Translation, cross-cultural adaptation, and measurement properties of the Brazilian version of the Identification of Functional Ankle Instability (IdFAI) questionnaire.

OBJECTIVES: The aim of this research was to describe the translation and cultural adaptation, and to test the validity and reliability of the Brazilian version of the Identification of Functional Ankle Instability (IdFAI) questionnaire. DESIGN: This was a clinical measurement. SETTING: This research took place at the Federal University of Sao Paulo in Brazil. PARTICIPANTS: Fifty college students participated in the translation and cultural adaptation, while another 50 students participated in the measurements (validity and reliability). MAIN OUTCOME MEASURES: The cross-cultural adaptation of the Brazilian IdFAI was accomplished using standard guidelines. For the validity and reliability, the individuals were asked to complete the IdFAI tests on the same day, and after two weeks maximum. The validity was assessed by correlating the Brazilian IdFAI with the Visual Analog Scale for Instability (VAS-I), the Cumberland Ankle Instability Tool (CAIT), and the Lower Extremity Functional Scale (LEFS) using Spearman's correlation coefficient. The test-retest reliability and internal consistency were determined by using an intraclass correlation (ICC2,1) and Cronbach's α, respectively. The agreement [standard error of measurement (SEM) and minimal detectable change at 90% (MDC90)] and the floor and ceiling effects were also assessed. RESULTS: The Brazilian IdFAI had strong correlation with the CAIT and moderate correlations with the VAS-I and LEFS scale, with excellent reliability, internal consistency and agreement. No ceiling or floor effects were observed. CONCLUSION: The Brazilian IdFAI questionnaire is a valid and reliable instrument to identify functional ankle instability. It can be used in both clinical and research settings.

Quality Improvement in Athletic Health Care.

CONTEXT: Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited. OBJECTIVES: To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training. DESCRIPTION: As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages: By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.