Postural stabilization after single-leg vertical jump in individuals with chronic ankle instability

ObjectivesTo investigate the impact different ways to define reference balance can have when analysing time to stabilization (TTS). Secondarily, to investigate the difference in TTS between people with chronic ankle instability (CAI) and healthy controls.DesignCross-sectional study.SettingLaboratory.ParticipantsFifty recreational athletes (25 CAI, 25 controls).Main outcome measuresTTS of the center of pressure (CoP) after maximal single-leg vertical jump using as reference method the single-leg stance, pre-jump period, and post-jump period; and the CoP variability during the reference methods.ResultsThe post-jump reference period had lower values for TTS in the anterior-posterior (AP) direction when compared to single-leg stance (P = 0.001) and to pre-jump (P = 0.002). For TTS in the medio-lateral (ML) direction, the post-jump reference period showed lower TTS when compared to single-leg stance (P = 0.01). We found no difference between CAI and control group for TTS for any direction. The CAI group showed more CoP variability than control group in the single-leg stance reference period for both directions.ConclusionsDifferent reference periods will produce different results for TTS. There is no difference in TTS after a maximum vertical jump between groups. People with CAI have more CoP variability in both directions during single-leg stance.     

Chronic ankle instability affects learning rate during repeated proprioception testing

Objectives1. To determine whether individuals with chronic ankle instability (CAI) have lower proprioception sensitivity scores from a test on the Active Movement Extent Discrimination Apparatus (AMEDA). 2. To determine whether individuals with CAI can improve proprioception sensitivity scores with repeated active movement testing using the AMEDA. 3. To assess the test-retest reliability of the AMEDA.DesignA cohort study comparing those with CAI or healthy ankles.SettingUniversity clinical laboratory.Participants61 healthy university students, 36 with CAI, 25 with stable ankles.Main outcome measuresA 2-way ANOVA was conducted to compare performance of CAI and stable ankle groups, over 3 test repetitions on the AMEDA. The reliability intra-class correlation coefficient (ICC) was obtained for test repetitions.ResultsThe scores improved in both groups when the AMEDA test was repeated (p = <0.001). The rates of improvement in proprioception test scores differed, with the CAI group showing a slower learning rate than the stable ankle group (p = 0.047). The ICC for the whole group across the three trials was 0.80 (95% CI = 0.69 to 0.87, p = <0.001).ConclusionsCAI participants improve their proprioception scores more slowly upon repeated AMEDA testing, suggesting differences in learning strategies.     

Differences in postural control between healthy and subjects with chronic ankle instability

IntroductionChronic ankle instability (CAI) is characterized by the occurrence of repetitive inversion mechanism of the ankle, resulting in numerous ankle sprains. CAI occurs in approximately 70% of patients with a history of a lateral ankle sprain. Many causes of functional ankle instability have been postulated and include deficits in proprioception, impaired neuromuscular-firing patterns, disturbed balance and postural control.ObjectiveThe purpose of this study was to compare postural control behaviour in subjects with chronic ankle instability and healthy subjects, using the traditional linear and nonlinear variables for the centre of pressure (CoP) displacement, during one-leg stance on stable and unstable surfaces.Methods16 CAI subjects and 20 healthy subjects were evaluated with the single leg stance on a stable surface and an unstable surface, for 60 s with a force plate. The traditional linear variables like CoP displacement, CoP amplitude and CoP velocity were calculated. Variability of CoP displacement was also submitted to nonlinear analysis and the approximated entropy, sample entropy, correlation dimension and Lyapunov exponent were calculated.ResultsOn the stable surface, no differences between groups for all the traditional variables were found but the correlation dimension of CoP mediolateral displacement had lower values on the CAI group with statistical significance (p < 0.05). On the unstable surface, no differences were found neither with linear variable neither with variability nonlinear analysis.ConclusionCorrelated dimension of CoP displacement during one-leg stance on a stable surface was the only variable that show significant differences between the two groups. The lower values of this variable in the CAI subjects may implicate a balance control system with more difficulties to adapt to the environment and the task demands. More studies are needed to better understand CAI subjects balance control.     

