Abstract
BackgroundChronic ankle conditions affect approximately 20% of Australian adults. Although there is a plethora of research on chronic hip and knee conditions, there is limited understanding of the impact of ankle problems. Thus, the significance of chronic ankle conditions is not clear. The aim of this study was to compare self-reported function, disability, instability, physical activity and quality of life (QoL) between adults with and without ankle symptoms. A secondary aim was to explore factors associated with QoL.MethodIndividuals with symptoms of ankle pain and stiffness (symptomatic individuals) and controls with no ankle pain or stiffness (asymptomatic individuals) completed a cross-sectional online survey. The survey included the Ankle Osteoarthritis Scale (AOS), Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), International Physical Activity Questionnaire (IPAQ), Assessment of QoL (AQoL-6D), and questions about ankle injury history.ResultsA total of 394 individuals (270 symptomatic and 124 asymptomatic) with mean age of 48.8 (standard deviation (SD): 12.1) years and body mass index of 28.7 (7.7) kgm− 2 completed the survey. Standardized mean differences (SMD) were large to very large (1.45 to 3.20) for greater disability (AOS) and instability (CAIT), and poorer function (FAAM) in symptomatic compared to asymptomatic individuals. Individuals with ankle symptoms had higher body mass index and lower QoL (medium effect: SMD > 1). There were no differences in self-report physical activity between groups. Lower activities of daily living (ADL) function (FAAM-ADL) best explained QoL in a multiple regression model (R2 = 0.66, p = 0.001).ConclusionIndividuals with ankle symptoms reported ankle instability, greater disability, compromised function and worse QoL compared to asymptomatic individuals. There was a strong relationship between ankle function and QoL. Ankle-specific ability during ADL best explained the reduced QoL in individuals with ankle symptoms. Clinicians and researchers should consider ankle function as an antecedent to poorer QoL in patients who have ankle symptoms.
Highlights
Chronic ankle conditions affect approximately 20% of Australian adults
Standardized mean differences (SMD) were large to very large (1.45 to 3.20) for greater disability (AOS) and instability (CAIT), and poorer function (FAAM) in symptomatic compared to asymptomatic individuals
Individuals with ankle symptoms reported ankle instability, greater disability, compromised function and worse quality of life (QoL) compared to asymptomatic individuals
Summary
Chronic ankle conditions affect approximately 20% of Australian adults. there is a plethora of research on chronic hip and knee conditions, there is limited understanding of the impact of ankle problems. While it has been generally established that pain and physical impairments related to musculoskeletal conditions negatively impact function, mental health and quality of life (QoL) [4], there is little evidence surrounding the impact of chronic ankle problems. Saltzman et al [5] investigated individuals with severe radiographic ankle OA (Kellgren-Lawrence grade 3–4) who presented to an orthopaedic surgeon and identified that these individuals have high pain and disability and poor QoL. This raises the question of the levels of pain, disability and QoL generally in individuals who have chronic ankle problems
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