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Yingyongsaksri S, Hiller CE, Tharawadeepimuk K, Nanbancha A. Reliability and validation of the Thai version of the Cumberland Ankle Instability Tool (CAIT-THA). Disabil Rehabil 2023; 45:3762-3767. [PMID: 36263888 DOI: 10.1080/09638288.2022.2135778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study aimed to provide a version of Cumberland Ankle Instability Tool (CAIT) for the Thai younger adult population and examine psychometric properties and determine the cut-off score. METHODS CAIT-Youth Thai version was modified to CAIT Thai version (CAIT-THA). To validate the CAIT-THA psychometric properties, 72 with chronic ankle instability (CAI) and 72 without (age 23.45 ± 4.45 years) were recruited. The validation was carried out by using internal consistency (Cronbach's alpha), concurrent validity (Spearman's rank correlation coefficient), discriminative validity (Receiver Operating Characteristic (ROC) curve), and test-retest reliability (intraclass correlation coefficient; ICC). A cut-off score was determined via Youden's index. RESULTS Validation showed good internal consistency (Cronbach's alpha = 0.837), and concurrent validity (Spearman's rank correlation coefficient = 0.762 and 0.731 for right ankle and left ankle, respectively). Test-retest reliability was excellent with ICC (2,1) of 0.945 (95% CI = 0.93-0.96). A cut-off score of ≤ 25, determined by ROC curve and Youden's index, was distinguished between participants with and without CAI. CAIT-THA obtained 97.2% sensitivity, 94.4% specificity, 0.03 negative, and 17.5 positive likelihood ratios. CONCLUSION CAIT-THA is a validated tool that can be used in Thai younger adults. Clinicians and researchers can confidently use a score of ≤ 25 to determine the presence of CAI.IMPLICATIONS FOR REHABILITATIONThe Cumberland Ankle Instability Tool Thai version (CAIT-THA) questionnaire is available for Thai young adults.The CAIT-THA had high sensitivity, specificity, and positive and negative likelihood cut-off ratio scores for discrimination between chronic ankle instability (CAI) and non-CAI.The CAIT-THA questionnaire may be used in rehabilitation and research settings for the identification and management of CAI conditions.
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Affiliation(s)
- Supannikar Yingyongsaksri
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Claire E Hiller
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Ampika Nanbancha
- College of Sports Science and Technology, Mahidol University, Salaya, Thailand
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Candeniz Ş, Kocaman H, Erol Çelik S, Bek N. Cross-cultural adaptation, reliability, and validity of the Turkish version of the Cumberland Ankle Instability Tool. Musculoskelet Sci Pract 2023; 68:102873. [PMID: 37897935 DOI: 10.1016/j.msksp.2023.102873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES The objective of the study was to cross-culturally adapt and assess the validity and reliability of the Turkish version of the CAIT (CAIT-TR). METHODS The CAIT was translated and adapted into Turkish according to accepted cross-cultural adaptation guidelines of self-reported measures. A total of 130 individuals, including healthy participants (n = 40) and with chronic ankle instability (CAI) (n = 90), were recruited in this study. The internal consistency and test-retest reliability of the CAIT-TR were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. To assess convergent validity, hypotheses were tested regarding expected correlations between CAIT-TR, Foot and Ankle Outcome Score (FAOS) subscales, and the Visual Analogue Scale (VAS). Discriminative validity was evaluated with the hypothesis that the CAIT-TR can distinguish between subjects with and without CAI and also calculated a cut-off score for CAI. The dimensional structure of the CAIT-TR was investigated with confirmatory factor analysis. Additionally, minimal detectable change (MDC), floor/ceiling effects, and measurement error values were determined. RESULTS The CAIT-TR demonstrated high Internal consistency (Cronbach's alpha = 0.854) and test-retest reliability (ICC = 0.919). Regarding convergent validity, the CAIT-TR exhibited a moderate-strong correlation with both the FAOS and VAS. The confirmatory factor analysis supported the unidimensional structure of the questionnaire. The identified cut-off value for the CAIT-TR was 25, and the MDC for individual-level CAIT-TR scores was determined to be 1.87. No floor or ceiling effects were observed. CONCLUSION The CAIT-TR is a valid and reliable questionnaire for the assessment of ankle instability within the Turkish population.
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Affiliation(s)
- Şeyda Candeniz
- Department of Therapy and Rehabilitation, Kızılcahamam Vocational School of Health Services, Ankara University, Ankara, Turkey.
| | - Hikmet Kocaman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey.
| | - Seher Erol Çelik
- Department of Therapy and Rehabilitation, Kızılcahamam Vocational School of Health Services, Ankara University, Ankara, Turkey.
| | - Nilgün Bek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey.
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Cervera-Garvi P, Marchena-Rodriguez A, Lopezosa-Reca E, Diaz-Miguel S, Ortega-Avila AB. Systematic review of the methodological quality of patient-reported outcome measure for patients with chronic ankle instability. Clin Rehabil 2023; 37:1332-1346. [PMID: 36987581 DOI: 10.1177/02692155231166217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJETIVE Chronic ankle instability is generally associated with ankle sprain. Its consequences can be measured by means of patient-reported outcome measures (PROMs). The aim of this review is to identify the PROMs specifically available for chronic ankle instability and to evaluate their methodological quality and that of the cross-cultural adaptations made. DATA SOURCES Papers were retrieved from PubMed, Embase, Scopus and Google Scholar databases, with no time limit applied, based on the following inclusion criteria: (1) type of participants: patients with chronic ankle instability, over 18 years of age; (2)type of study: those specifically focused on this pathology, using PROMs specific to chronic ankle instability and published in English; (3) type of outcome: measurement properties based on COSMIN criteria in patient-reported outcomes associated with chronic ankle instability. METHODS This systematic review, following the COSMIN checklist, was conducted to determine the methodological quality of PROMs specific to foot and ankle pathologies, for patients presenting chronic ankle instability. RESULTS Of the 576 studies identified in the initial search, 34 were included in the final analysis of measurement properties. Four - the Ankle Instability Instrument, the Chronic Ankle Instability Scale, the Cumberland Ankle Instability Tool and the Identification of Functional Ankle Instability - were original questionnaires, and the remaining 30 were cross-cultural adaptations. CONCLUSION The Cumberland Ankle Instability Tool and the Identification of Functional Ankle Instability questionnaires can be useful instruments for evaluating chronic ankle instability, both in patients with this condition and also in non-pathological patients.
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Affiliation(s)
- Pablo Cervera-Garvi
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Ana Marchena-Rodriguez
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Eva Lopezosa-Reca
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Salvador Diaz-Miguel
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
- Instituto de investigación Biomédica de Málaga (IBIMA), Malaga, Spain
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Contri A, Ballardin F, De Marco G, Gaucci M, Scariato A, Zanoni V, Vanti C, Pillastrini P. Italian version of the Cumberland Ankle Instability Tool (CAIT-I). Foot (Edinb) 2023; 56:102043. [PMID: 37295293 DOI: 10.1016/j.foot.2023.102043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/07/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
STUDY DESIGN Evaluation of the psychometric properties of a translated, culturally adapted questionnaire. OBJECTIVE Translating, culturally adapting, and validating the Italian version of the Cumberland Ankle Instability Tool (CAIT-I). SUMMARY OF BACKGROUND DATA Ankle sprains are one of the most common musculoskeletal injuries and can lead to chronic ankle instability (CAI). The International Ankle Consortium recommends the Cumberland Ankle Instability Tool (CAIT) as a valid and reliable self-report questionnaire assessing the presence and severity of CAI. At this moment, there is no validated Italian version of CAIT. METHODS The Italian version of the CAIT (CAIT-I) was developed by an expert committee. Test-retest reliability of the CAIT-I was measured in 286 healthy and injured participants within a 4-9-day period, by using Intraclass Correlation Coefficients (ICC2,1). Construct validity, exploratory factor analysis, internal consistency and sensitivity were examined in a sample of 548 adults. Instrument responsiveness over 4 time points was determined in a subgroup of 37 participants. RESULTS The CAIT-I demonstrated excellent test-retest reliability (ICC≥0.92) and good internal consistency (α = .84). Construct validity was confirmed. Identified cut-off for the presence of CAI was 24.75, with sensitivity= 0.77 and specificity= 0.65. There were significant differences across time for CAIT-I scores (P < .001), demonstrating responsiveness to change, but no floor or ceiling effects. CONCLUSION The CAIT-I demonstrates acceptable psychometric performance as a screening and outcome measure. The CAIT-I is a useful tool to assess the presence and severity of CAI.