Kinesiology tape length and ankle inversion proprioception at step-down landing in individuals with chronic ankle instability

ObjectivesTo determine the effect of different lengths of kinesiology tape (KT) on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI).DesignA repeated measures study.MethodsFifteen participants with unilateral CAI and fifteen participants with no CAI volunteered. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL) was used to measure ankle proprioceptive acuity. All participants were tested under four KT conditions: no tape (baseline), short tape length (only foot and ankle complex involved), mid length (below the knee) and long length (above the knee) taping. After the baseline test, participants underwent the 3 different taping tests in a random order.ResultsRepeated measures ANOVA indicated that, compared to those without CAI, individuals with CAI performed significantly worse across the 4 different conditions (F = 8.196, p = 0.008). There was a significant KT main effect (F = 7.489, p < 0.001) and a significant linear effect (F = 17.083, p < 0.001), suggesting that KT significantly improved ankle proprioceptive performance in landing, and with longer tape length there was greater proprioceptive enhancement. Post-hoc analysis showed that for the CAI group, both mid length (p = 0.013, 95%CI = −0.063, −0.009) and long length (p = 0.010, 95%CI = −0.067, −0.011) taping can significantly improve ankle proprioceptive performance compared to no tape, whereas for the non-CAI group, ankle proprioceptive acuity was significantly improved only with long length taping (p = 0.007, 95%CI = −0.080, −0.015).ConclusionsKT can be used to improve ankle inversion proprioceptive performance during landing in both individuals with and without CAI and increasing tape length may achieve greater proprioceptive improvement.     

Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability

ObjectiveTo study postural control and muscle activity during the limit of stability test (LOS) in subjects with chronic ankle instability.DesignObservational study.SettingUniversity laboratory.Participants10 healthy subjects were included in the control group and 10 subjects in the CAI group (age between 18 and 30 years, with history of the multiple ankle “giving way” episodes in the last six months and score ≤24 in the Cumberland Ankle Instability Tool).Main outcome measuresA computerized dynamic posturography equipment was used for assessing the LOS. The electromyography activity of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG) and peroneus longus (PL) was registered.ResultsSubjects with CAI had a greater activation in TA to forward (p < .01), forward affected (p = .001), backward affected (p = .007) and backward directions (p < .01); in PL to forward affected (p < .01) and affected directions (p = .001); in MG to forward (p = .023) and affected directions (p < .01) and in SOL to the affected direction (p = .009). We observed restricted excursions and less directional control in subjects with CAI.ConclusionsSubjects with CAI exhibited poorer ability to move their center of gravity within stability limits. In addition, they have an altered ankle muscle activity during LOS test toward the affected ankle joint.     

The influence of Mulligan ankle taping during balance performance in subjects with unilateral chronic ankle instability

Objective: To determine whether Mulligan ankle tape influenced the performance in subjects with unilateral chronic ankle instability (CAI) during static balance; postural sway recovery patterns after hopping and dynamic tracking balance tasks.Design: A cross-sectional, within-subjects experimental study design between 4 ankle conditions (taped; untaped: injured and uninjured).Participants: 20 volunteer recreational athletes with unilateral CAI were recruited. Means and standard deviations highlighted the athletes' characteristics: age = 23 ± 1 years; height = 173.1 ± 2.4 cm; weight = 69.3±3 kg; Functional Ankle Disability Index (FADI) = 93.5 ± 5.1% and FADI Sport = 84.2 ± 9.4%.Interventions: Mulligan ankle taping.Main Outcome Measurements: Static balance (10 s); postural sway recovery patterns after a 30 s functional hop test (immediately, 30 and 60 s); dynamic tracking balance tasks (wandering, target overshoot and reaction-time).Results: Between the four conditions, static balance showed no significant differences (p = 0.792); significant changes occurred in postural sway over time (p < 0.001); no significant changes were reported for the dynamic tracking tasks. Wandering was highly correlated with reaction-time and overshooting (p < 0.01).Conclusion: Under resting and fatigued conditions, Mulligan ankle taping did not impact on the neuromuscular control during static and dynamic balance in subjects with healthy and unstable ankles.     

