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Jayalath L, Senanayake K, Deeghanu M, Pathirana C. Cross-cultural adaptation, reliability, and validity of the Sinhala version of the Cumberland Ankle Instability Tool: an instrument for measuring chronic ankle instability in Sri Lanka. Disabil Rehabil 2024; 46:4807-4812. [PMID: 38062669 DOI: 10.1080/09638288.2023.2288938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 11/12/2023] [Accepted: 11/23/2023] [Indexed: 09/26/2024]
Abstract
PURPOSE To develop the Sinhala version of the Cumberland Ankle Instability Tool (CAIT-Sin) and evaluate its validity and reliability in native Sinhala speakers. METHODS The CAIT was translated and cross-culturally adapted into Sinhala, using a forward-backward translation method. CAIT-Sin, Karlsson score, and visual analog scale (VAS) were filled out by 156 university athletes and students with and without ankle instabilities, in order to test internal consistency, test-retest reliability, criterion validity, floor and ceiling effect, and discriminative ability of the CAIT-Sin. Furthermore, ROC analysis was used to identify the presence of chronic ankle instability (CAI). RESULTS The CAIT-Sin was with a high internal consistency (Cronbach's alpha = 0.88) and excellent test-retest reliability (ICC2,1 = 0.95, 95% CI: 0.93-0.96). The CAIT-Sin exhibited strong and positive correlations with the Karlsson score (r = 0.832, p < 0.001) and VAS (r = 0.876, p < 0.001). No ceiling or floor effect was observed in individuals with CAI. A CAIT-Sin score of 26 or lower indicated the presence of CAI. CONCLUSIONS The clinicians and researchers in Sri Lanka can use the CAIT-Sin for assessing and measuring CAI because its validity and reliability are confirmed.Implications for RehabilitationFunctional ankle instability is an ongoing chronic condition which presents for rehabilitation therapist.Outcome measurements are crucial in the rehabilitation of ankle sprains and it is important to administer these subjective outcome measures in their native language.The CAIT-Sin was found to have high internal consistency and excellent test-retest reliability.
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Affiliation(s)
- Lakshmi Jayalath
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Kaveera Senanayake
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Menuja Deeghanu
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Alexandre É, Monteiro D, SottoMayor R, Jacinto M, Silva FM, Cid L, Duarte-Mendes P. Assessing Functional Ankle Instability in Sport: A Critical Review and Bibliometric Analysis. Healthcare (Basel) 2024; 12:1733. [PMID: 39273757 PMCID: PMC11395028 DOI: 10.3390/healthcare12171733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/23/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
Functional Ankle Instability (FAI) is the subject of extensive research in sports and other environments. Given the importance of accurately measuring this latent construct, it is imperative to carry out a careful assessment of the available tools. In this context, the aim of this review was to take an in-depth look at the six most cited measurement tools to assess FAI, with a specific focus on patient-reported outcome measures related to ankle and foot. Four electronic databases (Web of Science, Scopus, Pubmed, and SportDiscus) were searched (up to November 2022) to identify the six most cited questionnaires for assessing FAI. Our analysis showed that the most cited questionnaires are the following: the Lower Extremity Functional Scale (LEFS), the Foot Function Index (FFI), the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the Olerud and Molander Ankle Score (OMAS), and the Cumberland Ankle Instability Tool (CAIT). Each questionnaire was thoroughly assessed and discussed in three sections: Development, Reliability, and Summaries. In addition, bibliometric data were calculated to analyze the relevance of each questionnaire. Despite variations in terms of validity and reliability, conceptualization, structure, and usefulness, the six questionnaires proved to be robust from a psychometric point of view, being widely supported in the literature. The bibliometric analyses suggested that the FAOS ranks first and the FFI ranks sixth in the weighted average of the impact factors of their original publications.
