The Effect of the Thrust Technique of Tibiotarsal Joint on the Symptomatology of Pain at Classical Ballet Dancers

This is a randomized clinical trial of quantitative character, realized in a classical ballet school in Teresina, Piauí, Brazil, from June to October 2017. The present research was approved by the Ethics and Research Committee of State University of Piauí. The participants or their guardians signed the Term of Free and Informed Consent in accordance with Resolution 466/12 of the National Health Council (CNS).

The Random randomization in two groups (n=10, each) happens through drawing lots, with the intervention group (GI) submitted to the thrust technique of the tibiotarsal joint for decoaptation of this joint, and the control group (GC), to its simulation.

The instruments used to data collect from the study were: (1) Visual Analog Scale (VAS), a scale that quantifies the intensity of pain through punctuated values, at one extreme of 0, indicating "no pain", to 10, pointing an "maximum pain" 19; (2) Digital algometer (Wagner Instuments®) with a capacity of ten kilograms-force (kgf) and compression deformation of 10 cm, to evaluate the threshold of painful pressure; (3) Questionnaire, developed by the researchers, relating to personal and anthropometric data and related to the ballet practice.

The data collection was carried out in an evaluation room at the ballet school, after the dancers had participated of the classical dance, by a research assistant that was blind to conditions for treatment. The evaluation of the dysfunction in compression of tibiotarsis and the osteopathic manipulation were performed by an experienced osteopath and familiarized with the technique.

To determine the presence of tibiotarsal compression dysfunction in dancers who presented pain during dancing and on palpation at the anterior and posterior tibiotalar joint, the tibiotarsal coaptation and decoaptation test was performed20 (Figure 01): the participants were positioned in dorsal decubitus, already the osteopath, with the internal hand slipped the pinky finger on the medial edge of the foot to the talus neck, the other fingers on the dorsum of the foot and the thumbs on the sole of the foot, the ankle of the dancer was kept in slight inversion and plantar flexion, the therapist flexed his knees, until his forearms stay in the same level as the lower limbs of the participant. Shortly after tractioned and related the joint to perceive if there articulation mobility, or if the joint was fixed.