Korean J Sports Med.  2022 Dec;40(4):226-233. 10.5763/kjsm.2022.40.4.226.

Reliability and Validity of Questionnaires for Classification of the Functional and Mechanical Ankle Instability

• Jeong HS
• Chung S
• Lee I
• Kim BH
• Jeon HG
• Lee SY

• KMID: 2536673
• DOI: http://doi.org/10.5763/kjsm.2022.40.4.226

Abstract

Purpose
The study aimed (1) to verify the reliability and validity of the self-reported Korean version questionnaire for predicting chronic ankle instability (CAI); (2) to suggest the accuracy of questionnaires for distinguishing mechanical ankle instability (MAI) and functional ankle instability (FAI), and (3) to set a cut-off value of classification for MAI and FAI.
Methods
This study involved 165 subjects (28.16±5.04 years) who consisted of 54 MAI (27 males, 27 females), and 111 FAI (72 males, 39 females). Five self-report questionnaires (Ankle Instability Instrument [AII], Cumberland Ankle Instability Tool [CAIT], Identification of Functional Ankle Instability [IdFAI], Foot and Ankle Ability Measure [FAAM], and Foot and Ankle Disability Index [FADI]) for predicting CAI were administered to all subjects twice at 2 weeks intervals. Questionnaire score was analyzed to calculate the intraclass correlation coefficient (ICC), standard error of measurement, sensitivity, specificity, positive and negative likelihood ratio, area under the curve, and cut-off values.
Results
All questionnaires including FADI-Sport (ICC=0.999), FAAM-Sport (ICC=0.992), FAAM-activities of daily living (ADL) (ICC=0.991), IdFAI (ICC=0.986), AII (ICC=0.984), CAIT (ICC=0.981), FADI-ADL (ICC=0.951) showed excellent reliability (ICC＞ 0.75). Furthermore, AII (sensitivity=0.830, specificity=0.924), CAIT (sensitivity=0.915, specificity=0.915), IdFAI (sensitivity=0.809, specificity=0.924), FAAM-ADL (sensitivity=0.681, specificity=0.924), FAAM-Sport (sensitivity=0.851, specificity=0.932), FADI-Sport (sensitivity=0.915, specificity=0.924), and FADI-ADL (sensitivity=0.660, specificity=0.924) questionnaires had high sensitivity and specificity. The cut-off values for MAI and FAI for each questionnaire were 6.5 AII, 20.01 CAIT, 18.52 IdFAI, 85.71% FAAM-ADL, 69.65% FAAM-Sport, 88.53% FADI-ADL, and 79.7% FADI-Sport.
Conclusion
Self-report questionnaires for identifying those with CAI may help to establish FAI and MAI selection criteria in sports, clinical, and laboratory settings.

Keyword

Ankle injuries; Joint instability; ROC curve; Patient selection; Self report

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