Outcome Measures CAI

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You need to assess joint range, laxity, strength & swelling


Neuromuscular deficits

No clear winner for outcome measures yet as the multifactorial nature of CAI makes things difficult.

Eechaute, et al (2007) - These are valid for use in CAI

• Functional Ankle Ability Index (FAAM)

• Foot & Ankle Disability Index (FADI) - used alot in the research.

• Foot & Ankle Outcome Scale (FAOS) – has less content validity for CAI

Donahue, et al (2011)

• No single measure was able to predict if individuals met the minimally accepted criteria for FAI.

• However, a significantly accurate prediction of ankle stability status was produced by combining the Cumberland Ankle Instability Tool (CAIT) and Ankle Instability Instrument (AII).

Dynamic Postural Control / Functional Perfomance tests

1. Star Excursion Balance Test (SEBT)

  • First described by Gray in 1995.
  • Chaiwanichsiri, et al (2005) – usefulness of the SEBT in rehab has also been demonstrated.

  • Munro and Herrington (2010) - Minimal clinical difference (MCD) - An improvement of 6-8% needed to be confident that a real change in SEBT performance has occurred.

Simplifying the SEBT:

Robinson, et al(2008) - Number of practice trials can be reduced from 6 to 4

Hertel, et al(2006) - 3 directions adequate in CAI - The "Y Balance Test"


2. Figure 8 hop test & lateral side-to-side hop test

Docherty, et al (2005)

Barefoot: - 5 metre figure 8 hop test (timed). Hop as quickly as possible twice through the course.

- Lateral hop test (timed). Hop laterally 30 cm & back x10 reps.

Chaiwanichsiri, D., Lorprayoon, E.,and Noomanoch. L. (2005) StarExcursion Balance Training: Effects on Ankle Functional Stability after AnkleSprain, J Med AssocThai, Vol. 88 Suppl.4, 90-94.

Docherty, C.L., Arnold, B.L., Gansneder, B.M., Hurwitz, S., and Gieck, J. (2005) Functional-Performance Deficits in Volunteers With Functional Ankle Instability, J Athl Train., 40 (1), p30-34.

Donahue, M., Simon, J., Docherty, C.L. (2011). Critical review of self-reported functional ankle instability measures. Foot Ankle Int, 32 (12),p1140-1146.

Eechaute, C., Vaes, P., Van Aerschot, L., Asman, S., Duquet, W. (2007). The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: A systematic review, BMC Musculoskeletal Disorders, 8 (6).

Gray, G.W. (1995). Wynn Marketing Inc; Adrian, MI: 1995. Lower Extremity Functional Profile (textbook).

Hertel, J., Braham, R.A., Hale, S.A., and Olmsted-Kramer, L.C. (2006) Simplifying the SEBT: Analysis of subjects with & without CAI, JOSPT, 36 (3), 131-137.

Munro, A.G., Herrington, L.C. (2010). Between-session reliability of the star excursion balance test, Physical Therapy in Sport, 11 (4), p128-132.

Robinson, R.H., Phillip, M.A., and Gribble, G (2008). Support for a Reduction in the Number of Trials Needed for the Star Excursion Balance Test, Arch Phys Med Rehab, 89 (2),364-370.