Postural control and functional ankle stability in professional and amateur dancers

OBJECTIVE The aim of this study was to compare the postural control and functional ankle stability between professional and amateur dancers as well as controls. METHODS Thirty professional dancers were compared to thirty amateur dancers and thirty controls. All participants (n=90) completed a questionnaire. Range of motion (ROM), ankle position sense and peroneal reaction time (PRT) were measured. Postural control was investigated with the Biodex Stability System (BSS) for the stable level 8 and the unstable level 2. RESULTS Professional dancers showed a significantly increased plantarflexion of both feet in comparison to all other groups (P ≤ 0.017). Even amateur dancers had a significantly increased plantarflexion of both feet in comparison to controls (P ≤ 0.017). The position sense test only showed significant differences between professionals, amateurs and controls at the position of 130° for the right leg (P ≤ 0.017). The PRT showed no significant differences among all groups except for the left peroneus brevis of amateur dancers in comparison to controls (P ≤ 0.017). Professional dancers had a significant better postural control in comparison to amateurs and controls for levels 8 and 2 at all tested positions (P ≤ 0.017). In addition, professional dancers had a specific balance distribution, whereas they balanced significantly more in the antero-lateral and less in the postero-medial part of their feet in comparison with amateur dancers and controls (P ≤ 0.017). CONCLUSIONS Despite a greater ROM, professional dancers have a better control of postural stability due to a specific balance distribution. However, the position sense test and the PRT were not influenced by the profession. SIGNIFICANCE The specific work-related demands of ankle joints did not improve all components of functional ankle stability in professional dancers. Therefore, the inclusion of proprioceptive exercises in the daily training program is highly recommended, aiming to improve functional ankle stability and thus to minimize the risk of ankle injuries.

[1]  S John Sullivan,et al.  Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis. , 2010, Journal of science and medicine in sport.

[2]  L. Konradsen,et al.  Prolonged peroneal reaction time in ankle instability. , 1991, International journal of sports medicine.

[3]  R. Schmidt,et al.  Die peroneale Reaktionszeit: Untersuchung in einem Normalkollektiv , 2001, Der Unfallchirurg.

[4]  A. Khasnis,et al.  Romberg's test. , 2003, Journal of postgraduate medicine.

[5]  M. Salavati,et al.  Attentional demands and postural control in athletes with and without functional ankle instability. , 2010, The Journal of orthopaedic and sports physical therapy.

[6]  H. Schmitt,et al.  Influence of Professional Dance Training on Peak Torque and Proprioception at the Ankle , 2005, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[7]  C. Johnson,et al.  Electromyographic response of peroneal muscles in surgical and nonsurgical injured ankles during sudden inversion. , 1993, The Journal of orthopaedic and sports physical therapy.

[8]  Margaret B. Freeman,et al.  The etiology and prevention of functional instability of the foot. , 1965, The Journal of bone and joint surgery. British volume.

[9]  Sarah J de la Motte,et al.  Concentric evertor strength differences and functional ankle instability: a meta-analysis. , 2009, Journal of athletic training.

[10]  D Glencross,et al.  Position sense following joint injury. , 1981, The Journal of sports medicine and physical fitness.

[11]  B. McFadyen,et al.  The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain , 2007, Clinical rehabilitation.

[12]  D. Richie.  Functional instability of the ankle and the role of neuromuscular control: a comprehensive review. , 2001, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[13]  Youlian Hong,et al.  A Systematic Review on Ankle Injury and Ankle Sprain in Sports , 2007, Sports medicine.

[14]  Claire E Hiller,et al.  Sensorimotor Control is Impaired in Dancers with Functional Ankle Instability , 2004, The American journal of sports medicine.

[15]  P. Schmitz,et al.  Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy , 1998, Journal of neurology, neurosurgery, and psychiatry.

[16]  Kai-Nan An,et al.  Ankle Disk Training Influences Reaction Times of Selected Muscles in a Simulated Ankle Sprain , 1997, The American journal of sports medicine.

[17]  L. Konradsen,et al.  Ankle instability caused by prolonged peroneal reaction time. , 1990, Acta orthopaedica Scandinavica.

[18]  D. Rosenbaum,et al.  Reliability of peroneal reaction time measurements. , 2000, Clinical biomechanics.

[19]  H. Tropp,et al.  Postural control in single‐limb stance , 1988, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[20]  M. Hoffman,et al.  Unilateral postural control of the functionally dominant and nondominant extremities of healthy subjects. , 1998, Journal of athletic training.

[21]  B. Arnold,et al.  Examination of balance measures produced by the biodex stability system. , 1998, Journal of athletic training.

[22]  Normand Teasdale,et al.  Alteration of the position sense at the ankle induced by muscular fatigue in humans. , 2002, Medicine and science in sports and exercise.

[23]  K. Krishnan,et al.  EVALUATION OF THE PROPRIOCEPTIVE INFLUENCE OF THE CUTANEOUS AFFERENTS TO THE ANKLE IN PATIENTS AFTER SURAL NERVE HARVESTING , 2009, Neurosurgery.

[24]  B. Friemert,et al.  The Peroneal Reaction Time (PRT) - Reference Data in a Healthy Sample Population , 2005, Foot & ankle international.

[25]  R. Newton,et al.  Balance abilities of professional dancers on select balance tests. , 1996, The Journal of orthopaedic and sports physical therapy.

[26]  W. Curl,et al.  Ankle Flexibility and Injury Patterns in Dancers , 1996, The American journal of sports medicine.

[27]  C. Testerman,et al.  Evaluation of Ankle Instability Using the Biodex Stability System , 1999, Foot & ankle international.

[28]  M T Gross,et al.  Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. , 1987, Physical therapy.

[29]  Kevin R Ford,et al.  Neuromuscular training improves single-limb stability in young female athletes. , 2004, The Journal of orthopaedic and sports physical therapy.

[30]  A. Nitz,et al.  Review of the afferent neural system of the knee and its contribution to motor learning. , 1994, The Journal of orthopaedic and sports physical therapy.

[31]  Gunnar Andreasson,et al.  The effect of external ankle support in chronic lateral ankle joint instability , 1992 .

[32]  A. Çakcı,et al.  Dynamic postural balance in ankylosing spondylitis patients. , 2006, Rheumatology.

[33]  A. Çakcı,et al.  Evaluation of dynamic postural balance using the Biodex Stability System in rheumatoid arthritis patients , 2006, Clinical Rheumatology.

[34]  S. Faghihzadeh,et al.  Balance problems after unilateral lateral ankle sprains. , 2006, Journal of rehabilitation research and development.

[35]  H. Schmitt,et al.  [Peak torque and proprioception at the ankle of dancers in professional training]. , 2004, Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin.

[36]  S N Garn,et al.  Kinesthetic awareness in subjects with multiple ankle sprains. , 1988, Physical therapy.

[37]  Hans Zwipp,et al.  Influence of Age, Body Mass Index and Leg Dominance on Functional Ankle Stability , 2010, Foot & ankle international.

[38]  E. Fuchs,et al.  Akute Verletzungen und chronische Überlastungen im klassischen Ballett , 2003 .

[39]  Randy J. Schmitz,et al.  Intertester and intratester reliability of a dynamic balance protocol using the Biodex Stability System , 1998 .

[40]  K Bennell,et al.  Hip and ankle range of motion and hip muscle strength in young female ballet dancers and controls. , 1999, British journal of sports medicine.

[41]  J. Hertel.  Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. , 2002, Journal of athletic training.