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Affiliation(s)
- Angela Contri
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio, Via del Pozzo n.74, 41100 Modena, Italy
| | - Francesco Ballardin
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna BO Bologna, Italy
| | - Gianluca De Marco
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna BO Bologna, Italy
| | - Matteo Gaucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna BO Bologna, Italy.
| | - Angela Scariato
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna BO Bologna, Italy
| | | | - Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna BO Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna BO Bologna, Italy; Unità Operativa di Medicina del Lavoro - IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Via Pelagio Palagi 9, 40123 Bologna BO Bologna, Italy
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Hui JYN, Tong AHK, Chui VWT, Fong DTP, Chau WW, Yung PSH, Ling SKK. Cross-cultural adaptation, reliability and validity of the Cantonese-Chinese Cumberland Ankle Instability Tool (CAIT-HK). Foot (Edinb) 2023; 56:102015. [PMID: 36958251 DOI: 10.1016/j.foot.2023.102015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023]
Abstract
Acute lateral ankle sprains are common amongst athletes, and screening is essential in preventing these long-term sequelae. Self-reported questionnaires, such as the Cumberland Ankle Instability Tool (CAIT), may help identify individuals with chronic ankle instability. To date, a Cantonese-Chinese version of the CAIT does not exist. A cross-cultural adaptation and validation of the CAIT were carried out: 46 individuals who were native in Cantonese completed the Cantonese-Chinese version of the CAIT and Chinese Foot and Ankle Outcome Score. For the test-retest analysis, the intraclass correlation coefficient was 0.874. Internal consistency showed a Cronbach's ɑ value of 0.726. Construct validity against the FAOS was fair but statistically significant with a Spearman's correlation coefficient of 0.353, 0.460, 0.303, 0.369 and 0.493 for the categories of symptoms, pain, daily function, sports function, and quality of life, respectively. A cutoff score of 20.5 was determined to differentiate healthy individuals from those with chronic ankle instability for this study population. The original English CAIT was successfully translated, cross-culturally adapted and validated into Cantonese-Chinese.
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Affiliation(s)
- Jasmine Yat-Ning Hui
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), HKSAR, China
| | - Anson Hei-Ka Tong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), HKSAR, China
| | - Vivian Wai-Ting Chui
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), HKSAR, China
| | - Daniel T P Fong
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, United Kingdom
| | - Wai-Wang Chau
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), HKSAR, China
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), HKSAR, China
| | - Samuel Ka-Kin Ling
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), HKSAR, China.
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Palomo-Fernández I, Martín-Casado L, Marcos-Tejedor F, Aldana-Caballero A, Rubio-Arias JÁ, Jiménez-Díaz JF. Lateral wedge insoles and their use in ankle instability. Scand J Med Sci Sports 2023; 33:1716-1725. [PMID: 37265052 DOI: 10.1111/sms.14414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
The aim of the present study is to assess the immediate effects of applying lateral wedge insoles of different heights (0.00, 0.3, 0.4, and 0.6 cm) in patients with chronic ankle instability (CAI) in normal and supinated feet during a Star Excursion Balance Test (SEBT) and in the reflex response of Peroneus Longus (PL), Peroneus Brevis (PB), and Tibialis Anterior (TA) over a 30° inversion of the feet. The effects of the height of the wedges were assessed using a double-blind, crossover design. In total, 25 participants were allocated into two groups, depending on the foot posture (Normal = 12, Supinated = 13) and performed the tests in a random fashion. Reaction time (RT) of stabilizing muscles of the ankle was measured using superficial electromyography (EMG) and postural balance with the SEBT. Foot posture did not show any significant effects on the analyzed variables. Nonetheless, the use of a 0.3 cm external rearfoot wedge (PB p = 0.002; PL p = 0.066 and TA p = 0.006) and 0.6 cm (PB p = 0.043; PL p = 0.058 and TA p = 0.071) reduces RT in stabilizing muscles of the ankle and improves results in SEBT, except for the anterolateral direction, in subjects with CAI. Therefore, our results suggest that the use of lateral wedge insoles could reduce RT and improve dynamic balance in chronic ankle instability.
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Affiliation(s)
- Inés Palomo-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Laura Martín-Casado
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Félix Marcos-Tejedor
- Department of Medical Sciences, Faculty of Health Sciences University of Castilla-La Mancha, Toledo, Spain
| | - Alberto Aldana-Caballero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Jacobo Á Rubio-Arias
- Department of Education, Health Research Center, University of Almeria, Almería, Spain
| | - J Fernando Jiménez-Díaz
- Laboratory of Physical Performance and Readaptation Injuries, University of Castilla-La Mancha, Toledo, Spain
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Olszewski M, Zając B, Golec J. Cross cultural adaptation, reliability and validity of the Polish version of the Cumberland Ankle Instability Tool. Disabil Rehabil 2023:1-6. [PMID: 37463065 DOI: 10.1080/09638288.2023.2232719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023]
Abstract
Purpose: The aim of this study was to develop a Polish version of the Cumberland Ankle Instability Tool (CAIT-PL) questionnaire and perform CAIT-PL cultural adaptation with assessment of its psychometric properties.Methods: The original CAIT was translated into the Polish language using standard guidelines. The CAIT-PL was completed on 2 occasions by 105 participants both with and without a history of ankle sprains. Psychometric evaluation of CAIT-PL included an assessment of internal consistency, test-retest reliability, standard error of measurement, convergent and construct validity.Results: The CAIT-PL was successfully translated and adapted into Polish culture with satisfactory internal consistency (Cronbach's α = 0.83) and adequate test-retest reliability resulting in ICC2,1 = 0.89 (95% CI: 0.84-0.92). Measurement error was low (SEM = 0.76 and MDC = 2.10). Convergent validity of the CAIT-PL ranged from weak to strong using Spearman's correlation coefficient between CAIT-PL and FAOS subscales (r = 0.39-0.67; p < 0.05). Construct validity was confirmed.Conclusion: The Polish version of the Cumberland Ankle Instability Tool is a valid and reliable questionnaire for assessment of functional ankle instability among the Polish population.
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Affiliation(s)
- Maciej Olszewski
- Doctoral School, University of Physical Education in Kraków, Poland
| | - Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Kraków, Poland
| | - Joanna Golec
- Institute of Rehabilitation in Traumatology, University of Physical Education in Kraków, Poland
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Li J, Qiu F, Legerlotz K. Cross-cultural adaptation and validation of the Chinese version of the ankle joint functional assessment tool (AJFAT) questionnaire. J Foot Ankle Res 2023; 16:22. [PMID: 37098578 PMCID: PMC10131472 DOI: 10.1186/s13047-023-00622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/11/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Ankle joint functional assessment tool (AJFAT) is gradually becoming a popular tool for diagnosing functional ankle instability (FAI). However, due to the lack of standard Chinese versions of AJFAT and reliability and validity tests, the use of AJFAT in the Chinese population is limited. This study aimed to translate and cross-culturally adapt the AJFAT from English into Chinese, and evaluate the reliability and validity of the Chinese version of AJFAT and to investigate its psychometric properties. METHODS The translation and cross-cultural adaptation of AJFAT was performed according to guidelines for cross-cultural adaptation of self-report measures. 126 participants with a history of ankle sprain completed the AJFAT-C twice within 14 days and completed the Cumberland ankle instability tool (CAIT-C) once. Test-retest reliability, internal consistency, ceiling and floor effects, convergent and structure validity and discriminative ability were investigated. RESULTS The test-retest reliability (ICC = 0.91, 95%CI = 0.87-0.94) and internal consistency (Cronbach's alpha = 0.87) of the AJFAT-C were excellent. No ceiling or floor effects were detected. A moderate correlation between the AJFAT-C and the CAIT-C suggested a moderate convergent validity. The AJFAT-C had a two-factor structure: 1. function of the unstable side of the ankle joint (9 items) and 2. symptoms of the unstable side of the ankle (2 items). The ideal cut-off point of the AJFAT-C was calculated as 26 points. CONCLUSION The Chinese version of AJFAT can be considered as a valid and reliable ankle joint function evaluation tool that can be applied in clinical and research work.
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Affiliation(s)
- Jinfeng Li
- Department of Kinesiology, Iowa State University, Ames, IA, 50011, USA
| | - Fanji Qiu
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter Den Linden 6, 10099, Berlin, Germany.
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter Den Linden 6, 10099, Berlin, Germany
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Liu J, Chen M, Xu T, Tian Z, Xu L, Zhou Y. Functional results of modified Mason-Allen suture versus horizontal mattress suture in the arthroscopic Broström-Gould procedure for chronic ankle instability. J Orthop Surg Res 2022; 17:459. [PMID: 36266690 PMCID: PMC9585854 DOI: 10.1186/s13018-022-03354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background The arthroscopic Broström–Gould procedure (ABG) gained particular attention among clinicians and researchers due to its high rate of satisfactory results. There is a lack of evidence regarding the differences in clinical outcomes for the various suture techniques. The purpose of this study was to compare the differences in clinical effect in patients treated with one-anchor modified Mason–Allen suture or two-anchor horizontal mattress suture for chronic ankle instability (CAI). Methods This retrospective cohort study examined CAI patients who underwent either one-anchor modified Mason–Allen suture or two-anchor horizontal mattress suture ABG between January 2018 and January 2020. Patients were divided into two groups based on the suture knot type used and the associated number of anchors. The operative time, surgical cost, Visual Analog Scale (VAS), American Orthopedic Foot & Ankle Society (AOFAS) Score, Karlsson Ankle Functional Score (KAFS), the rate of return to sports, complications, and measured biomechanical strength using standardized equipment were compared between groups. Results Sixty-four CAI patients were included (one-anchor modified Mason–Allen suture group n = 30, two-anchor horizontal mattress suture group n = 34). Compared to the two-anchor horizontal mattress suture group, the one-anchor modified Mason–Allen suture group had significantly shorter operative time (p < .001) and lower surgical cost (p < .001). There were no postoperative complications in the two groups, and no significant differences in the VAS, AOFAS, KAFS, and rate of return to sports in postoperative follow-up between the two groups at 1 and 2 years after surgery. There was no statistically significant difference in biomechanical strength anterior drawer test displacement (p > .05) between the one-anchor modified Mason–Allen suture and two-anchor horizontal mattress suture at 2 years after surgery. Conclusion ABG using a one-anchor modified Mason–Allen suture showed comparable clinical results to a two-anchor horizontal mattress suture in the treatment of CAI at intermediate-term follow-up time. However, one-anchor modified Mason–Allen suture may be a faster, simpler, cost-effective substitute technology. Level of evidence Level III, comparative study.
