PM, PL): centimeters (cm) Composite score: percent of leg length (%) Directional asymmetries: centimeters (cm) | baseline(single assessment session; Day 1) |
| Range of Motion (ROM) of the Ankle and First Metatarsophalangeal (1st MTP) Joint | Active joint range of motion will be measured with a universal goniometer. Ankle: dorsiflexion, plantar flexion, inversion, eversion. 1st MTP joint: dorsiflexion, flexion Units: Degrees (°). | Baseline (single assessment session; Day 1) |
| Static Balance Ability | Static balance: Center of pressure (CoP) trace length, sway area, and mean CoP velocity will be recorded during 30-second quiet stance (feet hip-width apart) using a pedobarography system. Units: Millimeters (mm), square millimeters (mm²), millimeters per second (mm/s). | baseline(single assessment session; Day 1) |
| Measure | Description | Time Frame |
|---|---|---|
| Strength Ratios | Plantar flexion / dorsiflexion (PF/DF) strength ratio. Inversion / eversion (INV/EV) strength ratio. Calculated as the ratio of peak torques obtained from isokinetic testing. Units: Unitless ratio. | Baseline (single assessment session; Day 1) |
| Side-to-Side Strength Asymmetry |
| Measure | Description | Time Frame |
|---|---|---|
| True Limb Length | Anatomical limb length measured from anterior superior iliac spine to medial malleolus bilaterally. Units: Centimeters (cm). | Baseline (single assessment session; Day 1) |
| Body Mass Index (BMI) |
Inclusion Criteria:
For the Dancer Group:
For the Control Group:
Exclusion Criteria:
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Ballet dancers will be ballet dancers aged 18 and over who live in Izmir and have been dancing professionally for at least 3 years. The control group will consist of participants aged 18 and over who are healthy and have no ankle injuries. Participants will be invited to participate in the study on a voluntary basis.
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| Name | Affiliation | Role |
|---|---|---|
| Mehmet E ENGİN, Resident | Ege University Faculty of Medicine, Department of Sports Medicine | Principal Investigator |
| SeƧkin ÅenıÅık, assistant professor | Ege University Faculty of Medicine, Department of Sports Medicine | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ege University Faculty of Medicine, Department of Sports Medicine, | Izmir | Bornova | 35100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17193868 | Background | Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006 Dec;36(12):911-9. doi: 10.2519/jospt.2006.2244. | |
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| ID | Term |
|---|---|
| D016512 | Ankle Injuries |
| ID | Term |
|---|---|
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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Calculated for PF/DF and INV/EV. Units: Percentage (%). |
| Baseline (single assessment session; Day 1) |
| Y-Balance Test Asymmetry | Absolute right-left differences in anterior, posteromedial, and posterolateral reach distances. Units: Centimeters (cm). | Baseline (single assessment session; Day 1) |
Height measurements will be converted from centimeters to meters for the calculation. BMI will be calculated as weight (in kilograms) / height (in meters) x height (in meters).
| Baseline (single assessment session; Day 1) |
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