Association between ankle sprain and the presence of low back pain in ballet dancers in Lima, Peru
DOI:
https://doi.org/10.47197/retos.v47.95593Keywords:
Ballet, Low Back Pain, Ankle injuries, Joint inestabiility, Sport injuriesAbstract
Background: low back pain (DL) and ankle sprain are very prevalent injuries in ballet dancers. Different studies relate both injuries, so it is suggested to carry out an investigation in this regard. Purpose: to determine if there is an association between ankle sprain and the presence of DL in ballet dancers older than 18 years old in the last year. Study design: analytical, prospective, observational and cross-sectional. Methods: 114 dancers from different schools and ballet companies in Lima were contacted; these responded to an online survey related to the presence of DL in the last six months, ankle sprain in the last 12 months, and other sociodemographic variables; as well as covariates of ankle instability, lower limb injury, ligament hypermobilty, among others. Results: 47 participants were included in the study analysis, 61.7 % of which were female and were a median age of 22 years old. Also, 57.5 % had DL and 25.5 % had an ankle sprain in the last 12 months. When associating the variables to DL, a significant association (p<0.05) with weight, BMI and ankle instability was found. Nevertheless, an association between ankle sprain and DL was not confirmed. Conclusion: No association was found between suffering from an ankle sprain in the last year and low back pain in the last 6 months.
Keywords: ballet, low back pain, ankle injuries, joint instability, sports injuries, body mass index, prevalence.
References
Allen, N., Nevill, A., Brooks, J., Koutedakis, Y., & Wyon, M. (2012). Ballet injuries: injury incidence and severity over 1 year. The Journal of Orthopaedic and Sports Physical Therapy, 42(9), 781–790. https://doi.org/10.2519/jospt.2012.3893
Angoules, A. G., Dionyssiotis, Y., Angoules, G. A., Balakatounis, K. C., Panou, A., & Papathanasiou, J. (2018). An Epi-demiological Study of Non-specific Low Back Pain in Non-professional Female Greek Classic Ballet Dancers. Folia Me-dica, 60(2), 248–253. https://doi.org/10.1515/folmed-2017-0087
Bronner, S., Ojofeitimi, S., & Mayers, L. (2006). Comprehensive surveillance of dance injuries. Journal of Dance Medicine & Science1. Bronner S, Ojofeitimi S, Mayers L. Comprehensive Surveillance of Dance Injuries. J Danc Med Sci [Inter-net]. 2006;10(3):69–80. Available from: https://iadms.org/publications-research/journal-of-dance-medicine-science/ https://www.ingentaconnect.com/contentone/jmrp/jdms/2006/00000010/f0020003/art00001
Cao, S., Wang, C., Ma, X., Jiang, S., Yu, Y., Wang, X., Huang, J., & Zhang, C. (2020). Stair descent biomechanics reflect perceived instability in people with unilateral ankle sprain history. Clinical biomechanics (Bristol, Avon), 72, 52–57. https://doi.org/10.1016/j.clinbiomech.2019.11.022
Cho, B.-K., & Park, J.-K. (2019). Correlation Between Joint-Position Sense, Peroneal Strength, Postural Control, and Functional Performance Ability in Patients With Chronic Lateral Ankle Instability. Foot & Ankle International, 40(8), 961–968. https://doi.org/10.1177/1071100719846114
Cholewicki, J., Silfies, S. P., Shah, R. A., Greene, H. S., Reeves, N. P., Alvi, K., & Goldberg, B. (2005). Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine, 30(23), 2614–2620. https://doi.org/10.1097/01.brs.0000188273.27463.bc
