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HealthyNCT07199985

Assessment of Intrinsic Risk Factors for Ankle Injuries in Ballet Dancers

An observational study of Healthy, run by Ege University at 1 site in Turkey (Türkiye).

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Healthy
How many people
45 participants
Where
1 siteTurkey (Türkiye)
Study dates
22 Sep 2025to Apr 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: 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.

Who may be able to join

  • For the Dancer Group:
  • Be 18 years of age or older
  • 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
  • Reside in the province of Izmir
  • Agree to participate voluntarily and have signed an informed consent form
  • For the Control Group:
Show all 11Show fewer
  • Be 18 years of age or older
  • Have no prior dance experience
  • 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
  • Reside in the province of İzmir
  • Agree to participate voluntarily and have signed an informed consent form

Who cannot join

  • Having undergone surgery on the lower extremities within the last 6 months
  • 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.)
  • Having a physical disability that prevents completion of isokinetic or balance tests
  • Pregnancy

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Ege University Faculty of Medicine, Department of Sports Medicine,

    Izmir, Bornova, 35100

Other trials in Turkey (Türkiye)

About this study

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.

Read the 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.

Conditions
Healthy
Keywords
Ballet dancers, ankle injuries, isokinetic strength, intrinsic risk
Medical subject headings
Ankle Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07199985
Study groupRoleWhat they receive
Ballet dancers without ankle injuryAnkle 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 injuryThe 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.
ControlThe 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.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 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).

    Measured: baseline(single assessment session; Day 1)

  2. 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)

    Measured: baseline(single assessment session; Day 1)

  3. 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 (°).

    Measured: Baseline (single assessment session; Day 1)

  4. 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).

    Measured: baseline(single assessment session; Day 1)

Secondary outcomes (3)
  1. 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.

    Measured: Baseline (single assessment session; Day 1)

  2. Side-to-Side Strength Asymmetry

    Calculated for PF/DF and INV/EV. Units: Percentage (%).

    Measured: Baseline (single assessment session; Day 1)

  3. Y-Balance Test Asymmetry

    Absolute right-left differences in anterior, posteromedial, and posterolateral reach distances.

    Units: Centimeters (cm).

    Measured: Baseline (single assessment session; Day 1)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Sep 2025
  2. Study start22 Sep 2025
  3. Primary completionJan 2026 (estimated)
  4. Study completionApr 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
45 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07199985
Sponsor's protocol ID
25-10T/15
Status last verified
Sep 2025
First submitted
19 Sep 2025
Last updated
4 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • 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.

    PubMed 17193868
  • Zurawski A, Sliwinski Z, Koziel D, Kiebzak W. Monitoring Expression of Balance during Therapy in Children with Postural Disorders. Children (Basel). 2023 May 30;10(6):974. doi: 10.3390/children10060974.

    PubMed 37371206
  • Martin RL, McPoil TG. Reliability of ankle goniometric measurements: a literature review. J Am Podiatr Med Assoc. 2005 Nov-Dec;95(6):564-72. doi: 10.7547/0950564.

    PubMed 16291848
  • Arnold BL, De La Motte S, Linens S, Ross SE. Ankle instability is associated with balance impairments: a meta-analysis. Med Sci Sports Exerc. 2009 May;41(5):1048-62. doi: 10.1249/MSS.0b013e318192d044.

    PubMed 19346982
  • Fong DT, Ha SC, Mok KM, Chan CW, Chan KM. Kinematics analysis of ankle inversion ligamentous sprain injuries in sports: five cases from televised tennis competitions. Am J Sports Med. 2012 Nov;40(11):2627-32. doi: 10.1177/0363546512458259. Epub 2012 Sep 11.

    PubMed 22967824
  • Ramkumar PN, Farber J, Arnouk J, Varner KE, Mcculloch PC. Injuries in a Professional Ballet Dance Company: A 10-year Retrospective Study. J Dance Med Sci. 2016 Mar;20(1):30-7. doi: 10.12678/1089-313X.20.1.30.

    PubMed 27025450
  • Gonosova Z, Linduska P, Bizovska L, Svoboda Z. Reliability of Ankle(-)Foot Complex Isokinetic Strength Assessment Using the Isomed 2000 Dynamometer. Medicina (Kaunas). 2018 Jun 4;54(3):43. doi: 10.3390/medicina54030043.

    PubMed 30344274
  • Nagy P, Brogden C, Greig M. Isokinetic ankle eversion and inversion strength profiling of female ballet dancers. J Sports Sci. 2021 Jan;39(1):1-9. doi: 10.1080/02640414.2020.1803185. Epub 2020 Aug 26.

    PubMed 32844718
  • Lin CW, You YL, Chen YA, Wu TC, Lin CF. Effect of Integrated Training on Balance and Ankle Reposition Sense in Ballet Dancers. Int J Environ Res Public Health. 2021 Dec 3;18(23):12751. doi: 10.3390/ijerph182312751.

    PubMed 34886476
  • Pavlovic M, Ogrinc N, Sarabon N. Body asymmetries as risk factors for musculoskeletal injuries in dancesport, hip-hop and ballet dancers? Eur J Transl Myol. 2022 Nov 28;32(4):11020. doi: 10.4081/ejtm.2022.11020.

    PubMed 36445245
  • Werber B. Dance medicine of the foot and ankle: a review. Clin Podiatr Med Surg. 2011 Jan;28(1):137-54. doi: 10.1016/j.cpm.2010.10.005.

    PubMed 21276523
  • Bowling A. Injuries to dancers: prevalence, treatment, and perceptions of causes. BMJ. 1989 Mar 18;298(6675):731-4. doi: 10.1136/bmj.298.6675.731.

    PubMed 2496824
  • Teitz, C. C. (2000). Hip and knee injuries in dancers. Journal of Dance Medicine & Science, 4, 23-29.

  • Furia JP, Juliano PJ, Wade AM, Schaden W, Mittermayr R. Shock wave therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal-diaphyseal fractures. J Bone Joint Surg Am. 2010 Apr;92(4):846-54. doi: 10.2106/JBJS.I.00653.

    PubMed 20360507
  • Volkova VG, Raisanen A, Benson LC, Ferber R, Kenny SJ. Systematic review of methods used to measure training load in dance. BMJ Open Sport Exerc Med. 2023 Jul 12;9(3):e001484. doi: 10.1136/bmjsem-2022-001484. eCollection 2023.

    PubMed 37457429

Questions about this trial

What is this clinical trial studying?

An observational study of Healthy, run by Ege University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 4 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ankle muscle strength (time frame: baseline(single assessment session; Day 1)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07199985, which also lists 31 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Dec 2025.

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