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Affiliation(s)
- Jinlang Liu
- Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - Mingliang Chen
- Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - Tao Xu
- Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - Zhipeng Tian
- Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - Liuhai Xu
- Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - You Zhou
- Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China.
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Kim KM, Estepa-Gallego A, Estudillo-Martínez MD, Castellote-Caballero Y, Cruz-Díaz D. Comparative Effects of Neuromuscular- and Strength-Training Protocols on Pathomechanical, Sensory-Perceptual, and Motor-Behavioral Impairments in Patients with Chronic Ankle Instability: Randomized Controlled Trial. Healthcare (Basel) 2022; 10:1364. [PMID: 35893186 DOI: 10.3390/healthcare10081364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Chronic ankle instability (CAI) is a complex condition that includes limited mobility, perceived instability, and recurrent ankle sprains are common characteristics that reduce the quality of life in subjects who suffer from CAI. Neuromuscular training and strength training have been recommended in CAI management interventions. However, there are contradictory findings on results when comparing neuromuscular training, strength training, and the control group. The objective of this study was to compare the effectiveness of 8 weeks of neuromuscular intervention training, strength training, and no intervention in a sporting population with reported CAI. (2) Methods: Sixty-seven athletes with CAI were randomly assigned to a neuromuscular training group (NG), strength training group (SG), or control group (CG). Participants completed 8 weeks of neuromuscular training (a combination of static and dynamic exercises), strength training (resistance band exercises), or no training. Outcome measures were assessed at baseline and after 8 weeks and included selfs-reported instability feeling (CAIT), dynamic balance (SEBT), ankle dorsiflexion range of motion (WBLT), and functional status (FAAM and FAAM-SPORT). (3) Results: There were significant differences between strength and control groups in the posteromedial direction of SEBT, FAAM, and FAAM-SPORT after 8 weeks of intervention. (4) Conclusions: Neuromuscular training and strength training based on resistance bands exercises showed significant improvements in ankle dorsiflexion, subjective feeling of instability, functional status, and dynamic balance in patients with CAI.
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Khan B, Ikram M, Rehman SSU, Un Nisa Z. Urdu translation and cross-cultural validation of Cumberland Ankle Instability Tool (CAIT). BMC Musculoskelet Disord 2022; 23:443. [PMID: 35549689 PMCID: PMC9097047 DOI: 10.1186/s12891-022-05408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background The Cumberland Ankle Instability Tool (CAIT) is a self-assessment tool for people with chronic ankle instability (CAI). This tool had been translated and validated in many languages but there is no Urdu version of CAIT available. Objective The aim was to translate the CAIT into the Urdu Language and determine its validity and reliability. Methods A standardized step-wise forward and backward translation process was followed. Content, construct, convergent validity, internal consistency, and test–retest reliability were determined. A pilot study was done on 10 patients with CAI. The final version was investigated in 120 patients (mean age 26.6 ± 4.8 yrs) with CAI for validity and test–retest reliability in which 105 participants filled the questionnaire in the second week. Internal consistency was calculated by Cronbach’s alpha. Intraclass correlation (ICC2,1) was calculated to assess test–retest reliability between two weeks. Standard error of measurement (SEM) and smallest detectable change (SDC) were calculated. Convergent validity was determined by correlating Urdu CAIT with the Foot and Ankle Outcome Score (FAOS) using Spearman’s correlation co-efficient. Factor analysis describes the structure of underlying factors. Results Content validity index was > 0.80 of each question. Internal consistency was acceptable (Cronbach’s alpha > 0.75). Convergent validity with FAOS total score showed a moderate negative correlation (r = -0.68) with U-CAIT and negatively correlated with subscales of FAOS. Test–retest reliability was excellent ICC2,1 > 0.80. Scree plot showed 3 factors > 1eigen value. Conclusion The Urdu version of CAIT is a valid and reliable assessment tool for patients with chronic ankle instability. It has good content validity, construct validity and reliability. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05408-4.
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Affiliation(s)
- Basma Khan
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan
| | - Mehwish Ikram
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan.
| | - Syed Shakil Ur Rehman
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan
| | - Zaib Un Nisa
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan
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Kim KM, Estudillo-Martínez MD, Castellote-Caballero Y, Estepa-Gallego A, Cruz-Díaz D. Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. Int J Environ Res Public Health 2021; 18:5364. [PMID: 34069907 DOI: 10.3390/ijerph18105364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/26/2022]
Abstract
Chronic Ankle Instability (CAI) is one of the most common musculoskeletal dysfunctions. Stroboscopic vision (SV) training has been deemed to enhance somatosensorial pathways in this population group; nevertheless, until recently no studies have addressed the additional effects of this treatment option to the traditional therapeutic approach. METHODS To evaluate the effectiveness of a partial visual deprivation training protocol in patients with CAI, a randomized controlled trial was carried out. Patients with CAI (n = 73) were randomized into either a balance training, SV training, or a control (no training) group. For participants assigned into training groups, they received 18 training sessions over 6 weeks. The primary outcome was dynamic balance as measured by the Star Excursion Balance Test assessed at baseline and after 6 weeks of intervention. Secondary outcome measures included ankle dorsiflexion range of motion, self-reported instability feeling, and ankle functional status. RESULTS Better scores in stroboscopic training and balance training groups in all outcome measures were observed in comparison with the control group with moderate to large effect sizes. Stroboscopic training was more effective than neuromuscular training in self-reported instability feeling (cohen's d = 0.71; p = 0.042) and anterior reach distance of the star excursion balance test (cohen's d = 1.23; p = 0.001). CONCLUSIONS Preliminary findings from the effects of SV Stroboscopic training in patients with CAI, suggest that SV may be beneficial in CAI rehabilitation.
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Lorenzo-Sánchez-Aguilera C, Rodríguez-Sanz D, Gallego-Izquierdo T, Lázaro-Navas I, Plaza-Rodríguez J, Navarro-Santana M, Pecos-Martín D. Neuromuscular Mechanosensitivity in Subjects with Chronic Ankle Sprain: A Cross-Sectional Study. Pain Med 2021; 21:1991-1998. [PMID: 30649506 DOI: 10.1093/pm/pny299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Ankle sprain is one of the most common musculoskeletal injuries in sports, at work, and at home. Subjects who suffer from this injury may develop ankle instability. Functional instability has been associated with a high rate of resprain and impaired neuromuscular control in patients with ankle instability. OBJECTIVE Measurement of neural and muscular mechanosensitivity after ankle sprain injury and establishment of the relationship between these variables. METHODS A cross-sectional case-control study was performed with a sample of 58 students from Alcalá de Henares University (21 males and 37 females, mean age ± SD = 21 ± 3.7 years). Subjects were divided into two groups: a case group (N = 29, subjects with unstable ankle) and a control group (N = 29, healthy subjects). The pressure pain threshold (PPT) of the tibialis anterior, peroneus longus, and peroneus brevis muscles and mechanosensitivity of the common peroneus and tibial nerves were evaluated in all subjects through a manual mechanical algometer. RESULTS Neuromuscular PPTs showed significant differences (P < 0.05) between both groups, such that, compared with the control group, the case group exhibited significantly lower PPT levels. In the case group, a strong positive correlation was observed between neural and muscular homolateral mechanosensitivity in both lower limbs. CONCLUSIONS Participants with chronic ankle instability showed higher neuromuscular mechanosensitivity in muscles and nerves surrounding the ankle joint than healthy subjects. These findings indicate that low PPT values may be associated with symptoms that characterize this disease.
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Wang W, Liao D, Kang X, Zheng W, Xu W, Chen S, Xie Q. Development of a valid Chinese version of the Cumberland Ankle Instability Tool in Chinese-speaking patients with chronic ankle instability disorders. Sci Rep 2021; 11:9747. [PMID: 33963201 PMCID: PMC8105356 DOI: 10.1038/s41598-021-87848-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/05/2021] [Indexed: 11/29/2022] Open
Abstract
As an effective scale for the condition assessment of patients with chronic ankle instability (CAI), the Cumberland Ankle Instability Tool (CAIT) is the most widely used scale, and its original version is written in English. Therefore, the purpose of our study is to apply the CAIT to Chinese patients and evaluate its responsiveness, reliability, and validity in terms of Chinese patients with CAI. First, we adapted the CAIT into the Chinese edition (CAIT-C), through which cross-cultural adaptation and translation can be carried out in a five-step procedure. Next, recruited patients completed the three periods of the Foot and Ankle Ability Measure (FAAM), CAIT-C, and the Medical Outcomes Study Short-Form 36 (SF-36) scales. Afterward, to assess the responsiveness, reliability, and validity, we calculated the standardized response mean (SRM), effect size (ES), Spearman's correlation coefficient (rs), minimal detectable change (MDC), standard error of measurement (SEM), intraclass correlation coefficient (ICC), and Cronbach’s alpha. Generally, in the use of CAI, 131, 119, and 86 patients favorably completed the three periods of the scales. The CAIT-C was proven to have good test–retest reliability (ICC = 0.930) and fine internal consistency (Cronbach’s alpha = 0.845–0.878). The low-value of MDC (0.04–2.28) and SEM (1.73) show it is possible to detect clinical changes when we take advantage of CAIT-C. Good or moderate correlations (rs = 0.422–0.738) were gained from the physical subscales of the SF-36 and the subscales of the FAAM and the CAIT-C. Fair or poor correlations (rs = 0.003–0.360) were gained between the mental subscales of the SF-36 and the CAIT-C, which sufficiently indicated that the CAIT-C had good validity. Moreover, good responsiveness was observed in the CAIT-C (ES = 1.316, SRM = 1.418). The CAIT-C scale is an effective, valid, and reliable tool to evaluate Chinese CAI patients.