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Affiliation(s)
| | - Diogo Monteiro
- ESECS-Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Research Center in Sport, Health, and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | | | - Miguel Jacinto
- ESECS-Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Research Center in Sport, Health, and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Fernanda M Silva
- Research Unit for Sport and Physical Activity (CIDAF), Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal
| | - Luis Cid
- Research Center in Sport, Health, and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2001-904 Santarém, Portugal
| | - Pedro Duarte-Mendes
- Department of Sports and Well-Being, Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal
- Sport Physical Activity and Health Research & Innovation Center, SPRINT, 2040-413 Santarém, Portugal
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Suphasubtrakul T, Lekskulchai R, Jalayondeja C. Balance, strength and physical activity after ankle sprain: Comparison between children with chronic ankle instability and copers. Phys Ther Sport 2024; 65:49-53. [PMID: 38011816 DOI: 10.1016/j.ptsp.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE The aim of this study was to compare muscle strength, balance, and physical activity between children with chronic ankle instability and copers. DESIGN Cross-sectional study. SETTING Pediatric Physical Therapy laboratory. PARTICIPANTS Children aged between 7 and 12 years old from regular schools who had a history of unilateral ankle sprain. MAIN OUTCOME MEASURES Lower extremity strength, Static and dynamic standing balance, and Level of physical activity. RESULTS Fifteen children with chronic ankle instability and 15 copers were recruited. Demographic data showed no differences between group except for sex and the Cumberland Ankle Instability Tool-Youth (CAITY) score. Children with CAI had a significantly lower score during the standing long jump test (p < 0.05), poorer performance of single leg stance test (p < 0.001) and Y-Balance test in the anterior, posteromedial, and posterolateral directions (p < 0.05) when compared to copers. Total METs per week was significantly higher in the copers (p < 0.05). CONCLUSION Children with chronic ankle instability exhibited weaker lower limb strength, poorer static and dynamic standing balance, and participate in less physical activity compared to those in a coper group which may have future negative health consequences. Knowledge about the differences between the two groups may provide guidance for physical educators and physical therapists. (200 words).
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Affiliation(s)
- Thitirat Suphasubtrakul
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
| | - Raweewan Lekskulchai
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
| | - Chutima Jalayondeja
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
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Chuadthong J, Lekskulchai R, Hiller C, Ajjimaporn A. A Home-Based Exercise Program With Active Video Games for Balance, Motor Proficiency, Foot and Ankle Ability, and Intrinsic Motivation in Children With Chronic Ankle Instability: Feasibility Randomized Controlled Trial. JMIR Serious Games 2023; 11:e51073. [PMID: 38235982 PMCID: PMC10811453 DOI: 10.2196/51073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 01/19/2024] Open
Abstract
Background Children with chronic ankle instability (CAI) frequently experience ankle unsteadiness, causing trips, falls, and ankle sprain injuries resulting in poor quality of life. A specific exercise program focused on physical and psychological purposes in children with CAI is needed. Objective The purpose of this study was to investigate the feasibility of a 4-week home-based exercise training program using active video games (AVGs) for balance, motor proficiency, foot and ankle ability, and intrinsic motivation in children with CAI. Methods Sixty children with CAI (mean age 10, SD 2 years) were randomly assigned to an experimental group (AVG group; n=30) or a control group (CG; n=30). The AVG group played 2 selected video games, Catching Fish and Russian Block, while the CG received the traditional exercise program for CAI. Both programs were scheduled for 30 minutes per day, 3 times per week, for 4 weeks at home. The single-leg stance test was used to assess static balance. The walking forward on a line and standing long jump tests were used to assess motor proficiency. The Foot and Ankle Ability Measure (FAAM) and the Intrinsic Motivation Inventory questionnaire were used to assess foot and ankle ability and intrinsic motivation, respectively. Assessments were conducted at baseline and after 4 weeks. Results In the AVG group, the single-leg stand test (eyes open; on floor and on foam conditions), the FAAM (activities of daily living subscale), and intrinsic motivation (interest/enjoyment, pressure/tension, and value/usefulness dimensions) were improved compared with the CG (all P<.05). Motor proficiency did not differ between the 2 groups at the end of the 4-week program (P=.31 for the walking forward on a line, P=.34 for the standing long jump test). Conclusions A 4-week home-based exercise training program using AVGs can be beneficial and may be an effective approach for improving balance, foot and ankle ability, and enhancing positive motivation by increasing the interest/enjoyment and value/usefulness dimensions and lowering the pressure/tension dimension in children with CAI that require long-term rehabilitation sessions.
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Affiliation(s)
- Janya Chuadthong
- Faculty of Physical Therapy, Mahidol University, Nakon Pathom, Thailand
| | | | - Claire Hiller
- Faculty of Medicine and Health, The University of Sydney, SydneyNew South Wales, Australia
| | - Amornpan Ajjimaporn
- College of Sports Science and Technology, Mahidol University, Salaya, Nakon Pathom, Thailand
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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] [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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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] [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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