Costa, M. S. S., Ferreira, A. S., Orsini, M., Silva, E. B., & Felicio, L. R. (2016). Characteristics and prevalence of musculo-skeletal injury in professional and non-professional ballet dancers. Brazilian Journal of Physical Therapy, 20(2), 166–175. https://doi.org/10.1590/bjpt-rbf.2014.0142
Cruz-Díaz, D., Hita-Contreras, F., Lomas-Vega, R., Osuna-Pérez, M. C., & Martínez-Amat, A. (2013). Cross-cultural adaptation and validation of the Spanish version of the Cumberland Ankle Instability Tool (CAIT): an instrument to as-sess unilateral chronic ankle instability. Clinical Rheumatology, 32(1), 91–98. https://doi.org/10.1007/s10067-012-2095-0
Curotto-Winder, D. A., Becerra- Bravo, G., & Bravo-Cucci, S. (2022). Asociación entre el nivel de actividad física, seden-tarismo y dolor de espalda en estudiantes de nutrición y dietética de una universidad de Lima en contexto de Pandemia por COVID-19 (Association between the level of physical activity, sedentary lifestyl. Retos, 45, 1019–1030. https://doi.org/10.47197/retos.v45i0.90979
DeJong, A. F., Koldenhoven, R. M., Hart, J. M., & Hertel, J. (2020). Gluteus medius dysfunction in females with chronic ankle instability is consistent at different walking speeds. Clinical biomechanics (Bristol, Avon), 73, 140–148. https://doi.org/10.1016/j.clinbiomech.2020.01.013
Drężewska, M., & Śliwiński, Z. (2013). Lumbo-sacral spine pain in ballet school students. Pilot study. Ortopedia Trauma-tologia Rehabilitacja, 15(2), 1–10. https://doi.org/10.5604/15093492.1041451
Freeman, M. A. R., & Wyke, B. (1967). The innervation of the ankle joint. An anatomical and histological study in the cat. Acta Anatomica, 68(3), 321–333. https://doi.org/10.1159/000143037
Fukano, M., Fukubayashi, T., & Kumai, T. (2020). In vivo talocrural and subtalar kinematics during the stance phase of walking in individuals with repetitive ankle sprains. Journal of biomechanics, 101, 109651. https://doi.org/10.1016/j.jbiomech.2020.109651
Fukuda, T. Y., Aquino, L. M., Pereira, P., Ayres, I., Feio, A. F., de Jesus, F. L. A., & Neto, M. G. (2021). Does adding hip strengthening exercises to manual therapy and segmental stabilization improve outcomes in patients with nonspecific low back pain? A randomized controlled trial. Brazilian journal of physical therapy, 25(6), 900–907. https://doi.org/10.1016/j.bjpt.2021.10.005
Gurav, R., Ganu, S., & Panhale, V. (2014). Reliability of the identification of functional ankle instability (Idfai) scale across different age groups in adults. North American Journal of Medical Sciences, 6(10), 516. https://doi.org/10.4103/1947-2714.143283
Haddas, R., Sawyer, S. F., Sizer, P. S., Brooks, T., Chyu, M. C., & James, C. R. (2017). Effects of Volitional Spine Stabili-zation and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recur-rent Low Back Pain. Journal of sport rehabilitation, 26(5), 329–338. https://doi.org/10.1123/jsr.2015-0171
Hakim, A. J., & Grahame, R. (2003). A simple questionnaire to detect hypermobility: an adjunct to the assessment of pa-tients with diffuse musculoskeletal pain. International Journal of Clinical Practice, 57(3), 163–166. http://www.ncbi.nlm.nih.gov/pubmed/12723715
Hertel, J. (2008). Sensorimotor deficits with ankle sprains and chronic ankle instability. Clinics in Sports Medicine, 27(3), 353–370, vii. https://doi.org/10.1016/j.csm.2008.03.006
Hertel, J., & Corbett, R. O. (2019). An Updated Model of Chronic Ankle Instability. Journal of Athletic Training, 54(6), 572. https://doi.org/10.4085/1062-6050-344-18
Heuch, I., Hagen, K., Heuch, I., Nygaard, Ø., & Zwart, J. (2010). The impact of body mass index on the prevalence of low back pain: the HUNT study. Spine, 35(7), 764–768. https://doi.org/10.1097/BRS.0b013e3181ba1531