The efficacy of elastic therapeutic tape variations on measures of ankle function and performance

ObjectivesTo investigate the effects of different variations of elastic therapeutic taping (ETT) on tests used to screen for ankle injury risk and function.DesignRandomized crossover.SettingLaboratory.ParticipantsTwelve professional male soccer players completed three experimental trials: No tape (NT), RockTape™ (RT), and Kinesio™ Tape (KT) applied to the ankle complex.Outcome MeasuresClinical and functional ankle screening tests were used to assess the effects of ETT on measures of joint position sense, postural stability and ground reaction forces.ResultsKT (P = 0.04) and RT (P = 0.01) demonstrated significant improvements in end range joint position sense. When compared to NT, RT significantly (P = 0.02) improved mid-range joint position sense at 15°, and time to complete a drop landing task. No significant differences were observed for measures of postural stability (P ≥ 0.12) nor ground reaction force variables (P ≥ 0.33).ConclusionsResults advocate the use of ETT for proprioceptive and functional tasks when applied to the ankles of healthy male soccer players. However, a greater number of practical and significant differences were observed when RT only was applied, indicating that practitioners may potentially advocate the use of RT for tasks requiring proprioception and functional performance.     

Can ankle proprioception be improved by repeated exposure to an ankle movement discrimination task requiring step-landing in individuals with and without CAI?

ObjectivesTo determine whether individuals with and without Chronic Ankle Instability (CAI) can improve their ankle movement discrimination sensitivity by repeated exposure to an ankle proprioceptive task requiring landing.DesignA repeated-measures study.SettingUniversity laboratory.Participants24 university students, 11 with CAI and 13 without CAI.Main outcome measuresAnkle proprioception was measured using the Ankle Inversion Discrimination Apparatus for Landing (AIDAL) over 3 occasions: AIDAL-1 and AIDAL-2 separated with a 10-min interval, and AIDAL-3 at 24 h post AIDAL-2.ResultsBetter Cumberland Ankle Instability Tool (CAIT) questionnaire scores were correlated with higher AIDAL scores (rho = 0.465, p = 0.022). Two-way ANOVA showed a significant CAI main effect for step landing ankle inversion proprioception, with CAI worse (F = 8.410, p = 0.008), but the Time main effect across the 3 AIDAL tests was not significant (F = 1.552, p = 0.223).ConclusionsThe AIDAL assessment was sensitive in terms of discriminating between individuals with or without CAI. However, the step-down component of the AIDAL proprioceptive task was possibly too challenging. For CAI, physical therapy exercises should take into account the difficulty of the training task, so that a demonstrable learning effect can be achieved.     

Lower limb kinematics during single leg landing in three directions in individuals with chronic ankle instability

ObjectivesTo compare the lower limb kinematics of participants with chronic ankle instability (CAI) and healthy participants during forward, lateral, and medial landings.DesignCross-sectional study.SettingLaboratory.ParticipantsEighteen athletes with CAI and 18 control athletes.Main outcome measuresHip, knee, and ankle joint kinematics during forward, lateral, and medial single-leg landings were compared between the groups using two-way ANOVA for discrete values and statistical parametric mapping two-sample t-tests for time-series data.ResultsThe CAI group had significantly greater ankle dorsiflexion than the control group (P ≤ 0.013), which was observed from the pre-initial contact (IC) for lateral and medial landings and post-IC for forward landing. The CAI group showed greater knee flexion than the control group from the IC for lateral landing and post-IC for forward landing (P ≤ 0.014). No significant differences in ankle inversion kinematics were found between the CAI and control groups. Lateral landing had a greater peak inversion angle and velocity than forward and medial landings (P < 0.001). Medial landing had a greater inversion velocity than forward landing (P < 0.001).ConclusionsThis study suggests that individuals with CAI show feedforward protective adaptations in the pre-landing phase for lateral and medial landings.     