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Affiliation(s)
- Wei Wang
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China.
| | - Dongfa Liao
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China
| | - Xia Kang
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China
| | - Wei Zheng
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China.
| | - Wei Xu
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China
| | - Song Chen
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China
| | - Qingyun Xie
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu City, 610000, People's Republic of China.
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Izquierdo TG, León ESD, Martín RT, Armero J, Rivas-Calvo P, Pecos-Martín D, Achalandabaso-Ochoa A, Rodríguez-Fernández ÁL. Adaptation and transcultural translation into Spanish of the Identification of Functional Ankle Instability questionnaire. Musculoskelet Sci Pract 2021; 52:102339. [PMID: 33582620 DOI: 10.1016/j.msksp.2021.102339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Functional ankle instability can hinder the ability to work and perform leisure tasks. Some questionnaires have been used to identify subjects with ankle instability. The English version of the identification functional ankle instability (IdFAI) questionnaire has been broadly used, but there is not a cross-cultural adaptation into Spanish. OBJECTIVE The purpose of this study was to cross-culturally adapt the Identification of Functional Ankle Instability questionnaire to a Spanish speaking population from Spain. DESIGN Cross-sectional study. METHODS One hundred and four patients with history of lateral ankle sprain completed the Spanish version of this questionnaire and the Spanish version of the Cumberland Ankle Instability Tool. The psychometric properties were measured for structural validity, internal consistency, convergent validity, test-retest reliability, standard error of each measurement, ceiling effect and floor effect. RESULTS The Spanish version of the Identification of Functional Ankle Instability questionnaire had a strong correlation with the Cumberland Ankle Instability Tool (rho = -0.717) with excellent reliability (ICC = 0.9) and internal consistency (Cronbach's α = 0.9). No ceiling or floor effects were detected. CONCLUSION The results of the present study show that the Spanish version of the Identification of Functional Ankle Instability questionnaire is a valid and reliable measurement tool that can be use in a Spanish population from Spain with functional ankle instability for clinical and research purposes.
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Affiliation(s)
| | | | | | | | | | - Daniel Pecos-Martín
- Department of Physical Therapy and Nursing, Universidad de Alcalá de Henares, Spain
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Martin RL, Davenport TE, Fraser JJ, Sawdon-Bea J, Carcia CR, Carroll LA, Kivlan BR, Carreira D. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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López-González L, Falla D, Lázaro-Navas I, Lorenzo-Sánchez-Aguilera C, Rodríguez-Costa I, Pecos-Martín D, Gallego-Izquierdo T. Effects of Dry Needling on Neuromuscular Control of Ankle Stabilizer Muscles and Center of Pressure Displacement in Basketball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. Int J Environ Res Public Health 2021; 18:ijerph18042092. [PMID: 33669979 PMCID: PMC7924825 DOI: 10.3390/ijerph18042092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/26/2022]
Abstract
This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.
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Affiliation(s)
- Luis López-González
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
- Department of Physical Therapy, University Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham B15 2TT, UK;
| | - Irene Lázaro-Navas
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
- Department of Physical Therapy, University Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Cristina Lorenzo-Sánchez-Aguilera
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
| | - Isabel Rodríguez-Costa
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
| | - Daniel Pecos-Martín
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
- Correspondence: ; Tel.: +34-918-854-719
| | - Tomás Gallego-Izquierdo
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
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Cervera-Garvi P, Ortega-Avila AB, Marchena-Rodriguez A, Gijon-Nogueron G. Transcultural adaptation and validation of the Spanish version of the Identification of Functional Ankle Instability questionnaire (IdFAI-Sp). Disabil Rehabil 2020; 44:3221-3227. [PMID: 33296608 DOI: 10.1080/09638288.2020.1857446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The study aim was to cross-culturally adapt the Identification of Functional Ankle Instability (IdFAI) into a Spanish-language version (IdFAI-Sp), which would then be validated and its psychometric properties evaluated for use in possible cases of ankle instability. METHODS The cross-cultural adaptation was performed following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Pearson correlations were calculated to assess the convergent validity between IdFAI and the Cumberland Ankle Instability Tool. Cronbach's alpha and test re-test reliability values were calculated and floor/ceiling effects analysed. Construct validity was assessed by confirmatory factor analysis (CFA). RESULTS The study population was composed of 110 participants, with a mean age of 40.49 years (10.43) and of whom 62 (56.36%) were female. Good test-retest results were obtained, with an intraclass correlation coefficient of 0.85 (ICC2,1: 95% CI: 0.82 - 0.88). The structure matrix was examined by CFA, which revealed a three-factor solution that accounted for 79.89% of the variance. The IdFAI-Sp obtained an excellent fit (RMSEA 0.068, GFI 0.94, CFI 0.98 and NFI 0.97). CONCLUSIONS This study validates the IdFAI-Sp questionnaire, corroborating its value to researchers and medical professionals as a self-reported outcomes measure for use with a Spanish-speaking population.IMPLICATIONS FOR REHABILITATIONThe Spanish-language version of the Identification of Functional Ankle Instability questionnaire (IdFAI-Sp) is a valid and reliable tool.The IdFAI-Sp enables researchers and healthcare professionals to identify and classify chronic ankle instability among Spanish-speaking patients.Accordingly, it can be considered a useful clinical instrument.Aapplication of the questionnaire before and after treatment can reveal the patient's degree of recovery over time.
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Affiliation(s)
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, University of Malaga, Malaga, Spain.,Biomedical Research Institute (IBIMA), Malaga, Spain
| | | | - Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, University of Malaga, Malaga, Spain.,Biomedical Research Institute (IBIMA), Malaga, Spain
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Kadli S, Lekskulchai R, Jalayondeja C, Hiller CE. Cross-cultural adaptation of the Cumberland Ankle Instability Tool - Youth Thai version. Pediatr Int 2020; 62:1374-1380. [PMID: 32472723 DOI: 10.1111/ped.14320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study aimed to translate the original version of the Cumberland Ankle Instability Tool (CAITY) into a Thai version by using cross-cultural adaptation, and to examine the psychometric properties and cut-off score of the CAITY - Thai version (CAITY-T). METHODS Six cross-cultural adaptation steps were used to translate and validate the psychometric properties with 267 participants, 140 with chronic ankle instability (CAI) and 127 without CAI. Their mean age was 12.3 ± 2.42 years. Validation was carried out for internal consistency and concurrent validity against a visual analog scale for global perceived ankle instability, and for discriminant validity (receiver operating characteristic curve). The CAITY-T was completed twice by 133 volunteer children (49.62%) for test-retest reliability. The cut-off score was determined using Youden's index. RESULTS The CAITY was successfully adapted for the Thai language. Validation showed good internal consistency (Cronbach's α = 0.767) and concurrent validity (Pearson correlation coefficient = 0.8 right ankle and 0.784 left ankle). The test-retest reliability was substantial with an intraclass correlation coefficient (2,1) of 0.865 (95% Confidence Interval = 0.809-0.904). The receiver operating characteristic curve and Youden's index showed the cut-off score that discriminated between children with and without CAI on the CAITY-T at ≤25. The CAITY-T obtained 95.2% sensitivity, 97% specificity, 0.05 negative, and 32 positive likelihood ratios. CONCLUSION The CAITY-T was valid and available for Thai children aged 8-16 years. It displayed positive reliability, good validity, and an acceptable cut-off score. The cut-off score for children had high sensitivity, specificity, and positive and negative likelihood ratios.
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Affiliation(s)
- Supannikar Kadli
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | | | | | - Claire E Hiller
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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Lin CI, Mayer F, Wippert PM. Cross-cultural adaptation, reliability, and validation of the Taiwan-Chinese version of Cumberland Ankle Instability Tool. Disabil Rehabil 2020; 44:781-787. [PMID: 32539475 DOI: 10.1080/09638288.2020.1774928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Purpose: To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Taiwan-Chinese version (CAIT-TW), and to evaluate the validity, reliability and cutoff score of CAIT-TW for Taiwan-Chinese athletic population.Materials and methods: The English version of CAIT was translated to CAIT-TW based on a guideline of cross-cultural adaptation. 77 and 58 Taiwanese collegial athletes with and without chronic ankle instability filled out CAIT-TW, Taiwan-Chinese version of Lower Extremity Functional Score (LEFS-TW) and Numeric Rating Scale (NRS). The construct validity, test-retest reliability, internal consistency and cutoff score of CAIT-TW were evaluated.Results: In construct validity, the Spearman's correlation coefficients were moderate (CAIT-TW vs LEFS-TW: Rho = 0.39, p < 0.001) and strong (CAIT-TW vs NRS: Rho= 0.76, p < 0.001). The test retest reliability was excellent (ICC2.1 = 0.91, 95% confidential interval = 0.87-0.94, p < 0.001) with a good internal consistency (Cronbach's α: 0.87). Receiver operating characteristic curve showed a cutoff score of 21.5 (Youden index: 0.73, sensitivity: 0.87, specificity 0.85).Conclusions: The CAIT-TW is a valid and reliable tool to differentiate between stable and instable ankles in athletes and may further apply for research or daily practice in Taiwan.Implications for rehabilitationFor athletes, chronic ankle instability is prevalent and causes negative sequela, such as lowered quality of daily life, affected functional performance, and may cause post traumatic osteoarthritis.The psychometric properties of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool showed moderate to strong construct validity, excellent test retest reliability, a good internal consistency and a cutoff score of 21.5.The validity and reliability of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool are to enable clinicians to evaluate and manage ankle instability in Taiwanese who speaks Mandarin Chinese.
