Demographic, postural stability and questionnaire variables were compared using independent samples ttests. Originally developed in english, our goal was to translate it, while culturally adapting it, and finally by validating the psychometric properties of the newly frenchtranslated aii. Pdf development and reliability of the ankle instability instrument. The predictor variables were seven ankle instability questionnaires. Ankle instability treatment minneapolis ankle surgeon. Chronic ankle instability, ankle sprain, coper and noncoper, cait formatted for submission to the journal of sport rehabilitation. Most people with ankle ligament instability have damage to the ankle ligaments usually caused by a trauma to the ankle. The ankle instability instrument aii was designed specifically to determine ankle instability. Hale and hertel advocate the use of the fadi and fadi sport selfreport instruments in clinical care and research applications in young adults with cai. Any volunteer, regardless of ankle injury history was included in the study. The clinimetric qualities of patientassessed instruments. Clinicians may incorporate a discriminative instrument, such as the cumberland ankle instability tool, to assist in identifying the presence and severity of ankle instability associated with the icd category of disorder of ligament, instability second. If left untreated, they can result in chronic instability.
Investigating the relationship between fai questionnaires and. Screen for signs of instability in those with moderate to severe ankle sprains 46 weeks after initial injury. The assessment of outcomes from the patients perspective becomes more recognized in health care. Joint mobilization and static stretching for individuals. Development and reliability of the ankle instability instrument. The foot and ankle disability index was designed to assess functional limitations related to foot and ankle conditions. Pdf development and reliability of the ankle instability. One hundred ten participants were asked to complete the idfai on 2 occasions and the lower extremity functional screen lefs on 1 occasion.
There is an association between ankle instability and peroneal tendon instability. Reliability and validity of an ankle instability instrument. Inclusion criteria when investigating insufficiencies in. Deficits in peroneal latency and electromechanical delay. Cumberland ankle instability tool, to assist in identifying the presence and severity of ankle instability. While research on chronic ankle instability cai and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant or patient selection criteria across studies presents a potential obstacle to addressing the problem properly. The validated cutoff score for the cait for the identification of fi is. However, several other conditions may also cause chronic ankle pain. For objective 1 fit to the 2 models, outcomes were cumberland ankle instability tool score, anterior drawer test results, and number of sprains.
Ankle instability treatment minneapolis ankle surgeon dr. The clinimetric qualities of patientassessed instruments for. Development and reliability of the ankle instability. Individuals were excluded if they reported no history of ankle sprain or no perception of giving way in the ankle. The creation of the ankle instability instrument is a first step in recognizing a more objective way of identifying patients suffering from functional ankle instability. Investigating the relationship between fai questionnaires. Docherty and others published reliability and validity of an ankle instability instrument find, read and cite all the research you need on researchgate. It captures the severity of the initial injury, history of ankle instability. Five studies used functional scales to classify if subjects discriminate between ankle instability subjects and noninjured controls. Subjects completed the questionnaires for their dominant limb during a single testing session. The decision about which patientassessed instrument is most appropriate for clinical practice should be based upon. Selfreport test is very useful for researchers and clinical practice, and cai is a widespread tool. Further, subjects answered yes to questions 3, 5, 6, 7, and 9, and no to questions 4, 8, and 10 on the functional ankle instability questionnaire. Another questionnaire, the ankle instability instrument aii could be a tool to be considered by the practitioner in the management of ankle instabilities, in order to identify the functional aspects.
Accuracy of mri scan in the diagnosis of ligamentous and chondral pathology in the. Joshy s, abdulkadir u, chaganti s, sullivan b, hariharan k. Typically patients complain of repeated giving way of the ankle which is usually painful. Tools to identify chronic instability, assess severity and measure progress include the foot and ankle ability measure faam and the ankle instability instrument. Nonsurgical measures, including functional rehabilitation, are the management methods of choice for acute injuries, with surgical intervention reserved for highdemand athletes.
Ankle sprain is a common athletic injury and about 20% of acute ankle sprain patients develop chronic ankle instability 1. Usually, the giving way occurs while walking or doing other activities, but it can also happen when. The cais is a valid and reliable instrument for quantifying the multidimensional profile of patients with cai. Ankle instability instrument, cumberland ankle instability tool, and identi. A dynamicbalancetraining dbt program supplemented with the graston instrumentassisted softtissue mobilization gistm technique has not been evaluated collectively as a treatment in subjects with chronic ankle instability cai. Selection criteria for patients with chronic ankle. Drouin 2008 validity of the foot and ankle ability measure in athletes with chronic ankle instability. Henderson a thesis submitted to the faculty of the university of delaware in partial fulfillment of.
Signs and symptoms pain, usually on the outer side of the ankle. Rehab exercises for ankle sprain seattle podiatrist. Chronic ankle instability and selfreported function lower. Instability is demonstrated with the anterior draw and tilt tests. Thus, the ankle instability instrument aii was developed and initially validated in english. Development and reliability of the ankle instability instrument ncbi. Pdf functional ankle instability has been defined in a variety of ways. Chronic ankle instability and selfreported function lower extremity.