The effect of ankle taping on functional performance in participants with functional ankle instability

ObjectiveTo investigate the effect of rigid ankle tape on functional performance, self-efficacy and perceived stability, confidence and reassurance during functional tasks in participants with functional ankle instability.DesignClinical measurement, crossover design.MethodsParticipants (n = 25) with functional ankle instability (Cumberland Ankle Instability Score < 25) were recruited from university students and sporting clubs. Participants performed five functional tests with and without the ankle taped. The tests were: figure-8 hopping test, hopping obstacle course, star excursion balance test (SEBT), single-leg stance and stair descent test. Secondary outcome measures were self-efficacy and perception measures.ResultsRigid tape significantly decreased the stair descent time by 4% (p = 0.014), but had no effect on performance in the other tests. Self-efficacy increased significantly (p < 0.001). Perceived stability, confidence and reassurance also increased with the ankle taped (p < 0.05) during the stair and two hopping tasks, but not during the SEBT or single-leg stance test.ConclusionAlthough taping the ankle did not affect performance, except to improve stair descent, it increased self-efficacy and perceived confidence in dynamic tasks. These findings suggest that taping may reduce apprehension without affecting functional performance in those with functional ankle instability and permit continued physical activity or sport participation.     

Individuals with chronic ankle instability exhibit altered ankle kinematics and neuromuscular control compared to copers during inversion single-leg landing

ObjectivesThis study compares the ankle kinematics and muscle activities of the individuals with chronic ankle instability (CAI), coper, and control groups in normal and inversion single-leg landings.Designcross-sectional study;SettingBiomechanics laboratory.ParticipantsPhysically active adults with CAI (N = 12); and coper (N = 12) and control (N = 12) groups.Main outcome measuresThe participants performed normal and inversion single-leg landing. The muscle activity 200 ms before and after landing of the tibialis anterior, the medial gastrocnemius, and the fibularis longus (FL) were recorded. The FL latency, sagittal and frontal co-contraction indexes (CCI), ankle inversion angle at the initial contact, and the maximum inversion angle were recorded.ResultsSignificantly longer FL latency, decreased FL muscle activity, frontal CCI, and an increased maximum inversion angle at post-landing were discovered during inversion single-leg landing in the CAI group compared to the coper and control groups. However, no significant difference was observed among the CAI and coper groups during normal single-leg landing.ConclusionThese results suggest prolonged FL latency and altered ankle kinematics suggest an increased risk of recurrent lateral ankle sprains in CAI with inversion single-leg landing.     

Reliability and discriminative validity of sudden ankle inversion measurements in patients with chronic ankle instability

BackgroundStudies investigating peroneal muscle reaction times in chronically unstable ankle joints present conflicting results. The degree of reliability and accuracy of these measurements is unknown in patients with chronic ankle instability (CAI).Methods40 patients with CAI and 30 healthy subjects were tested using a sudden ankle inversion of 50° while standing on a trapdoor device. Sudden ankle inversion measurements were registered using electromyography, accelerometry and electrogoniometry. For reliability testing, intra-class coefficients (ICCs; model 3,1) and standard errors of measurements of the latency time, motor response time and electromechanical delay of the peroneus longus muscle, the time and angular position of onset of decelerations, the mean and maximum inversion speed and the total inversion time were calculated in 15 patients with CAI. To assess between-group differences, t-tests for independent samples (p < .05) were used.ResultsICCs ranged from .20 (angular position of onset of the second deceleration) to .98 (electromechanical delay of the peroneus longus muscle). Significant between-group differences were observed in only 2 of the 12 variables (for the electromechanical delay of the peroneus longus muscle, p = .001; time of onset of the second deceleration, p = .040).ConclusionsThe latency time and motor response time of the peroneus longus muscle, the total inversion time and the mean inversion speed demonstrate acceptable reliability in healthy subjects and patients. The latency time and motor response time of the peroneus longus muscle are not delayed in patients with CAI. Ankle inversion measurements are not discriminative for CAI.     