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Affiliation(s)
- Chiao-I Lin
- Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Frank Mayer
- University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Potsdam, Germany
| | - Pia-Maria Wippert
- Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
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Geerinck A, Beaudart C, Salvan Q, Van Beveren J, D'Hooghe P, Bruyère O, Kaux JF. French translation and validation of the Cumberland Ankle Instability Tool, an instrument for measuring functional ankle instability. Foot Ankle Surg 2020; 26:391-7. [PMID: 31118138 DOI: 10.1016/j.fas.2019.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ankle sprains are one of the most common musculoskeletal injuries, and can lead to chronic ankle instability (CAI). The Cumberland Ankle Instability Tool (CAIT) measures a subset of CAI, functional ankle instability (FAI). Because no French version existed, we set out to translate and validate the CAIT in French. METHODS The CAIT was translated using a forward-backward methodology. We examined its psychometric properties and calculated a cut-off score for FAI in a sample of 102 subjects (median age 22 years). RESULTS The CAIT was translated without significant problems. The CAIT-F can discriminate between those with and without FAI (p < 0.001), with a cut-off score of ≤ 23 points. The test-retest reliability is excellent (ICC = 0.960), as is the internal consistency (α = 0.885). Construct validity was confirmed. No floor or ceiling effects were detected among subjects with FAI. CONCLUSIONS The CAIT is now available in French, and is a valid and reliable instrument.
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Cruz-Díaz D, Kim KM, Hita-Contreras F, Bergamin M, Aibar-Almazán A, Martínez-Amat A. Effects of 12 Weeks of Tai Chi Intervention in Patients With Chronic Ankle Instability: A Randomized Controlled Trial. J Sport Rehabil 2020; 29:326-31. [PMID: 30747567 DOI: 10.1123/jsr.2018-0222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/11/2018] [Accepted: 01/08/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Tai Chi is a physical activity modality which is widely practiced over the world. The effectiveness of Tai Chi on postural control and balance has been described in older population, but until recently there are no studies that include patients with chronic ankle instability. OBJECTIVES The aim of this study was to evaluate the effectiveness of 12 weeks of Tai Chi intervention on dynamic balance and self-reported instability in patients with chronic ankle instability. STUDY DESIGN A randomized controlled trial was carried out. SETTING University physical therapy facility. PARTICIPANTS Fifty-two participants were allocated to an intervention group (n = 26) based on Tai Chi training or a control group (n = 26) who received no intervention. INTERVENTION The participants completed 12 weeks of Tai Chi intervention (1 h session/2 times per week) or no intervention in the control group. MAIN OUTCOME MEASURES Outcome measures included postural control and self-reported instability feeling assessed by the Star Excursion Balance Test and the Cumberland Ankle Instability Tool, respectively. RESULTS There was observed significant improvement in all Star Excursion Balance Test reach distances (anterior [F = 6.26, P < .01]; posteromedial [F = 9.58, P < .01], and posterolateral [F = 8.42, P < .01]) in the Tai Chi group with no change in the control group (P < .01). The intervention group demonstrated significant improvement on self-reported instability feeling assessed by the Cumberland Ankle Instability Tool questionnaire (F = 21.36, P < .01). CONCLUSION The obtained results suggested that 12 weeks of Tai Chi intervention have positive effects on postural control and self-reported instability feeling in patients with chronic ankle instability.
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Cruz-Díaz D, Hita-Contreras F, Martínez-Amat A, Aibar-Almazán A, Kim KM. Ankle-Joint Self-Mobilization and CrossFit Training in Patients With Chronic Ankle Instability: A Randomized Controlled Trial. J Athl Train 2020; 55:159-168. [PMID: 31935136 DOI: 10.4085/1062-6050-181-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Ankle-joint mobilization and neuromuscular and strength training have been deemed beneficial in the management of patients with chronic ankle instability (CAI). CrossFit training is a sport modality that involves these techniques. OBJECTIVE To determine and compare the influence of adding self-mobilization of the ankle joint to CrossFit training versus CrossFit alone or no intervention in patients with CAI. DESIGN Randomized controlled clinical trial. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Seventy recreational athletes with CAI were randomly allocated to either self-mobilization plus CrossFit training, CrossFit training alone, or a control group. INTERVENTION(S) Participants in the self-mobilization plus CrossFit group and the CrossFit training-alone group pursued a CrossFit training program twice a week for 12 weeks. The self-mobilization plus CrossFit group performed an ankle self-mobilization protocol before their CrossFit training, and the control group received no intervention. MAIN OUTCOME MEASURE(S) Ankle-dorsiflexion range of motion (DFROM), subjective feeling of instability, and dynamic postural control were assessed via the weight-bearing lunge test, Cumberland Ankle Instability Tool, and Star Excursion Balance Test (SEBT), respectively. RESULTS After 12 weeks of the intervention, both the self-mobilization plus CrossFit and CrossFit training-alone groups improved compared with the control group (P < .001). The self-mobilization plus CrossFit intervention was superior to the CrossFit training-alone intervention regarding ankle DFROM as well as the posterolateral- and posteromedial-reach distances of the SEBT but not for the anterior-reach distance of the SEBT or the Cumberland Ankle Instability Tool. CONCLUSIONS Ankle-joint self-mobilization and CrossFit training were effective in improving ankle DFROM, dynamic postural control and self-reported instability in patients with CAI.
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Affiliation(s)
- David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
| | - Agustin Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
| | - Kyung-Min Kim
- Department of Kinesiology and Sport Sciences, University of Miami, FL
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Li Y, Guan L, Ko J, Zhang S, Brown CN, Simpson KJ. Cross-cultural adaptation and validation of an ankle instability questionnaire for use in Chinese-speaking population. J Sport Health Sci 2019; 8:555-560. [PMID: 31720067 PMCID: PMC6834975 DOI: 10.1016/j.jshs.2017.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/10/2016] [Accepted: 02/20/2017] [Indexed: 05/11/2023]
Abstract
BACKGROUND The Identification of Functional Ankle Instability (IdFAI) is a valid and reliable tool to identify chronic ankle instability; however, it was developed in English, thus limiting its usage only to those who can read and write in English. The objectives of our study were to (1) cross-culturally adapt a Chinese (Mandarin) version of the IdFAI and (2) determine the psychometric properties of the Chinese version IdFAI. METHODS The cross-cultural adaptation procedures used by the investigators and translators followed previously published guidelines and included 6 stages: (1) initial translation, (2) synthesis of the translations, (3) back translation, (4) developing the pre-final version for field testing, (5) testing the pre-final version, and (6) finalizing the Chinese version of IdFAI (IdFAI-C). Five psychometric properties of the IdFAI-C were assessed from results of 2 participant groups: bilingual (n = 20) and Chinese (n = 625). RESULTS A high degree of agreement was found between the English version of IdFAI and IdFAI-C (intra-class correlation2,1 = 0.995). An excellent internal consistency (Cronbach's α = 0.89), test-retest reliability (intra-class correlation2,1 = 0.970), and construct validity (r(625) = 0.67) was also found for the IdFAI-C. In addition, the results of exploratory and confirmatory factor analysis indicated that ankle instability was the only construct measured from the IdFAI. CONCLUSION The IdFAI-C is a highly reliable and valid self-report questionnaire that can be used to assess ankle instability. Therefore, we suggest that it can be used to effectively and accurately assess chronic ankle instability in clinical settings for Chinese-speaking individuals.