Ankle instability recurring or persistent chronic pain on the outer lateral side of the ankle often develops after an injury such as a sprained ankle. Ankle stability and movement coordination impairments. Also in patients with chronic ankle instability, the degree of present impairments, disabilities and participation problems should be documented from the perspective of the patient. Functional ankle instability has been defined in a variety of ways. We routinely perform an ankle arthroscopy in combination with all lateral ankle stabilization procedures. This condition often develops after repeated ankle sprains. Nevertheless, there is lack of measurement instruments validated into spanish, which represents a major difficulty for research dealing. Evaluation of the cumberland ankle instability tool as a predictor of ankle reinjury in collegiate athletes by emily m. The mean importance rating by the patients of three of the original 17 items how frequently do you use external ankle supports when performing other activities than recreational or sports activities as a result of your ankle instability. Several selfreported questionnaires have been published in the past decade.
The hertel model of chronic ankle instability cai is commonly used in research but may not be sufficiently comprehensive. If a subject reported bilateral ankle instability, the selfreported worse limb was used. Crosscultural adaptation and validation of the spanish. Thats why smith and nephew offers instrumentation designed specifically for the foot and anklenovel solutions for the procedures you routinely perform. When someone twists their ankle, the first ligaments to tear are the anterior talofibular, then the calcaneofibular, usually in that order. Chronic ankle instability in patients with chronic ankle instability, mri showed 100% specificity for the diagnosis of atfl and cfl tears and accuracy of 91.
It captures the severity of the initial injury, history of ankle instability, and instability during activities of daily living adls. Therefore, the information provided by selfadministered questionnaires is essential. Komenda and ferkel found that in 52 ankles with chronic ankle instability, 93 percent of the ankles exhibited intraarticular pathology with the most common finding being synovitis followed by the presence of loose bodies. This condition occurs when an ankle injuryusually an inversion ankle sprain causing injury to the lateral ankle ligamentsstretches, ruptures, or tears. Breitenseher mj, trattnig s, kukla c, gaebler c, daider, a, baldt m et al. However, some, especially those with varus or cavovarus deformity, develop symptoms of ankle instability without injury. The decision about which patientassessed instrument is most appropriate for clinical practice should be based. Three studies used the ankle instability instrument, with the other two studies using the cumberland ankle instability tool cait. Reliability and validity of a new questionnaire created to. Mechanical instability and functional instability are considered part of a continuum, and recurrent sprain occurs when both conditions are present. Jan 18, 2007 the assessment of outcomes from the patients perspective becomes more recognized in health care.
Factors that are frequently used in this definition include a history of a. Is chronic ankle instability associated with impaired muscle. Whether these ligaments are stretched from a remote injury old ankle sprain or from repetitive giveway episodes, they are no longer functional after injury. The cumberland ankle instability tool cait is a valid instrument to determine the presence of chronic ankle instability cai and to assess its severity. Keywords validity cumberland ankle instability tool. Effects of a proximal or distal tibiofibular joint. Mri versus lateral stress radiography in acute lateral ankle ligament injuries. The ptfl courses from the posterior border of the lateral malleolus to the lateral tubercle of the talus. For objective 2, outcomes were 2 balance tasks number of foot lifts in 30 seconds, ability to balance on the ball of the foot and time to recover from an inversion perturbation. The independent variables were the score on three selfreport ankle instability questionnaires. Thousands of people sustain ankle sprains each day. Functional ankle instability affects 2040% of individuals who have already suffered from a sprain. Ankle joint functional assessment tool ajfat, chronic.
Factors that are frequently used in this definition include a history of a severe ankle sprain, a history of multiple ankle sprains, and a recurrent feeling of instability or. While research on chronic ankle instability cai and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant or patient selection criteria across studies presents a potential. Chronic ankle instability can be both a cause and a result of an ankle sprain. Chronic ankle instability is a condition characterized by a recurring giving way of the outer lateral side of the ankle. Validity of the foot and ankle ability measure in athletes. Ankle instability usually results from injuries to the outside ligaments. The high reliability we found shows that selfreporting of ankle symptoms is a feasible.
Rehab exercises for ankle sprain and ankle instability and arch strengthening exercises the best exercises for strengthening an unstable ankle are oneleg balance exercises studies over the past ten years have demonstrated that these oneleg balance exercises are a critical part of rehabilitation after an ankle sprain or following a diagnosis. The cumberland ankle instability tool cait cyberleninka. Is chronic ankle instability associated with impaired. Nevertheless, there is lack of measurement instruments validated into spanish, which represents a major difficulty for research. Management of acute and chronic ankle instability abstract acute lateral ankle ligament injuries are common. Most patients with chronic instability give a clear history of one or more ankle injuries. When ankle df was measured in nwb using arom methods, the relationship between ankle df rom and dynamic balance was fair r0. Scores on the foot and ankle ability measure activities of daily living and sports subscales were greater in healthy athletes than in those with chronic ankle instability and were greater in the athletes who indicated that their ankles were normal than in those who indicated that their ankles were nearly normal or abnormal.
The high reliability we found shows that selfreporting of ankle symptoms is a feasible, appropriate way to obtain information on the presence of instability symptoms. The tray offers convenient storage for manual and size appropriate handheld instruments as well as cannulas, obturators and microvector to deliver an allinclusive solution for ankle. Specifically, selfreported ankle instability should be confirmed with a validated ankle instabilityspecific questionnaire using the associated cutoff score. Validity of the foot and ankle ability measure in athletes with.