Applicability of cutoff scores of Chinese Cumberland Ankle Instability Tool and Foot and Ankle Ability Measure as inclusion criteria for study of chronic ankle instability in Chinese individuals

ObjectiveTo examine the applicability of Chinese Cumberland Ankle Instability Tool (CAIT-C) and Foot and Ankle Ability Measure (FAAM-C) as inclusion criteria recommended by the International Ankle Consortium (IAC) for study of chronic ankle instability in the Chinese individuals.DesignCross-sectional comparative design with known groups.SettingResearch laboratory.Participants145 participants with chronic ankle instability (CAI) and 66 participants without injury.Main outcome measuresCAIT-C and FAAM-C Activities of Daily Living (FAAM-C-ADL) and FAAM-C Sports (FAAM-C-Sports).ResultsThe CAIT-C scores (18.2 ± 5.6), FAAM-C-ADL scores (97.0 ± 4.3) and FAAM-C-Sports scores (92.2 ± 10.3) of the CAI group were all lower than the CAIT-C scores (27.4 ± 3.1), FAAM-ADL scores (99.0 ± 2.1) and FAAM-Sports scores (98.4 ± 3.1) (P < 0.01) of the uninjured group. The recommended cutoff score of CAIT-C<24 by the IAC for identifying CAI had a sensitivity of 80.7% and a specificity of 84.9%. If the recommended cutoff scores of FAAM-ADL<90，FAAM-Sports<80 by the IAC as inclusion criteria for the study of CAI were applied, 97% of participants with CAI in this sample would be excluded.ConclusionThe results support the recommended cutoff score of CAIT-C<24 by the IAC to identify Chinese individuals with CAI for study. However, the recommended cutoff scores of FAAM-ADL<90 and FAAM-Sports<80 will exclude most Chinese individuals with CAI having only mild functional impairments.     

Fibular taping does not influence ankle dorsiflexion range of motion or balance measures in individuals with chronic ankle instability

ObjectivesTo determine the effects of fibular taping on ankle dorsiflexion range of motion (ROM) and dynamic balance in individuals with chronic ankle instability (CAI).DesignSingle-blind, randomized crossover.MethodsTwenty-three individuals (age = 23.4 ± 2.5 years, height = 171.6 ± 12.4 cm, mass = 71.5 ± 13.1 kg) with CAI were allocated to either a fibular taping intervention or sham taping intervention (tape applied without tension) over the course of two visits. Weight-bearing ankle dorsiflexion ROM and components of the Star Excursion Balance Test (SEBT) were measured before and after intervention.ResultsThere was not a significant change in ankle dorsiflexion ROM when comparing the taping interventions (F_1,43 = 1.03, P = .32), but both interventions resulted in a small increase (F_1,43 = 8.07, P = .007) in dorsiflexion ROM (pre = 36.7° ± 6.9°, post = 37.7° ± 6.2°). This increase in ROM did not exceed the established minimal detectable change for dorsiflexion ROM. Fibular taping with tension produced an increase (F_1,41 = 5.84, P = .02) (pre = 69.0 ± 9.1%, post = 70.6 ± 8.6%) in posterolateral reach distance when compared to taping without tension (pre = 72.7 ± 11.0%, post = 71.4 ± 9.6%), but this increase did not exceed the established minimal detectable change. There was not a significant change in dynamic balance between groups for the anterior (F_1,41 = 2.33, P = .14) and posteromedial (F_1,41 = .41, P = .53) reach directions.ConclusionsAlthough small changes in ankle dorsiflexion ROM and posterolateral reach distances were observed, these changes did not exceed established minimal detectable change values for these measures. These results suggest that the benefits of fibular taping are not related to an increase in ankle dorsiflexion ROM or dynamic balance.     

