Health-Related Quality of Life in Individuals With Chronic Ankle Instability

Abstract

Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is required to determine the extent to which CAI influences the multidimensional profile of health-related quality of life.Objective: To determine whether global, regional, and psychological health-related outcomes differ between individuals with and without CAI.Design: Case-control study. Setting: Laboratory.Patients or Other Participants: Twenty-five participants with CAI (age ¼ 21.9 6 2.5 years, height ¼ 170.8 6 8.6 cm, mass ¼ 69.8.0 6 11.7 kg) were sex-and limb-matched to 25 healthy participants (age ¼ 22.0 6 2.1 years, height ¼ 167.4 6 9.1 cm, mass ¼ 64.8 6 11.2 kg).Main Outcome Measure(s): Both groups completed the Disablement in the Physically Active Scale, the Foot and Ankle Ability Measure (FAAM), the FAAM-Sport, the Tampa Scale of Kinesiophobia-11, and the Fear-Avoidance Beliefs Questionnaire. Dependent variables were scores on these instruments, and the independent variable was group.Results: Compared with healthy individuals, those with CAI reported decreased function on the Disablement in the Physically Active Scale, FAAM, and FAAM-Sport (P , .001) and increased fear of reinjury on the Tampa Scale of Kinesiophobia-11 and Fear-Avoidance Beliefs Questionnaire (P , .001). In the CAI group, the FAAM and FAAM-Sport demonstrated a significant relationship (r ¼ 0.774, P , .01).Conclusions: Individuals with CAI reported decreased function and increased fear of reinjury compared with healthy control participants. Also, within the CAI group, there was a strong relationship between FAAM and FAAM-Sport scores but not between any other instruments. These findings suggest that health-related quality of life should be examined during the rehabilitation process of individuals with CAI.Key Words: ankle sprains, impairment, fear of reinjury, psychology Key PointsIndividuals with chronic ankle instability reported global, regional, and psychological health-related quality-of-life deficits compared with healthy control participants. Functional deficits and psychological barriers reported by the patient should be taken into consideration when clinicians treat individuals with chronic ankle instability.

Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains

“…In a systematic review, this group concluded that patients with CAI demonstrated disability and deficits in function on ankle-specific patient-reported outcome measures, as well as generic health-related QOL outcome measures compared with non-injured and LAS coper populations 193. In their own case–control study, this group reported that individuals with CAI displayed decreased function using the Disablement in the Physically Active Scale, while simultaneously displaying increased levels of fear of injury using the Fear-Avoidance Beliefs Questionnaire and the Tampa Scale of Kinesiophobia 190. Additionally, this group has demonstrated that the ankle-specific disability measures can be explained with physical and functional clinical measures, such as balance, strength or ROM 192.…”

“…Houston et al 190 192 193 also have considered the effect of ankle injury history on QOL, and what factors might help explain this decline. In a systematic review, this group concluded that patients with CAI demonstrated disability and deficits in function on ankle-specific patient-reported outcome measures, as well as generic health-related QOL outcome measures compared with non-injured and LAS coper populations 193.…”

“…The work described by Houston et al 190 192 193 illustrates that the degradation in QOL occurs as patients with LAS downgrade into CAI populations. Alarmingly, this is being observed in young adult patients under the age of 30 years.…”

Interrater and intrarater reliability of the semmes-weinstein monofilament 4-2-1 stepping algorithm

“…Lower extremity injuries are responsible for up to 70% of the time lost from athletic participation, and knee and ankle sprains encompass a large percentage of the injuries . While lower extremity injuries typically have an immediate impact on function, they often lead to repetitive injury, recurrent instability, and decreased health‐related quality of life which can have long term negative implications . Therefore, lower extremity injuries are common, and understanding the contributing factors to residual problems following these injuries continues to be an important area of research.…”

Acute Lateral Ankle Sprain Prediction in Collegiate Women's Soccer Players

“…3 Lateral ankle sprain (LAS) is the most commonly reported injury resulting in 10 or more days of activity loss in collegiate women's soccer. 2 Along with time loss, there is added concern for recurrent injury, 4 impaired neuromuscular control, [5][6][7] decreased physical activity, 7,8 decreased health-related quality of life, 8 and posttraumatic osteoarthritis 9 in individuals with a history of LAS.…”