Iunes, D. H., Elias, I. F., Carvalho, L. C., & Dionísio, V. C. (2016). Postural adjustments in young ballet dancers compared to age matched controls. Physical Therapy in Sport, 17, 51–57. https://doi.org/10.1016/j.ptsp.2015.04.004
Jagodinsky, A. E., Angles, R., Wilburn, C., & Weimar, W. H. (2020). Lower-Extremity Motor Synergies in Individuals With and Without Chronic Ankle Instability. Journal of applied biomechanics, 1–7. Advance online publication. https://doi.org/10.1123/jab.2019-0398
Kobayashi, T., & Gamada, K. (2014). Lateral Ankle Sprain and Chronic Ankle Instability. Foot & Ankle Specialist, 7(4), 298–326. https://doi.org/10.1177/1938640014539813
Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., & Jørgensen, K. (1987). Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics, 18(3), 233–237. https://doi.org/10.1016/0003-6870(87)90010-x
Leanderson, C., Leanderson, J., Wykman, A., Strender, L.-E., Johansson, S.-E., & Sundquist, K. (2011). Musculoskeletal injuries in young ballet dancers. Knee Surgery, Sports Traumatology, Arthroscopy, 19(9), 1531–1535. https://doi.org/10.1007/s00167-011-1445-9
Lee, I., Ha, S., Chae, S., Jeong, H. S., & Lee, S. Y. (2021). Altered biomechanics in individuals with chronic ankle instabil-ity compared with copers and controls during gait. Journal of athletic training, 57(8), 760–770. Advance online publica-tion. https://doi.org/10.4085/1062-6050-0605.20
Lin, C.-W., Su, F.-C., & Lin, C.-F. (2014). Influence of ankle injury on muscle activation and postural control during ballet grand plié. Journal of Applied Biomechanics, 30(1), 37–49. https://doi.org/10.1123/jab.2012-0068
Marshall, P. W. M., McKee, A. D., & Murphy, B. A. (2009). Impaired trunk and ankle stability in subjects with functional ankle instability. Medicine and Science in Sports and Exercise, 41(8), 1549–1557. https://doi.org/10.1249/MSS.0b013e31819d82e2
Martínez, M. M., & Alvarado Muñoz, R. (2017). Validación del Cuestionario Nórdico Estandarizado de Síntomas Muscu-loesqueléticos para la población trabajadora chilena, adicionando una escala de dolor. Revista de Salud Pública, 21(2), 43. https://doi.org/10.31052/1853.1180.v21.n2.16889
Mizoguchi, Y., Akasaka, K., Otsudo, T., & Hall, T. (2019). Factors associated with low back pain in elite high school vol-leyball players. Journal of Physical Therapy Science, 31(8), 675–681. https://doi.org/10.1589/jpts.31.675
Moix-Queraltó, M.-J., & Vidal-Fernández, J. (2008). Aetiology, chronification, and treatment of low back pain. Clínica y Salud, 19(3), 379–392. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-52742008000300007
Nadler, S. F., Wu, K. D., Galski, T., & Feinberg, J. H. (1998). Low back pain in college athletes. A prospective study cor-relating lower extremity overuse or acquired ligamentous laxity with low back pain. Spine, 23(7), 828–833. https://doi.org/10.1097/00007632-199804010-00018
O’Leary, C. B., Cahill, C. R., Robinson, A. W., Barnes, M. J., & Hong, J. (2013). A systematic review: the effects of podiatrical deviations on nonspecific chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation, 26(2), 117–123. https://doi.org/10.3233/BMR-130367
O’Loughlin, P. F., Hodgkins, C. W., & Kennedy, J. G. (2008). Ankle sprains and instability in dancers. Clinics in Sports Medicine, 27(2), 247–262. https://doi.org/10.1016/j.csm.2007.12.006
