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Achilles tendon structure in full-time pre-professional ballet dancers: an Ultrasound Tissue Characterization study

Grant number: 22/06130-2
Support Opportunities:Scholarships abroad - Research Internship - Doctorate (Direct)
Effective date (Start): October 17, 2022
Effective date (End): October 16, 2023
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Fábio Viadanna Serrão
Grantee:Bruna Mariana Tessarin
Supervisor: Ebonie Kendra Rio
Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
Research place: La Trobe University, Australia  
Associated to the scholarship:20/00020-5 - Clinical factors that predict ultrasound alterations in Achilles tendon in professional ballet dancers: a nonlinear analysis, BP.DD


Ballet dancers are a population with extreme athletic and aesthetic demands. Young dancers who wish to pursue a professional career often undergo a full-time pre-professional training program designed to replicate the professional setting. Due to a high volume and intensity of training, pre-professional dancers may be predisposed to musculoskeletal injury. The literature presents a risk of injury of 76% over one year and a rate of injury of 1.38/1000 hours of dance that increased throughout the following training years. Overuse ankle injuries are the most common. Given the burden injuries can cause to the dancers' lives, reducing injury risk during pre-professional training can improve likelihood of a professional contract, and prolong their careers. Considering the high prevalence of ankle overuse injuries, monitoring and management of training load can help prevent injuries. Ultrasound Tissue Characterization (UTC) is an imaging modality able to detect subtle changes in tendon structure, providing quantifiable and objective information to predict, diagnose, and monitor tendon conditions. Research using UTC in the ballet dancer population is in its infancy and no study has investigated the relationship between dance load, injury profile and the Achilles tendon structure quantified using UTC in a large cohort of pre-professional ballet dancers. Our purpose will be to report the Achilles tendon structure (echo-type profile) on UTC in full-time pre-professional ballet dancers and changes over a season. The second aim will be to investigate the relationship between the echo-type profile with training load data and lower limb injuries in pre-professional dancers. Injury surveillance and load data will be collected weekly through self-report using a web-based software platform (REDCAp); Achilles tendon structure will be quantified using the UTC imaging tool (UTC Tracker, UTC Imaging, Netherlands). The UTC data will be processed using an algorithm that quantifies the stability of the echo pattern observed in the contiguous transverse images in four echo-types. The four echo-types will be quantified utilising relative percentages of total pixels in each tendon's region of interest (ROI). The anteroposterior diameter will be calculated at 2cm proximal from the tendon's insertion. (AU)

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