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

Abstract

PurposeTo develop the Sinhala version of the Cumberland Ankle Instability Tool (CAIT-Sin) and evaluate its validity and reliability in native Sinhala speakers.MethodsThe 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).ResultsThe 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.ConclusionsThe 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.