Petersen, A. K., Zebis, M. K., Lauridsen, H. B., Hölmich, P., Aagaard, P., & Bencke, J. (2022). Impaired one-legged land-ing balance in young female athletes with previous ankle sprain: a cross-sectional study. The Journal of sports medicine and physical fitness, 62(11), 1489–1495. https://doi.org/10.23736/S0022-4707.22.12960-9
Ramkumar, P. N., Farber, J., Arnouk, J., Varner, K. E., & Mcculloch, P. C. (2016). Injuries in a Professional Ballet Dance Company: A 10-year Retrospective Study. Journal of Dance Medicine & Science, 20(1), 30–37. https://doi.org/10.12678/1089-313X.20.1.30
Roussel, N., De Kooning, M., Schutt, A., Mottram, S., Truijen, S., Nijs, J., & Daenen, L. (2012). Motor Control and Low Back Pain in Dancers. International Journal of Sports Medicine, 34(02), 138–143. https://doi.org/10.1055/s-0032-1321722
Safran, M. R., Benedetti, R. S., Bartolozzi, A. R., & Mandelbaum, B. R. (1999). Lateral ankle sprains: a comprehensive review: part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Medicine and Science in Sports and Exercise, 31(7 Suppl), S429-37. https://doi.org/10.1097/00005768-199907001-00004
San Martín Barra, C., Rojas Cabezas, G., & Troc Gajardo, J. (2021). Propuesta de modelo predictivo de riesgo de lesión en base a descriptores anatómicos y funcionales que se relacionan con la inestabilidad articular en rodilla y tobillo en jugado-res de baloncesto no profesionales - Dialnet. Retos, 39, 257263. https://dialnet.unirioja.es/servlet/articulo?codigo=7594123
Serra-Añó, P., Inglés, M., Espí-López, G. V., Sempere-Rubio, N., & Aguilar-Rodríguez, M. (2021). Biomechanical and viscoelastic properties of the ankle muscles in men with previous history of ankle sprain. Journal of biomechanics, 115, 110191. https://doi.org/10.1016/j.jbiomech.2020.110191
Simon, J., Donahue, M., & Docherty, C. (2012). Development of the Identification of Functional Ankle Instability (IdFAI). Foot & Ankle International, 33(9), 755–763. https://doi.org/10.3113/FAI.2012.0755
Simon, J., Hall, E., & Docherty, C. (2014). Prevalence of Chronic Ankle Instability and Associated Symptoms in University Dance Majors: An Exploratory Study. Journal of Dance Medicine & Science, 18(4), 178–184. https://doi.org/10.12678/1089-313X.18.4.178
Simpson, J. D., Stewart, E. M., Turner, A. J., Macias, D. M., Wilson, S. J., Chander, H., & Knight, A. C. (2019). Neu-romuscular control in individuals with chronic ankle instability: A comparison of unexpected and expected ankle inver-sion perturbations during a single leg drop-landing. Human Movement Science, 64(August 2018), 133–141. https://doi.org/10.1016/j.humov.2019.01.013
Simpson, J. D., Koldenhoven, R. M., Wilson, S. J., Stewart, E. M., Turner, A. J., Chander, H., & Knight, A. C. (2020). Ankle kinematics, center of pressure progression, and lower extremity muscle activity during a side-cutting task in par-ticipants with and without chronic ankle instability. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology, 54, 102454. https://doi.org/10.1016/j.jelekin.2020.102454
Smith, P. J., Gerrie, B. J., Varner, K. E., McCulloch, P. C., Lintner, D. M., & Harris, J. D. (2015). Incidence and Preva-lence of Musculoskeletal Injury in Ballet: A Systematic Review. Orthopaedic Journal of Sports Medicine, 3(7), 2325967115592621. https://doi.org/10.1177/2325967115592621
Smith, T O, de Medici, A., Oduoza, U., Hakim, A., Paton, B., Retter, G., Haddad, F. S., & Macgregor, A. (2017). Na-tional survey to evaluate musuloskeletal health in retired professional ballet dancers in the United Kingdom. Physical Therapy in Sport, 23, 82–85. https://doi.org/10.1016/j.ptsp.2016.07.009
