Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 9 , Pages 1235-1241, September 2006

The Cumberland Ankle Instability Tool: A Report of Validity and Reliability Testing

Presented in part to the Second International Ankle Symposium, October 15–16, 2004, Newark, DE (abstract appears in Br J Sports Med 2005;39:390) and the First World Conference of Sports Injury Prevention, June 23–25, 2005, Oslo, Norway (abstract appears in J Orthop Sports Phys Ther 2005;35:A20).

  • Claire E. Hiller, MAppSc

      Affiliations

    • School of Physiotherapy, University of Sydney, Lidcombe, Australia
    • ,
  • Kathryn M. Refshauge, PhD

      Affiliations

    • School of Physiotherapy, University of Sydney, Lidcombe, Australia
    • Corresponding Author InformationReprint requests to Kathryn M. Refshauge, PhD, School of Physiotherapy, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia
    • ,
  • Anita C. Bundy, ScD

      Affiliations

    • School of Occupational and Leisure Sciences, University of Sydney, Lidcombe, Australia.
    • ,
  • Rob D. Herbert, PhD

      Affiliations

    • School of Physiotherapy, University of Sydney, Lidcombe, Australia
    • ,
  • Sharon L. Kilbreath, PhD

      Affiliations

    • School of Physiotherapy, University of Sydney, Lidcombe, Australia

Abstract 

Hiller CE, Refshauge KM, Bundy AC, Herbert RD, Kilbreath SL. The Cumberland Ankle Instability Tool: a report of validity and reliability testing.

Objective

To test the Cumberland Ankle Instability Tool (CAIT), a 9-item 30-point scale, for measuring severity of functional ankle instability.

Design

Cross-sectional study.

Setting

General community.

Participants

Volunteer sample of 236 subjects.

Interventions

Not applicable.

Main Outcome Measures

Concurrent validity by comparison with the Lower Extremity Functional Scale (LEFS) and a visual analog scale (VAS) of global perception of ankle instability by using the Spearman ρ. Construct validity and internal reliability with Rasch analysis using goodness-of-fit statistics for items and subjects, separation of subjects, correlation of items to the total scale, and a Cronbach α equivalent. Discrimination score for functional ankle instability by maximizing the Youden index and tested for sensitivity and specificity. Test-retest reliability by intraclass correlation coefficient, model 2,1 (ICC2,1).

Results

There were significant correlations between the CAIT and LEFS (ρ=.50, P<.01) and VAS (ρ=.76, P<.01). Construct validity and internal reliability were acceptable (α=.83; point measure correlation for all items, >0.5; item reliability index, .99). The threshold CAIT score was 27.5 (Youden index, 68.1); sensitivity was 82.9% and specificity was 74.7%. Test-retest reliability was excellent (ICC2,1=.96).

Conclusions

CAIT is a simple, valid, and reliable tool to measure severity of functional ankle instability.

Key Words:  Ankle , Joint instability , Questionnaires , Rehabilitation , Sprains and strains

 

 Supported by the National Health and Medical Research Council of Australia.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(06)00519-3

doi:10.1016/j.apmr.2006.05.022

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 9 , Pages 1235-1241, September 2006

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