Assessment of Intrinsic Risk Factors for Ankle Injuries in Ballet Dancers

Not yet recruiting

• Conditions: Healthy

• Registration Number: NCT07199985
• Lead Sponsor: Ege University

Brief Summary

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.

Detailed Description

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:

* Ankle muscle strength (4 directions in concentric and eccentric modes)

* Joint range of motion (ROM)

* Static balance

* Dynamic balance Strength measurements will be assessed using an isokinetic dynamometer (Isomed 2000), joint range of motion using a goniometer, dynamic balance using the Y Balance Test (YBT), and static balance using the Diers Formetric 4D pedobarographic balance system. Strength measurements will be performed at angular velocities of 30°/s and 120°/s for plantar flexion and dorsiflexion and 60°/s and 90°/s for inversion and eversion in both the dancer and control groups.

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.

Study Timeline

• Status Verified: 2025-09
• Study First Submitted: 2025-09-19
• Study First Submitted QC: 2025-09-28
• Last Update Submitted: 2025-09-28
• Study First Posted: 2025-09-30
• Last Update Posted: 2025-09-30
• Study Start: 2025-10-01
• Primary Completion: 2026-01
• Study Completion: 2026-04-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 45

Inclusion Criteria

• For the Dancer Group:

  1. Be 18 years of age or older
  2. Be a professional or academic-level dancer who has been practicing classical ballet regularly (at least 3 days a week) for the past 3 years
  3. Reside in the province of Izmir
  4. Agree to participate voluntarily and have signed an informed consent form

• For the Control Group:

  1. Be 18 years of age or older
  2. Have no prior dance experience
  3. Not have participated in sports that place specific stress on the ankle area (such as ballet, artistic gymnastics, martial arts, soccer, etc.), even if engaging in regular physical activity
  4. Reside in the province of İzmir
  5. Agree to participate voluntarily and have signed an informed consent form

Exclusion Criteria

1. Having undergone surgery on the lower extremities within the last 6 months
2. Having a history of diagnosed chronic disease related to the nervous system, vestibular system, or musculoskeletal system (e.g., peripheral neuropathy, MS, rheumatoid arthritis, etc.)
3. Having a physical disability that prevents completion of isokinetic or balance tests
4. Pregnancy

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Ankle muscle strength	baseline(single assessment session; Day 1)	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).
Dynamic Balance Ability	baseline(single assessment session; Day 1)	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)
Range of Motion (ROM) of the Ankle and First Metatarsophalangeal (1st MTP) Joint	Baseline (single assessment session; Day 1)	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 (°).
Static Balance Ability	baseline(single assessment session; Day 1)	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).

Secondary Outcome Measures

Name	Time	Method
Strength Ratios	Baseline (single assessment session; Day 1)	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.
Side-to-Side Strength Asymmetry	Baseline (single assessment session; Day 1)	Calculated for PF/DF and INV/EV. Units: Percentage (%).
Y-Balance Test Asymmetry	Baseline (single assessment session; Day 1)	Absolute right-left differences in anterior, posteromedial, and posterolateral reach distances.; Units: Centimeters (cm).

Trial Locations

Locations (1)

Ege University Faculty of Medicine, Department of Sports Medicine,; Izmir, Bornova, Turkey (Türkiye)