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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ankle injuries in basketball.Br J Sports Med. 2001; 35: 103-108
- Effects of ankle sprain in a general clinical population 6 to 18 months after medical evaluation.Arch Fam Med. 1999; 8: 143-148
- Persistent disability associated with ankle sprains.Foot Ankle Int. 1998; 19: 653-660
- Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability.J Athl Train. 2002; 37: 364-375
- The relationship between muscle function and ankle stability.J Orthop Sports Phys Ther. 1990; 11: 605-611
- Instability of the foot after injuries to the lateral ligament of the ankle.J Bone Joint Surg Br. 1965; 47: 669-677
- Commentary.J Athl Train. 2002; 37: 512-515
- Kinesthesia is not affected by functional ankle instability status.J Athl Train. 2002; 37: 481-486
- Balance training for persons with functionally unstable ankles.J Orthop Sports Phys Ther. 1999; 29: 478-486
- The prognosis of ankle sprains.Int J Sports Med. 1997; 18: 285-289
- The contributions of proprioceptive deficits, muscle function and anatomic laxity to functional instability of the ankle.J Orthop Sports Phys Ther. 1995; 21: 206-215
- Prolonged reaction time in patients with chronic lateral instability of the ankle.Am J Sports Med. 1995; 23: 414-417
- Ankle instability caused by prolonged peroneal reaction time.Acta Orthop Scand. 1990; 61: 388-390
- The Lower Extremity Functional Scale (LEFS).Phys Ther. 1999; 79: 371-383
- Analysis of subjective knee complaints using visual analogue scales.Am J Sports Med. 1991; 19: 112-118
- Perceived exertion. Human Kinetics, Champaign1996
- Applying the Rasch model. Lawrence Erlbaum Associates, Mahwah2001
- Evidence-based medicine. 3rd ed. Elsevier Churchill Livingston, Philadelphia2005
- Health measurement scales. A practical guide to their development and use. Oxford Univ Pr, Oxford1995
Article Info
Footnotes
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.
Identification
Copyright
© 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
