Functional tests as predictors of ankle instability six months after an acute lateral ankle sprain.

BACKGROUND: This study investigated whether functional tests performed in the acute-subacute phase after a lateral ankle sprain and demographic data are predictive of ongoing ankle instability. METHODS: Thirty-three subjects (mean age 23.6±3.6 years, 63.6% males) were tested within three weeks of injury using the Balance Error Scoring System (BESS) modified with a dual cognitive task, the single-leg drop landing task (SLDL) and the drop vertical jump task (DVJ). The Cumberland Ankle Instability Tool (CAIT) at six months and the occurrence of a new sprain during follow-up were used to define potential ankle instability. Associations between functional tests and demographic variables to ankle instability outcomes were measured with χ2, Mann-Whitney U Test, and logistic regressions. RESULTS: Twenty-one participants (63.6%) met the ankle instability criteria at six months from injury. Each extra point in the Modified-BESS Foam-Tandem sub-task increased the likelihood of ankle instability (OR=1.55, P=0.037). Unwillingness to perform SLDL increased the likelihood of ankle instability (OR=10.0, 95% CI: 1.1-91.9, RR=1.8, 95% CI: 1.1-2.8), as did non-dominant ankle sprain (OR=6.0, 95% CI: 1.2-29.4, RR=1.88, 95% CI: 1.03-3.4). These three outcomes explained between 33.6% to 45.9% of the variance and correctly classified 75.8% of cases (sensitivity, 85.7%; specificity, 58.3%; P=0.004). CONCLUSIONS: The variables studied may help identify individuals who have an increased potential to develop ankle instability and may be used in decision-making. Further studies should validate these findings with a larger and broader sample.

Reliability and Validity of Patient-Reported Outcome Measures for Ankle Instability in Hebrew.

BACKGROUND The International Ankle Consortium has recommended several instruments for assessing and diagnosing chronic ankle instability. These include the Ankle Instability Instrument (AII), Cumberland Ankle Instability Tool (CAIT), Identification of Functional Ankle Instability (IdFAI), and Foot and Ankle Ability Measure (FAAM). This study aimed to translate, culturally adapt, and assess the reliability, validity, discriminative power, and classification agreement of the Hebrew online versions of the AII, CAIT, IdFAI, and FAAM. MATERIAL AND METHODS After translation and cross-cultural adaptation of the questionnaires, we recruited 87 participants with self-reported ankle disorders to evaluate the psychometric properties of the questionnaires. To evaluate each questionnaire's discriminative power, we recruited 75 healthy participants. Reliability was assessed by calculating internal consistency (Cronbach's alphas) and test-retest intraclass correlation coefficients. Convergent and divergent validity were assessed by Spearman's correlation between each instrument and the Short-Form-12 (SF-12) score for physical and mental components, respectively. RESULTS All instruments had acceptable internal consistency (alpha>0.7) and good test-retest reliability (ICC2,1>0.8), except for the IdFAI (ICC2,1=0.73). All instruments had moderate convergent validity (ρ>0.4 with SF-12 physical component) except for AII (r=0.36). No instrument was correlated with the SF-12 mental component score (good divergent validity, ρ<0.3). All instruments had excellent discriminative power (area under the receiver operator characteristic curve >0.9). Strong correlations were found between all instruments. CONCLUSIONS The Hebrew online versions of the AII, CAIT, IdFAI, and FAAM are reliable and valid and can be used in research or clinical settings.