Instrumented measures of postural control in college dancers with and without chronic ankle instability

ObjectivesTo determine whether collegiate dancers with chronic ankle instability (CAI) demonstrated impaired postural control during instrumented measures of single-leg static balance compared to dancers without CAI.DesignCross sectional design.SettingUniversity dance studios.ParticipantsWe included N = 39 dance majors from a large, public university. We stratified participants into CAI (n = 20, age = 20 ± 1.8, IdFAI = 17.3 ± 5.7, number of sprains = 1.9 ± 1.1) and Control groups (n = 19, age = 20 ± 1.2, IdFAI = 2.5 ± 3.0).Main outcome measuresParticipants performed 3 x 10-s single-leg, static balance trials on a pressure mat in two different conditions, foot-flat eyes closed and demi-pointe eyes open. We measured six different time-to-boundary (TTB) measurements during each balance trial and calculated the average of the 3 trials for each condition. Participants also completed the Foot and Ankle Ability Measure (FAAM) sport and activities of daily living (ADL) questionnaires.ResultsThe CAI group reported greater IdFAI and lower FAAM-ADL and FAAM-Sport scores compared to the control group. We observed no significant differences in TTB measurements between the CAI and control groups during either balance conditions.ConclusionsInstrumented measures of static postural control were not impaired in college dancers with CAI compared dancers without CAI.     

Ankle laxity affects ankle kinematics during a side-cutting task in male collegiate soccer athletes without perceived ankle instability

ObjectivesTo investigate whether ankle joint laxity alone influences lower limb kinematics during a side-cutting task.DesignA cross-sectional study.SettingSports medicine research laboratory.ParticipantsIn total, 66 male collegiate soccer players with history of ankle sprains with no perceived ankle instability were categorised into three groups: no-laxity copers (n = 26), laxity copers (n = 23), and severe-laxity copers (n = 17).Main outcome measuresThe hip, knee, ankle, rearfoot, midfoot, and forefoot kinematic data during the stance phase (0%–100% indicated initial contact to take-off) of a 45° side-cutting task were analysed using one-dimensional statistical parametric mapping.ResultsThe horizontal plane kinematics of the rearfoot differed significantly among the three groups during 30%–91% of the stance phase (P < .05). Severe-laxity copers exhibited a greater external rotation angle than no-laxity copers during 6%–14% and 32%–92% of the stance phase (P < .05).ConclusionOur data suggest that severe ankle joint laxity affects rearfoot horizontal plane kinematics in individuals without perceived ankle instability performing a 45° side-cutting task. These findings could be used by clinicians in developing rehabilitation programs to prevent further ankle sprains in patients with severe ankle joint laxity.     

The effects of gluteus medius and tibialis anterior kinesio taping on postural control,knee kinematics,and knee proprioception in female athletes with dynamic knee valgus

ObjectivesThis study aimed to investigate the effects of Kinesio taping on postural control, kinematics, and knee proprioception in female athletes with dynamic knee valgus (DKV).Design: a single-blind randomized clinical trial.Participants40 female athletes between the age of 18 and 28 years with DKV in single-leg drop landing (>13°) participated in this study. They were randomly classified into the Kinesio taping (KT) and placebo control (PC) groups.Main outcome measuresAll the evaluations and measurements were performed on each subject in the pre-test and post-test stages (with an interval of 72 h). The dynamic balance (Y balance test), proprioception (Knee position sense error), and knee kinematics (flexion and DKV angles) of the subjects were measured, prior and post gluteus medius and tibialis anterior KT.ResultsThe results of study demonstrate that the DKV angle and knee position sense error significantly decreased and YBT increased in the KT group from pre-test to post-test (p < 0.05). Nevertheless, there was no significant difference in knee flexion angle (p > 0.05).ConclusionThe results of the present study indicated that KT improves dynamic balance and proprioception and reduces the DKV angle. Therefore, KT is recommended for female athletes with DKV.     

