Fear Avoidance Beliefs in College Athletes with a History of Ankle Sprain

Abstract

Ankle sprains are the most prevalent injuries, and elevated fear avoidance beliefs after ankle sprain episodes could inhibit athletic performance and contribute to residual symptoms, such as functional and/or mechanical instability. However, it remains unclear how fear avoidance beliefs differ according to conditions of posttraumatic sequelae. The purpose of this study was to determine whether fear of movement/reinjury differed between individuals with and without functional ankle instability (FI, NFI) and healthy controls (CON) and to examine the relationship between fear and ankle joint laxity by sex. Participants (115 male athletes, 105 female athletes) completed the Identification of Functional Ankle Instability, Athlete Fear Avoidance Questionnaire (AFAQ), Tampa Scale for Kinesiophobia (TSK), and ankle joint laxity test. Total 168 athletes (79 males, 89 females) data were eligible for analysis. The results demonstrated that fear of movement/reinjury was lower in individuals in the absence of functional ankle instability although they experienced ankle sprain (FI; TSK=38.6±4.5, AFAQ=27.4±6.2, NFI; TSK=35.7±5.6, AFAQ=24.5±6.6). The fear of movement/reinjury had correlation with ankle joint laxity only in female athletes (TSK; r=0.285, p=0.013, AFAQ; r 0=0.322, p=0.045).

Athlete Fear Avoidance Questionnaire: Cross-cultural Adaptation and Validation in Italian Athletes With Musculoskeletal Injuries

“…Consistent with the cognitive-behavioural model of fear-avoidance [4], the AFAQ-I scores were also associated with measures of similar constructs such as fear of movement and catastrophizing. This result supports the scale's construct validity and suggests that individuals who persistently focus on maladaptive thinking after an athletic musculoskeletal lesion tend to be more avoidant and catastrophizers also in other stressful life events, as also found in previous studies [10,13].…”

“…Fear-avoidance beliefs can critically in uence whether a person adjusts to the injury and recovers, or engages in negative behaviors that impede full recovery [4][5][6][7]. Previous studies found fear-avoidance as a barrier to the return to sport, and recommended the need to support athletes in this regard to help them fully recover their activities [8][9][10][11][12][13][14].…”

“…Psychometric testing demonstrated good internal consistency and acceptable concurrent validity, as assessed through established measures of fear-avoidance and catastrophizing [15]. Despite clinical use of this tool in different countries [9,13,16,17], to our knowledge no psychometric validation of the AFAQ in a language other than English has been indexed in PubMed. One of the main reasons for the development of the AFAQ was to create a scale targeted to athletes and on their wavelength, so having the questionnaire in the athlete's rst language would help ensure that the answers truly re ect what the athlete is experiencing.…”

Sex Differences in the Relationship of Hip Strength and Functional Performance to Chronic Ankle Instability Scores

“…This may be related to sex differences in one-leg jump landing strategy and fear of ankle re-sprain . [21,22] Previous studies have shown that in a functional task like single-leg jump landing, females showed a more rigid landing strategy, and female' knee joints absorbed 4.5% more energy than male knee joints, whereas male hip joints absorbed 4.3% more energy than female hip joints. [21] Additionally, females with limited sagittal plane motion during landing exhibit a biomechanical pro le that may put them at greater risk for anterior cruciate ligament injury.…”

“…25 Comparing the ankle instability for individuals of different sexes, results revealed that the ankle instability of female patients was related to fear. [22] Studies have shown that constant fear of injury is a major obstacle to exercise and activity.…”