Correlation between self-reported instability, balance, and health status in individuals with chronic functional ankle instability

Abstract

Background and Objective: Functional ankle instability (FAI), characterized by feeling of “giving way” and recurrent episodes of ankle sprain, is the most prevalent problem following ankle sprain which causes balance deficits and limitations in activity and sport and can affect health status. Little is known about correlation between self-reported instability-as chief complaint of individuals- with balance and health status in individuals with FAI.


Materials and Methods: 23 subjects with unilateral FAI and 23 healthy people were participated in this study. Ankle Instability Index and SF-36 questionnaire were completed by participants; otherwise balance error scoring system (BESS) was used to measure static balance. To compare balance and health status between groups, independent sample and Mann-Whitney tests were used and Spearman correlation coefficient was used to determine correlation between main variables.


Results: BESS scores in FAI group was significantly more than the control group (P<0.05). The Spearman’s correlation analysis revealed significant correlations between the ankle Instability Index with all of SF-36 subscales except for energy/fatigue and social function(r= 0.43 to 0.85, P> 0.05). There was no significant correlation, however, between balance tests scores with the Instability Index.


Conclusion: High correlation of ankle instability with physical part of SF-36 revealed that self-reported instability affect physical health but there is not any correlation between self-reported instability with balance tests.

Keywords


1. Docherty CL, Valovich TC, Shultz SJ. Postural control deficits in participants with functional ankle instability as measured by the balance error scoring system. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine 2006;16(3):203-8. 2. Delahunt E, Eamonn S. Neuromuscular contributions to functional instability of the ankle joint. Journal of Bodywork and Movement Therapies 2007;11(3):203-13. 3. Doherty CL, Caulfield B, Hertel J. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Medicine Journal 2014;44(1):123-40. 4. Tanaka H, Mason L. Chronic ankle instability. Orthopaedics and Trauma 2011;25(4):269-78. 5. Hintermann B, Boss A , Schafer D. Arthroscopic findings in patients with chronic ankle instability. American Journal of Sport Medicine 2002;30:402-9. 6. Tropp H. Pronator muscle weakness in functional instability of the ankle joint. Internatinal Journal of Sports Medicine 1986;7(5):291-4. 7. Forkin DM, Koczur C, Battle R, Newton RA. Evaluation of kinesthetic deficits indicative of balance control in gymnasts with unilateral chronic ankle sprains. Journal of Orthopaedic & Sports Physical Therapy 1996;23(4):245-50. 8. Lentell G, Katzman LL, Walters MR. The Relationship between Muscle Function and Ankle Stability. Journal of Orthopaedic & Sports Physical Therapy 1990;11(12):605-11. 9. Garn SN, Newton RA. Kinesthetic Awareness in Subjects with Multiple Ankle Sprains. Physical Therapy 1988;68(11):1667-71. 10. Riemann BL, Kevin M, Edgar W. Relationship Between Clinical and Forceplate Measures of Postural Stability. Journal of Sport Rehabilitation 1999; 8(2): 71. 11. Lee A, Lin W , Huang CH. Impaired properioception and poor static postural control in subjects with functional instability of the ankle. Journal of Exercise Science & Fitness 2006;4(2):117-25. 12. Michell TB, Ross SE , Blackburn JT . Functional balance training with or without exercise sandals for subjects with stable and unstable ankles. Journal of Athletic Training‌2006;41(4):393-8. 13. Wickstrom EA, Borsa PA. Detection of dynamic stability dificits in subjects with functional ankle instability. Medicine & Science in Sports & Exercise 2005;37(2):169-75. 14. Hubbard TJ, Kramer LC. Contributing factors to chronic ankle instability. Foot & Ankle International 2007;28(3):343-54. 15. Brown CN, Mynark R. Balance deficits in recreational athletets with chronic ankle instability. Journal of Athletic Training 2007;42(3):367-73. 16. Hale SA, Hertel J, olmsted-kramer LC. The effect of a 4-week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. Journal of Orthopaedic & Sports Physical Therapy 2007; 37(6):303-11. 17. Iverson GL, Koehle MS. Normative data for the balance error scoring system in adults. Rehabilitation Research and Practice‌ 2013. 18. Ross SE, Guskiewicz KM. Single leg jump landing stabilization times in subjects with functionally unstable ankles. Journal of Athletic Training 2005;40(4):298-304. 19. Docherty CL, Arnold BL, Bruce M. Functional Performance Deficits in Volunteers With Functional Ankle Instability. Journal of Athletic Training 2005;40(1):30-4. 20. Sharma N, Sandhu J. Functional Performance Testing in Athletes with Functional Ankle Instability. Asian Journal of Sports Medicine 2011;2:249-58. 21. Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. British Medical Journal (Clinical Research Ed.)1992;305(6846):160-4. 22. Domholdt E. Physical therapy research: principles and applications. 2nd ed. Philadelphia: Sounders;2000: p.275. 23. Brent L, Arnold P, Cynthia J. Functional Ankle Instability and Health-Related Quality of Life. Journal of Athletic Training 2011;46(6):634-41. 24. Anandacoomarasamy LB, Grujic L. long term outcomes of inversion ankle injuries. British Journal of Sports Medicine 2005;39.