The Effect of Training on Hemodynamic Factors in Ballet Dancer

Venous Insufficiency Clinical Trial

Official title:

The Effect of Ballet Training on Plantar Venous Pump Activity in Ballerinas

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04469361
• Other study ID #: 09.2017.129
• Status: Completed
• Start date: September 4, 2017
• Est. completion date: January 5, 2018

Study information

• Verified date: February 2017
• Source: Marmara University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Classic ballet dance is a demonstration of complex motor skills to be revealed in aesthetic combinations and repetitively, and it demands intensive use of the lower extremities within extreme of range of motion (ROM). Because ballet practice depends on advanced technical skills, it involves intensive physical training and causes an overload on the musculoskeletal system and foot deformities such as pes planus.

Plantar venous pump (PVP) is a network of multiple venous vessels located between the muscles of the foot arch. PVP is considered the first step of venous return and discharges into the posterior tibial vein (PTV). PVP is reported to be active during gait while it is inactive in resting position. There are different views on the mechanisms enabling its activation 1-3. The general view is that during the stance phase of the gait, the flattening of the plantar arch with weight transfer causes the veins in this region to narrow and creates a force that pumps the blood up.

The aim of this study is the investigation what kind of hemodynamic changes ballet training causes in the lower extremity

Recruitment information / eligibility

• Status: Completed
• Enrollment: 28
• Est. completion date: January 5, 2018
• Est. primary completion date: November 3, 2017
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 14 Years to 19 Years

Eligibility

Inclusion Criteria (for balerinas):

• receiving ballet training at least 10 h per week for at least 4 years

• receiving formal dancing training system

Inclusion Criteria (for non-dancer group)

• never receiving formal dancing training

• having sedentary lifestyle

Exclusion Criteria:

• Participants with a history of foot or ankle surgery,

• Participants with connective tissue disease,

• Participants with rigid pes planus-cavus,

• Participants with chronic venous insufficiency

• Participants with acute ankle injury in recent 3 months

Related Conditions & MeSH terms

• Foot Drop (Acquired)
• Peroneal Neuropathies
• Venous Insufficiency

Intervention

Other:
• Navicular drop measurement
The difference in navicular height between sitting and standing positions was recorded (mm) as the amount of navicular drop.
• Measurement of venous return parameters in supine
Venous return parameters of posterior tibial vein was measured when participant applied force equivalent to their own body weight on plantar surface of their right leg in supine position
• Measurement of venous return parameters in standing
In standing, venous return parameters was measured of posterior tibial vein when participants shift all of their weight to the right leg for 3 second with their leg muscles as relaxed as possible and their knee joint in full extension.
• measurement of midfoot pressure distrubition
In standing, midfoot pressure distrubution was measured when participants shift all of their weight to the right leg

Locations

Country	Name	City	State
Turkey	Marmara University	Istanbul

Sponsors (1)

Lead Sponsor	Collaborator
Marmara University

Country where clinical trial is conducted

Turkey, 

References & Publications (6)

Allen N, Nevill A, Brooks J, Koutedakis Y, Wyon M. Ballet injuries: injury incidence and severity over 1 year. J Orthop Sports Phys Ther. 2012 Sep;42(9):781-90. doi: 10.2519/jospt.2012.3893. Epub 2012 Jul 19. — View Citation

Gardner AM, Fox RH. The venous pump of the human foot--preliminary report. Bristol Med Chir J. 1983 Jul;98(367):109-12. — View Citation

Guss-West C, Wulf G. Attentional Focus in Classical Ballet: A Survey Of Professional Dancers. J Dance Med Sci. 2016 Mar;20(1):23-9. doi: 10.12678/1089-313X.20.1.23. — View Citation

Khan K, Brown J, Way S, Vass N, Crichton K, Alexander R, Baxter A, Butler M, Wark J. Overuse injuries in classical ballet. Sports Med. 1995 May;19(5):341-57. Review. — View Citation

Kim TI, Forbang NI, Criqui MH, Allison MA. Association of foot and ankle characteristics with progression of venous disease. Vasc Med. 2015 Apr;20(2):105-11. doi: 10.1177/1358863X14568443. — View Citation

Pearson SJ, Whitaker AF. Footwear in classical ballet: a study of pressure distribution and related foot injury in the adolescent dancer. J Dance Med Sci. 2012;16(2):51-6. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Evaluation of navicular drop	Navicular drop was measured in mm	Cchange from baseline navicular height in pre-intervention and immediately after the intervention/
Primary	Evaluation of diameter of tibialis posterior vein in supine	Diameter of tibialis posterior vein was measured in mm	Change from baseline diameter of tibialis posterior vein during intervention
Primary	Evaluation of flow velocity of tibialis posterior vein in supine	Flow velocity of tibialis posterior vein was measured in cm/s	Change from baseline flow velocity of tibialis posterior vein during intervention
Primary	Evaluation of volume flow of tibialis posterior vein in supine	Volume flow of tibialis posterior vein was measured in ml/min	Change from baseline volume flow of tibialis posterior vein during intervention
Primary	Evaluation of diameter of tibialis posterior vein during weight bearing	Diameter of tibialis posterior vein was measured in mm	Change from baseline diameter of tibialis posterior during intervention
Primary	Evaluation of flow velocity of tibialis posterior vein during weight bearing	Flow velocity of tibialis posterior vein was measured in cm/s	Change from baseline flow velocity of tibialis posterior vein during intervention
Primary	Evaluation of volume flow of tibialis posterior vein during weight bearing	Volume flow of tibialis posterior vein was measured in ml/min	Change from baseline volume flow of tibialis posterior vein during intervention
Primary	Evaluation of midfoot plantar pressure during weight bearing	Midfoot plantar pressure was measured in gr/cm2	Change from baseline midfoot pressure during intervention