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Affiliation(s)
- Yumeng Li
- Department of Kinesiology, California State University Chico, Chico, CA 95926, USA
- Corresponding author.
| | - Li Guan
- Department of Psychology, University of Georgia, Athens, GA 30605, USA
| | - Jupil Ko
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Shuqi Zhang
- Department of Kinesiology and Physical Education, Northern Illinois University, Dekalb, IL 60115, USA
| | - Cathleen N. Brown
- Department of Athletic Training and Kinesiology, Oregon State University, Corvallis, OR 97331, USA
| | - Kathy J. Simpson
- Department of Kinesiology, University of Georgia, Athens, GA 30605, USA
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Abstract
PURPOSE The Cumberland Ankle Instability Tool is a common patient reported outcome used to assess those with Chronic Ankle Instability. However, paper versions of the Cumberland Ankle Instability Tool have only been assessed for reliability purposes. The purpose of this study was to assess the agreement and reliability of a digital version of the Cumberland Ankle Instability Tool-Digital. MATERIALS AND METHODS Sixty-eight participants with a history of ankle sprain(s) were recruited to participate in this study. Participants completed a paper version of the Cumberland Ankle Instability Tool and a digital version then returned one week later and completed them again. Intraclass correlation coefficients (ICC) and Kappa coefficients were used to determine the agreement between the paper and digital versions as well as test-retest reliability between the two time periods. RESULTS The digital version showed excellent reliability (ICC = 0.93, 95% CI: 0.89-0.96) with the paper version. The test-retest reliability between testing sessions was considered good (ICC = 0.86, 95% CI: 0.77-0.92). A majority of individual items on the digital version demonstrated substantial agreement (κ = 0.60-0.81) with the paper version. CONCLUSIONS A digital version of the Cumberland Ankle Instability Tool demonstrated good to excellent psychometric properties. Clinicians who utilize a digital version as part of an electronic medical record system can utilize them confidently to accurately assess patients with Chronic Ankle Instability. Future studies may want to consider assessing a digital version with expanded clinical and research populations.Implications for rehabilitationThe digital version of the Cumberland Ankle Instability Tool demonstrated adequate psychometric properties.The digital version of the Cumberland Ankle Instability Tool can be considered a reliable instrument for the assessment of Chronic Ankle Instability.A digital version of the Cumberland Ankle Instability Tool can provide automated scoring and quick administration for clinicians in a rehabilitation setting.
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Affiliation(s)
- Adam B Rosen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Madison Johnston
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Sunghoon Chung
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Christopher J Burcal
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
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Navarro-Santana MJ, Albert-Lucena D, Gómez-Chiguano GF, Plaza-Manzano G, Fernández-de-Las-Peñas C, Cleland J, Pérez-Silvestre Á, Asín-Izquierdo I. Pressure pain sensitivity over nerve trunk areas and physical performance in amateur male soccer players with and without chronic ankle instability. Phys Ther Sport 2019; 40:91-98. [PMID: 31505432 DOI: 10.1016/j.ptsp.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Chronic ankle instability (CAI) is reported after ankle sprain. Our aim was to assess differences in mechanical pain sensitivity of lower extremity nerve trunks and physical performance between amateur soccer players with and without CAI. DESIGN A cross-sectional case-control study. SETTING Amateur soccer teams. PARTICIPANTS Fifty-five male soccer players, 28 with and 27 without CAI participated. MAIN OUTCOME MEASURES The perceived instability was assessed with the Cumberland Ankle Instability Tool (CAIT). Pressure pain thresholds (PPTs) on the common peroneal and tibialis nerve trunks, vertical jump, lateral step-down test and joint position sense of the knee were assessed by a blinded assessor. RESULTS Soccer players with CAI showed lower PPTs over the common peroneal nerve than those without CAI (between-groups mean difference: 1.0 ± 0.8 kg/cm2, P < 0.001). No differences for PPT over the tibialis posterior (P = 0.078) or any physical performance outcome (knee joint positioning sense [P = 0.798], lateral step-down test [P = 0.580] and vertical jump variables [all, P > 0.310]) were found. PPT over the common peroneal nerve exhibited a significant moderate correlation with the CAIT score (r = 0.528, P < 0.001). CONCLUSION Amateur soccer players with CAI have higher pressure pain sensitivity over the common peroneal nerve but exhibit similar physical performance to amateur soccer players without CAI.
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Affiliation(s)
- Marcos J Navarro-Santana
- Health and Rehabilitation Center San Fernando (Centro Médico Rehabilitación San Fernando), Madrid, Spain
| | | | | | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria Del Hospital Clínico San Carlos, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - Joshua Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, NH, USA; Rehabilitation Services, Concord Hospital, NH, USA; Manual Therapy Fellowship Program, Regis University, Denver, CO, USA
| | - Ángel Pérez-Silvestre
- Centre for Sports Medicine, Spanish Agency for Health Protection in Sports (AEPSAD in its Spanish acronym), Madrid, Spain
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Mirshahi M, Halabchi F, Golbakhsh M, Saadat S. Reliability and Recalibration of the Persian Version of Cumberland Ankle Instability Tool Cut-off Score in Athletes with Functional Ankle Instability. Adv J Emerg Med 2019; 3:e26. [PMID: 31410403 DOI: 10.22114/ajem.v0i0.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction The Cumberland Ankle Instability Tool (CAIT) is a valid instrument for determining the presence and severity of functional ankle instability. This questionnaire was recently cross-culturally adapted into Persian; however, the reliability of the Persian version has not been examined in athletes. CAIT has also been used with various independently-selected cut-off scores to determine instability. Objective The present study was conducted to evaluate the psychometric properties of the Persian version of CAIT and to determine its optimal cut-off score in athletic populations. Method One-hundred and sixteen athletes (volleyball, basketball and track and field players) over 18 years old both with and without ankle instability completed the Persian version of the CAIT. The internal consistency, test-retest reliability and discriminative ability of the tool were assessed. A receiver operating characteristic (ROC) curve was drawn to confirm the cut-off point of the Persian version of CAIT using the Youden index. Results The average CAIT score was 25.14±4.98 for the right and 25.76±4.94 for the left ankle. The Persian version of CAIT had a good internal consistency (Cronbach's α of 0.78 for the right ankle and 0.79 for the left ankle) and substantial reliability (ICC2, 1 = 0.88; 95% CI: 0.86 - 0.90) in athletes. No ceiling or floor effects were observed. The optimal cut-off score for discriminating between athletes with and without FAI was 24. Conclusion The Persian version of CAIT was shown to be a reliable tool for assessing functional ankle instability among Iranian athletes.
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Tsekoura M, Billis E, Fousekis K, Christakou A, Tsepis E. Cross cultural adaptation, reliability, and validity of the Greek version of the Cumberland Ankle Instability Tool. Physiother Theory Pract 2019; 37:954-962. [PMID: 31387438 DOI: 10.1080/09593985.2019.1652944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: This study's objective was to translate and cross-culturally adapt the Cumberland Ankle Instability Tool (CAIT) into the Greek language and to evaluate its psychometric properties.Methods: CAIT was translated and adapted into Greek according to official cross-cultural adaptation guidelines of self-reported measures. The Greek version of the CAIT (CAIT-GR) was tested for reliability (internal consistency, test-retest reliability), validity (discriminative and convergent validity) and floor-ceiling effects. Additionally, a cut-off value discriminating between stable and unstable ankles across healthy participants and participants with ankle complaints was calculated. A convenience sample of 123 Greek individuals was recruited, 43 of which had a history of at least one ankle sprain. All participants completed the final version of the CAIT-GR twice within 7-10 days. Participants with a history of ankle sprain also completed the Greek version of the Lower Extremity Functional Scale (LEFS) and the Visual Analogue Scale (VAS).Results: CAIT-GR mean scores were 26.9 ± 3.16 for participants without a history of ankle sprain and 20.6 ± 4.62 for the instability group. The cut-off value was at 24.5 points of the total CAIT score (range 0-30). CAIT-GR had a moderate correlation with VAS (0.54) and a high correlation with LEFS (0.735). Results indicated good discriminative validity, high internal consistency (Cronbach's alpha of 0.97) and excellent test-retest reliability (ICC2,1 = 0.97, 95%CI = 0.97-0.98). Neither a floor nor a ceiling effect was observed.Conclusions: The CAIT-GR questionnaire was found to be a reliable and valid measure for chronic ankle instability. It is therefore, available for use in future clinical research and practice.
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Affiliation(s)
- Maria Tsekoura
- Physiotherapy Department, School of Health and Caring Professions, Technological Educational Institute (TEI) of Western Greece, Aigio, Greece
| | - Evdokia Billis
- Physiotherapy Department, School of Health and Caring Professions, Technological Educational Institute (TEI) of Western Greece, Aigio, Greece
| | - Konstantinos Fousekis
- Physiotherapy Department, School of Health and Caring Professions, Technological Educational Institute (TEI) of Western Greece, Aigio, Greece
| | - Anna Christakou
- Physiotherapy Department, General Hospital 'Evaggelismos', Athens, Greece.,Physiotherapy Department, University of Western Attica, Aigaleo, Greece
| | - Elias Tsepis
- Physiotherapy Department, School of Health and Caring Professions, Technological Educational Institute (TEI) of Western Greece, Aigio, Greece
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Korakakis V, Abassi M, Kotsifak A, Manai H, AbuEsba A. Cross-cultural adaptation and psychometric properties' evaluation of the modern standard Arabic version of Cumberland Ankle Instability Tool (CAIT) in professional athletes. PLoS One 2019; 14:e0217987. [PMID: 31185034 PMCID: PMC6559661 DOI: 10.1371/journal.pone.0217987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/22/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To cross-culturally adapt the Cumberland Ankle Instability Tool into modern standard Arabic and to assess its psychometric properties. Method Cross-cultural adaptation followed a combination of guidelines and for psychometric evaluation a sample of 107 athletes as recruited. All recommended measurement properties by the Consensus-based Standards for the selection of health status Measurement Instruments were evaluated, including face, structural, convergent, and discriminant validity; reproducibility; distribution-based responsiveness, and interpretability. We also used a structured content analytic method to evaluate content validity. Results The tool presented excellent internal consistency (α = 0.92) and reliability (ICC 0.75–0.98), and good convergent validity compared with Lower Extremity Functional Scale (ρ = 0.67). For reproducibility testing: Minimal detectable change ranged from 0.41 to 6.0 points; for responsiveness assessment: the effect sizes were large (Glass’Δ range 2.03–2.08, Cohen’s d range 2.22 to 2.53) and the Area under the Curve was 0.869. Its unidimensionality was proved by a 1-factor solution explaining 63.8% of the variance. Conclusion The Arabic version of Cumberland Ankle Instability Tool presented acceptable psychometric properties comparable to the original version. The questionnaire is understood across most of the Arabic speaking world and can be used in research and clinical practice to assess patients suffering from chronic ankle instability.
