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Clinical Tests Have Limited Predictive Value for Chronic Ankle Instability When Conducted in the Acute Phase of a First-Time Lateral Ankle Sprain Injury

Published:December 20, 2017DOI:https://doi.org/10.1016/j.apmr.2017.11.008

      Abstract

      Objective

      To evaluate whether a battery of clinical assessments for acute lateral ankle sprain (LAS) can be used to predict long-term recovery.

      Design

      Cohort study.

      Setting

      University biomechanics laboratory.

      Participants

      Individuals (N=82) were assessed using a clinical test battery within 2 weeks of incurring a first-time LAS.

      Interventions

      Not applicable.

      Main Outcome Measures

      The clinical test battery included scores on the talar glide test (degrees), the anterior drawer, talar tilt, figure of 8 for swelling (millimeters) and knee to wall (millimeters) tests, and handheld goniometric range of motion (inversion, eversion, and plantarflexion [in degrees]). Scores on the Cumberland Ankle Instability Tool taken 12 months after the clinical test battery were used to classify participants as having chronic ankle instability (CAI) or as being LAS copers.

      Results

      Forty percent of participants were designated as having CAI, with 60% being designated as LAS copers. A logistic regression analysis revealed that a combined model using scores from the talar glide, talar tilt, and anterior drawer tests in addition to plantarflexion range of motion was statistically significant (P<.01) and correctly classified cases with moderate accuracy (68.8%). The final model had moderate sensitivity (64%) and good specificity (72%).

      Conclusions

      The clinical tests used in this investigation have limited predictive value for CAI when conducted in the acute phase of a first-time LAS injury.

      Keywords

      List of abbreviations:

      CAI (chronic ankle instability), CAIT (Cumberland Ankle Instability Tool), LAS (lateral ankle sprain), ROM (range of motion)
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