Smith, Toby O., Davies, L., de Medici, A., Hakim, A., Haddad, F., & Macgregor, A. (2016). Prevalence and profile of musculoskeletal injuries in ballet dancers: A systematic review and meta-analysis. Physical Therapy in Sport, 19, 50–56. https://doi.org/10.1016/j.ptsp.2015.12.007
Song, K., Pietrosimone, B., Blackburn, J. T., Padua, D. A., Tennant, J. N., & Wikstrom, E. A. (2022). Dorsiflexion and Hop Biomechanics Associate with Greater Talar Cartilage Deformation in Those with Chronic Ankle Instability. Medi-cine and science in sports and exercise, 54(7), 1176–1182. https://doi.org/10.1249/MSS.0000000000002902
Solomon, R., Brown, T., Gerbino, P. G., & Micheli, L. J. (2000). The Young Dancer. Clinics in Sports Medicine, 19(4), 717–739. https://doi.org/10.1016/S0278-5919(05)70234-9
Sotelo, N., Valencia, A., Soto, R. (2017). Prevalencia y factores asociados a la inestabilidad de tobillo en estudiantes de danza contemporánea Item Type info:eu-repo/semantics/bachelorThesis [Universidad Peruana de Ciencias Aplicadas (UPC)]. http://hdl.handle.net/10757/621841
Sribastav, S. Sen, Long, J., He, P., He, W., Ye, F., Li, Z., Wang, J., Liu, H., Wang, H., & Zheng, Z. (2018). Risk Factors Associated with Pain Severity in Patients with Non-specific Low Back Pain in Southern China. Asian Spine Journal, 12(3), 533–543. https://doi.org/10.4184/asj.2018.12.3.533
Swain, C. T. V., Bradshaw, E. J., Ekegren, C. L., & Whyte, D. G. (2019). The Epidemiology of Low Back Pain and Injury in Dance: A Systematic Review. Journal of Orthopaedic & Sports Physical Therapy, 49(4), 239–252. https://doi.org/10.2519/jospt.2019.8609
Swain, C. T. V., Bradshaw, E. J., Whyte, D. G., & Ekegren, C. L. (2017). Life history and point prevalence of low back pain in pre-professional and professional dancers. Physical Therapy in Sport, 25, 34–38. https://doi.org/10.1016/j.ptsp.2017.01.005
Swain, C. T. V., Bradshaw, E. J., Whyte, D. G., & Ekegren, C. L. (2018). The prevalence and impact of low back pain in pre-professional and professional dancers: A prospective study. Physical Therapy in Sport, 30, 8–13. https://doi.org/10.1016/j.ptsp.2017.10.006
Tsekoura, M., Billis, E., Panopoulou, K., Fousekis, K., & Tsepis, E. (2017). Musculoskeletal Disorders among Greek Pro-fessional Ballet Dancers. British Journal of Medicine and Medical Research, 19(11), 1–8. https://doi.org/10.9734/BJMMR/2017/31876
Vásquez Orellana, K., López Vásquez, M., Méndez Rebolledo, G., & Guzmán Muñoz, E. E. (2022). Efectos de un entre-namiento neuromuscular sobre el equilibrio postural dinámico y propiocepción en basquetbolistas juveniles con inestabi-lidad funcional de tobillo - Dialnet. Retos, 44, 1104–1112. https://dialnet.unirioja.es/servlet/articulo?codigo=8308987
Golanó, P., Vega, J. (2013). Ankle Sprain: Diagnosis and Therapy Starts With Knowledge. Aspetar Sports Medicine Jour-nal, June 2013, 234–242. https://www.researchgate.net/publication/259911297_Ankle_sprain_Diagnosis_and_therapy_starts_with_knowledge_of_anatomy
Wright, I. ., Neptune, R. ., van den Bogert, A. ., & Nigg, B. . (2000). The influence of foot positioning on ankle sprains. Journal of Biomechanics, 33(5), 513–519. https://doi.org/10.1016/S0021-9290(99)00218-3
Yabe, Y., Hagiwara, Y., Sekiguchi, T., Momma, H., Tsuchiya, M., Kanazawa, K., Itaya, N., Yoshida, S., Sogi, Y., Yano, T., Onoki, T., Itoi, E., & Nagatomi, R. (2020). Association between lower back pain and lower extremity pain among young volleyball players: A cross-sectional study. Physical Therapy in Sport, 43, 65–69. https://doi.org/10.1016/j.ptsp.2020.02.005
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