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Affiliation(s)
| | - Mohsen Abassi
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Argyro Kotsifak
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Hassine Manai
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Anas AbuEsba
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Shin HJ, Kim SH, Jeon ET, Lee MG, Lee SJ, Cho HY. Effects of therapeutic exercise on sea sand on pain, fatigue, and balance in patients with chronic ankle instability: a feasibility study. J Sports Med Phys Fitness 2019; 59:1200-1205. [PMID: 30758170 DOI: 10.23736/s0022-4707.19.09405-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Chronic ankle instability (CAI) is a common disease following ankle sprain and appears balance and gait problems, pain, and fatigue. This study aimed to examine the effect of therapeutic exercise performed on sea sand on pain, fatigue, and balance ability in patients with CAI. METHODS This study was designed as a randomized controlled trial. Subjects with a Cumberland Ankle Instability Tool (CAIT) score of less than 27 were selected. 22 subjects were randomly assigned to the sea sand (SS) group (N.=11) or the self-management (SM) group (N.=11). The SS group performed the therapeutic exercise on sea sand and the SM group conducted the exercises on a firm surface at home 5 times over the course of a week. To measure static balance, center of pressure (COP) of one-leg standing on the force plate was assessed. Visual Analog Scale (VAS) was used to measure pain and fatigue. RESULTS The SS group showed statistically significant improvements in all static balance outcomes (COP-area, COP-average velocity, minor-axis, major-axis) after the intervention (P<0.05), while the SM group did not show a significant change in all static balance parameters (P>0.05). Also, the SS group showed statistically significant improvements in pain and fatigue (P<0.05). All outcomes except major axis showed statistically significant differences between SS group and SM group at change value (P<0.05). CONCLUSIONS Therapeutic exercise on sea sand effectively improved balance and decreased pain and fatigue. Thus, it can be considered a rehabilitation method for CAI patients.
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Affiliation(s)
- Ho-Jin Shin
- Department of Health Science, Gachon University Graduate School, Incheon, South Korea
| | - Sung-Hyeon Kim
- Department of Health Science, Gachon University Graduate School, Incheon, South Korea
| | - Eun-Tae Jeon
- Department of Health Science, Gachon University Graduate School, Incheon, South Korea
| | - Min-Goo Lee
- Department of Physiology, Korea University College of Medicine, Seoul, South Korea
| | - Sung-Jae Lee
- Department of Integrative Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, Gachon University, Incheon, South Korea -
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Sierra-Guzmán R, Jiménez-Diaz F, Ramírez C, Esteban P, Abián-Vicén J. Whole-Body-Vibration Training and Balance in Recreational Athletes With Chronic Ankle Instability. J Athl Train 2018; 53:355-363. [PMID: 29569943 DOI: 10.4085/1062-6050-547-16] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Deficits in the propioceptive system of the ankle contribute to chronic ankle instability (CAI). Recently, whole-body-vibration (WBV) training has been introduced as a preventive and rehabilitative tool. OBJECTIVE To evaluate how a 6-week WBV training program on an unstable surface affected balance and body composition in recreational athletes with CAI. DESIGN Randomized controlled clinical trial. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Fifty recreational athletes with self-reported CAI were randomly assigned to a vibration (VIB), nonvibration (NVIB), or control group. INTERVENTION(S) The VIB and NVIB groups performed unilateral balance training on a BOSU 3 times weekly for 6 weeks. The VIB group trained on a vibration platform, and the NVIB group trained on the floor. MAIN OUTCOME MEASURE(S) We assessed balance using the Biodex Balance System and the Star Excursion Balance Test (SEBT). Body composition was measured by dual-energy x-ray absorptiometry. RESULTS After 6 weeks of training, improvements on the Biodex Balance System occurred only on the Overall Stability Index ( P = .01) and Anterior-Posterior Stability Index ( P = .03) in the VIB group. We observed better performance in the medial ( P = .008) and posterolateral ( P = .04) directions and composite score of the SEBT in the VIB group ( P = .01) and in the medial ( P < .001), posteromedial ( P = .002), and posterolateral ( P = .03) directions and composite score of the SEBT in the NVIB group ( P < .001). No changes in body composition were found for any of the groups. CONCLUSIONS Only the VIB group showed improvements on the Biodex Balance System, whereas the VIB and NVIB groups displayed better performance on the SEBT.
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Affiliation(s)
- Rafael Sierra-Guzmán
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Fernando Jiménez-Diaz
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Carlos Ramírez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Paula Esteban
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
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Vuurberg G, Kluit L, van Dijk CN. The Cumberland Ankle Instability Tool (CAIT) in the Dutch population with and without complaints of ankle instability. Knee Surg Sports Traumatol Arthrosc 2018; 26:882-891. [PMID: 27714439 PMCID: PMC5847203 DOI: 10.1007/s00167-016-4350-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/28/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE To develop a translated Dutch version of the Cumberland Ankle Instability Tool (CAIT) and test its psychometric properties in a Dutch population with foot and ankle complaints. METHODS The CAIT was translated into the Dutch language using a forward-backward translation design. Of the 130 subsequent patients visiting the outpatient clinic for foot and ankle complaints who were asked to fill out a questionnaire containing the CAIT, the Foot and Ankle Outcome Score (FAOS), and the numeric rating scale (NRS) pain, 98 completed the questionnaire. After a 1-week period, patients were asked to fill out a second questionnaire online containing the CAIT and NRS pain. This second questionnaire was completed by 70 patients. With these data, the construct validity, test-retest reliability, internal consistency, measurement error, and ceiling and floor effects were assessed. Additionally, a cut-off value to discriminate between stable and unstable ankles, in patients with ankle complaints, was calculated. RESULTS Construct validity showed moderate correlations between the CAIT and FAOS subscales (Spearman's correlation coefficient (SCC) = 0.36-0.43), and the NRS pain (SCC = -0.55). The cut-off value was found at 11.5 points of the total CAIT score (range 0-30). Test-retest reliability showed to be excellent with an intraclass correlation coefficient of 0.94. Internal consistency was high (Cronbach's α = 0.86). No ceiling or floor effects were detected. CONCLUSION Based on the results, the Dutch version of the CAIT is a valid and reliable questionnaire to assess ankle instability in the Dutch population and is able to differentiate between a functionally unstable and stable ankle. The tool is the first suitable tool to objectify the severity of ankle instability specific complaints and assess change in the Dutch population. Level of evidence II.
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Affiliation(s)
- Gwendolyn Vuurberg
- Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Lana Kluit
- Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - C. Niek van Dijk
- Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands
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Ko J, Rosen AB, Brown CN. Cross-cultural adaptation, reliability, and validation of the Korean version of the identification functional ankle instability (IdFAI). Disabil Rehabil 2017; 40:3185-3190. [DOI: 10.1080/09638288.2017.1375032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Jupil Ko
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, AZ, USA
| | - Adam B. Rosen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Cathleen N. Brown
- College of Public Health and Human Science, Oregon State University, Corvallis, OR, USA
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Jia Y, Huang H, Gagnier JJ. A systematic review of measurement properties of patient-reported outcome measures for use in patients with foot or ankle diseases. Qual Life Res 2017; 26:1969-2010. [DOI: 10.1007/s11136-017-1542-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 12/20/2022]
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Baldwin JN, Mckay MJ, Hiller CE, Nightingale EJ, Moloney N, Burns J, Baldwin J, Mckay M, Chard A, Ferreira P, Yan AF, Hawke F, Hiller C, Lee (née Zheng) F, Mackey M, Mousavi S, Nicholson L, Nightingale E, Pourkazemi F, Raymond J, Rose K, Simic M, Sman A, Wegener C, Refshauge KM, Burns J, Moloney N, Hübscher M, Vanicek N, Quinlan K, North K. Correlates of Perceived Ankle Instability in Healthy Individuals Aged 8 to 101 Years. Arch Phys Med Rehabil 2017; 98:72-9. [DOI: 10.1016/j.apmr.2016.08.474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/02/2016] [Accepted: 08/26/2016] [Indexed: 12/26/2022]
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Plaza-Manzano G, Vergara-Vila M, Val-Otero S, Rivera-Prieto C, Pecos-Martin D, Gallego-Izquierdo T, Ferragut-Garcías A, Romero-Franco N. Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial. ACTA ACUST UNITED AC 2016; 26:141-149. [PMID: 27598553 DOI: 10.1016/j.math.2016.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/06/2016] [Accepted: 08/22/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recurrent ankle sprains often involve residual symptoms for which subjects often perform proprioceptive or/and strengthening exercises. However, the effectiveness of mobilization to influence important nerve structures due to its anatomical distribution like tibial and peroneal nerves is unclear. OBJETIVES To analyze the effects of proprioceptive/strengthening exercises versus the same exercises and manual therapy including mobilizations to influence joint and nerve structures in the management of recurrent ankle sprains. STUDY DESIGN A randomized single-blind controlled clinical trial. METHOD Fifty-six patients with recurrent ankle sprains and regular sports practice were randomly assigned to experimental or control group. The control group performed 4 weeks of proprioceptive/strengthening exercises; the experimental group performed 4 weeks of the same exercises combined with manual therapy (mobilizations to influence joint and nerve structures). Pain, self-reported functional ankle instability, pressure pain threshold (PPT), ankle muscle strength, and active range of motion (ROM) were evaluated in the ankle joint before, just after and one month after the interventions. RESULTS The within-group differences revealed improvements in all of the variables in both groups throughout the time. Between-group differences revealed that the experimental group exhibited lower pain levels and self-reported functional ankle instability and higher PPT, ankle muscle strength and ROM values compared to the control group immediately after the interventions and one month later. CONCLUSIONS A protocol involving proprioceptive and strengthening exercises and manual therapy (mobilizations to influence joint and nerve structures) resulted in greater improvements in pain, self-reported functional joint stability, strength and ROM compared to exercises alone.
