Abstract

BackgroundBalance impairment is a common consequence of chronic ankle instability (CAI). This study aimed to assess the discriminative validity of four clinical tests for quantifying balance impairment in individuals with CAI.MethodsParticipants were screened for their balance using the single-leg balance test (SLBT) and were assigned to either the positive or the negative SLBT groups. Fifty-four individuals with CAI (N = 27 per group) were recruited and completed four clinical tests including the foot-lift test (FLT), the time-in-balance test (TIBT), the modified star excursion balance test in the posteromedial (mSEBT-PM) direction and the side-hop test (SHT). The receiver operating characteristics (ROC) curve coupled with Youden index were calculated to determine the optimal cut-off scores of each test.ResultsWe found significant differences in balance between groups for all tests, with good to excellent values for the area under the ROC curve (AUC). All four tests reached good to excellent sensitivity and specificity values and had significant cut-off scores to discriminate balance performance among CAI participants.ConclusionAll four clinical tests can be conducted with their respective cut-off scores to quantify balance impairment in individuals with CAI.

Highlights

  • A lateral ankle sprain (LAS) is a major injury that frequently occurs in athletes and physically active populations, and it has the highest recurrence rate of all musculoskeletal injuries (1)

  • Balance impairment is addressed as a result of sensorimotor deficits related to chronic ankle instability (CAI) that occurs after damage to the lateral ligament complex (1, 3, 5, 6)

  • We examined the discriminative validity of the foot-lift test (FLT), the time-in-balance test (TIBT), the mSEBT-PM and the side-hop test (SHT) in CAI subjects

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Summary

Introduction

A lateral ankle sprain (LAS) is a major injury that frequently occurs in athletes and physically active populations, and it has the highest recurrence rate of all musculoskeletal injuries (1). Over 30% of individuals with an index LAS will suffer from long-term symptoms caused by repeated injuries, including recurrent LAS, pain, limited ankle joint range of motion and the development of chronic ankle instability (CAI) (1–2). Balance impairment is addressed as a result of sensorimotor deficits related to CAI that occurs after damage to the lateral ligament complex (1, 3, 5, 6). Within 12 months of the initial injury, some individuals with CAI (i.e. copers) demonstrate successful sensorimotor adaptation and display no further symptoms (7). Those who cannot improve their sensorimotor function during this period will likely sustain balance deficits and re-sprain their ankles (7–8).

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