Ankle inversion proprioception measured during landing in individuals with and without chronic ankle instability

BackgroundResearch evidence has suggested that a more sensitive ankle proprioceptive testing method with higher ecological validity is needed for assessing proprioceptive deficits in individuals with chronic ankle instability (CAI).Objectives(1) To determine the test–retest reliability of a novel ankle proprioception assessment tool, the Ankle Inversion Discrimination Apparatus for Landing (AIDAL); (2) To assess whether AIDAL scores were sufficiently sensitive to detect proprioceptive deficits in chronic ankle instability (CAI); and (3) To examine whether AIDAL scores correlated with Cumberland Ankle Instability Tool (CAIT) scores.DesignCross-sectional study.MethodsThe AIDAL was purpose-built to assess ankle discrimination in four positions of ankle inversion (10°, 12°, 14° and 16°) upon landing from a 10 cm drop. Area Under the Receiver Operating Curve (AUC) was employed as the ankle proprioceptive discrimination score. Seven-day test–retest reliability was evaluated with 23 university students (12 CAI and 11 non-CAI), and another 36 university students (18 CAI and 18 non-CAI) were in the comparison study.ResultsThe test–retest reliability ICC score for the whole group was 0.763 (95% CI = 0.519–0.892), which showed an excellent reliability level. ICC _(3,1) was 0.701 for the non-CAI group (95%CI = 0.210–0.910) and 0.804 for the CAI group (95%CI = 0.451–0.939). The CAI group performed at a significantly lower level on the AIDAL assessment than the non-CAI group (0.777 ± 0.05 vs. 0.815 ± 0.05, F = 5.107, p = 0.03). The discriminative AUC value for the AIDAL test was 0.756 with a cut point of 0.819 (sensitivity = 0.733, specificity = 0.800). The MDC₉₀ scores for CAI and non-CAI groups were both 0.04. Spearman's correlation showed that the CAIT scores were significantly correlated with the ankle proprioceptive discrimination scores (rho = 0.401, p = 0.015).ConclusionThe AIDAL showed good test–retest reliability for both non-CAI and CAI groups. Measuring ankle inversion proprioception during landing may be important for assessing the outcomes of CAI rehabilitation, as proprioceptive performance obtained from the AIDAL was significantly correlated with severity of functional ankle instability CAIT scores.     

Differences in clinician-oriented outcomes among controls,copers, and chronic ankle instability groups

ObjectiveTo compare clinician-oriented outcome measures among uninjured controls, copers, and chronic ankle instability (CAI) groups.DesignCase-control study.SettingResearch Laboratory.ParticipantsParticipants were 25 active adults with unilateral CAI ([mean ± SD] age: 23.7 ± 4.9 years), 21 copers ([mean ± SD] age: 23.2 ± 4.7 years), and 20 uninjured controls ([mean ± SD] age: 21.1 ± 2.5 years).Main outcome measuresRange of motion and posterior talar glide were assessed via a weight-bearing lunge and a talar glide test, respectively. Cutaneous sensation was measured during a Semmes–Weinstein Monofilament test. Dynamic balance was measured during the Star Excursion Balance Test (SEBT). Muscular strength was assessed during manual muscle tests of the dorsiflexors, plantar flexors, invertors, and evertors.ResultsThe CAI group had decreased dorsiflexion range of motion relative to controls (p = 0.02). Those with CAI also had decreased balance during the posterior-medial reach of the SEBT compared to copers and controls (p < 0.01). Both copers and the CAI group had decreased normalized dorsiflexion strength compared to controls (p < 0.01) but only the CAI group had normalized plantar flexion strength deficits relative to controls (p = 0.04).ConclusionsSome clinician-oriented outcomes, but not all, can detect differences among uninjured controls, copers, and those with CAI.