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Affiliation(s)
- Gustavo Plaza-Manzano
- Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Spain.
| | - Marta Vergara-Vila
- Community Health Centre Maria Wolff, Madrid, Spain; Physiotherapy Department, University of Alcalá, E-28871, Madrid, Spain.
| | - Sandra Val-Otero
- Physiotherapy Department, University of Alcalá, E-28871, Madrid, Spain.
| | | | | | | | | | - Natalia Romero-Franco
- Physiotherapy and Nursery Department, University of the Balearic Islands, E-07122, Mallorca, Spain.
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Hadadi M, Ebrahimi Takamjani I, Ebrahim Mosavi M, Aminian G, Fardipour S, Abbasi F. Cross-cultural adaptation, reliability, and validity of the Persian version of the Cumberland Ankle Instability Tool. Disabil Rehabil 2016; 39:1644-1649. [DOI: 10.1080/09638288.2016.1207105] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mohammad Hadadi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ismail Ebrahimi Takamjani
- Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Mosavi
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Gholamreza Aminian
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shima Fardipour
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Faeze Abbasi
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kunugi S, Masunari A, Noh B, Mori T, Yoshida N, Miyakawa S. Cross-cultural adaptation, reliability, and validity of the Japanese version of the Cumberland ankle instability tool. Disabil Rehabil 2016; 39:50-58. [DOI: 10.3109/09638288.2016.1138555] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Shun Kunugi
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Akihiko Masunari
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Byungjoo Noh
- Department of Kinesiology and Integrative Physiology, Michigan Technology University, Michigan, USA
| | - Toshio Mori
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Naruto Yoshida
- Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
| | - Shumpei Miyakawa
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
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Salom-Moreno J, Ayuso-Casado B, Tamaral-Costa B, Sánchez-Milá Z, Fernández-de-Las-Peñas C, Alburquerque-Sendín F. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial. Evid Based Complement Alternat Med 2015; 2015:790209. [PMID: 26064172 DOI: 10.1155/2015/790209] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 01/31/2023]
Abstract
Objective. To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33 ± 3 years) individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM) and ankle pain intensity assessed with a numerical pain rate scale (NPRS). They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F = 8.211; P = 0.008; SPORTS: F = 13.943; P < 0.001) and for pain (F = 44.420; P < 0.001): patients receiving TrP-DN plus proprioceptive/strengthening exercises experienced greater improvements in function and pain than those receiving the exercise program alone. Between-groups effect sizes were large in all outcomes (SMD > 2.1) in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability.
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Rodríguez-Fernández ÁL, Rebollo-Roldán J, Jiménez-Rejano JJ, Güeita-Rodríguez J. Psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool. Disabil Rehabil 2014; 37:1888-94. [DOI: 10.3109/09638288.2014.984879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cruz-Díaz D, Lomas Vega R, Osuna-Pérez MC, Hita-Contreras F, Martínez-Amat A. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disabil Rehabil 2014; 37:601-10. [PMID: 24989067 DOI: 10.3109/09638288.2014.935877] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the effects of joint mobilization, in which movement is applied to the ankle's dorsiflexion range of motion, on dynamic postural control and on the self-reported instability of patients with chronic ankle instability (CAI). METHODS A double-blind, placebo-controlled, randomized trial with repeated measures and a follow-up period. Ninety patients with a history of recurrent ankle sprain, self-reported instability, and a limited dorsiflexion range of motion, were randomly assigned to either the intervention group (Joint Mobilizations, 3 weeks, two sessions per week) the placebo group (Sham Mobilizations, same duration as joint mobilization) or the control group, with a 6 months follow-up. Dorsiflexion Range of Motion (DFROM), Star Excursion Balance Test (SEBT) and CAI Tool (CAIT) were outcome measures. A separate 3 × 4 mixed model analysis of variance was performed to examine the effect of treatment conditions and time, and intention-to-treat (ITT) analysis was applied to evaluate the effect of the independent variable. RESULTS The application of joint mobilization resulted in better scores of DFROM, CAIT, and SEBTs in the intervention group when compared with the placebo or the control groups (p < 0.001). The effect sizes of group-by-time interaction, measured with eta-squared, oscillated between 0.954 for DFROM and 0.288 for SEBT posteromedial distance. In within-group analysis, the manipulation group showed an improvement at 6 months follow-up in CAIT [mean = 5.23, CI 95% (4.63-5.84)], DFROM [mean = 6.77, CI 95% (6.45-7.08)], anterior SEBT [mean = 7.35, CI 95% (6.59-8.12)], posteromedial SEBT [mean = 3.32, CI 95% (0.95-5.69)], and posterolateral SEBT [mean = 2.55, CI 95% (2.20-2.89)]. CONCLUSION Joint mobilization techniques applied to subjects suffering from CAI were able to improve ankle DFROM, postural control, and self-reported instability. These results suggest that joint mobilization could be applied to patients with recurrent ankle sprain to help restore their functional stability. Implications for Rehabilitation Functional instability is a very common sequela in patients with CAI, resulting in reduced quality of living due to the limitations it imposes on daily life activities. The mobilization with movement technique presented by Mulligan, and based on the joint mobilization accompanied by active movement, appears as a valuable tool to be employed by physical therapists to restore ankle function after a recurrent ankle sprain history. ROM restriction, subjective feeling of instability and dynamic postural control are benefiting from the joint mobilization application.
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Affiliation(s)
- David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén , Jaén , Spain and
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Wright CJ, Arnold BL, Ross SE, Linens SW. Recalibration and validation of the Cumberland Ankle Instability Tool cutoff score for individuals with chronic ankle instability. Arch Phys Med Rehabil 2014; 95:1853-9. [PMID: 24814563 DOI: 10.1016/j.apmr.2014.04.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To independently recalibrate and revalidate the Cumberland Ankle Instability Tool (CAIT) cutoff score for discriminating individuals with and without chronic ankle instability (CAI). There are concerns the original cutoff score (≤27) may be suboptimal for use in the CAI population. DESIGN Case control. SETTING Research laboratory. PARTICIPANTS Two independent datasets were used (total N=200). Dataset 1 included 61 individuals with a history of ≥1 ankle sprain and ≥2 episodes of giving way in the last year (CAI group) and 57 participants with no history of ankle sprain or instability in their lifetime (uninjured group). Dataset 2 included 27 uninjured participants, 29 participants with CAI, and 26 individuals with a history of a single ankle sprain and no subsequent instability (copers). INTERVENTIONS All participants completed the CAIT during a single session. In dataset 1, a receiver operating characteristic (ROC) curve was calculated using the CAIT score and group membership as test variables. The ideal cutoff score was identified using the Youden index. The recalibrated cutoff score was validated in dataset 2 using the ROC analysis and clinimetric characteristics. MAIN OUTCOME MEASURES CAIT cutoff score and clinimetrics. RESULTS In dataset 1, the optimal cutoff score was ≤25, which is lower than previously reported. In dataset 2, the recalibrated cutoff score demonstrated a sensitivity of 96.6%, specificity of 86.8%, positive likelihood ratio of 7.318, and negative likelihood ratio of .039. There were 7 false positives and 1 false negative. CONCLUSIONS The recalibrated CAIT score demonstrated very good clinimetric properties; all properties improved compared with the original cutoff score. Clinicians using the CAIT should use the recalibrated cutoff score to maximize test characteristics. Caution should be taken with copers, who had a high rate of false positives.
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Affiliation(s)
- Cynthia J Wright
- Department of Health and Human Performance, Virginia Commonwealth University, Richmond, VA.
| | - Brent L Arnold
- Department of Health and Human Performance, Virginia Commonwealth University, Richmond, VA
| | - Scott E Ross
- Department of Health and Human Performance, Virginia Commonwealth University, Richmond, VA
| | - Shelley W Linens
- Department of Health and Human Performance, Virginia Commonwealth University, Richmond, VA
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Cruz-Díaz D, Lomas-Vega R, Osuna-Pérez MC, Hita-Contreras F, Fernández ÁD, Martínez-Amat A. The Spanish lower extremity functional scale: A reliable, valid and responsive questionnaire to assess musculoskeletal disorders in the lower extremity. Disabil Rehabil 2014; 36:2005-11. [DOI: 10.3109/09638288.2014.890673] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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