Quality of life, function and disability in individuals with chronic ankle symptoms: a cross‐sectional online survey

Abstract

Background Chronic ankle conditions affect approximately 20% of Australian adults. Although there is a plethora of research on chronic hip and knee conditions, there is limited understanding of the impact of ankle problems. Thus, the significance of chronic ankle conditions is not clear. The aim of this study was to compare self-reported function, disability, instability, physical activity and quality of life (QoL) between adults with and without ankle symptoms. A secondary aim was to explore factors associated with QoL. Method Individuals with symptoms of ankle pain and stiffness (symptomatic individuals) and controls with no ankle pain or stiffness (asymptomatic individuals) completed a cross-sectional online survey. The survey included the Ankle Osteoarthritis Scale (AOS), Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), International Physical Activity Questionnaire (IPAQ), Assessment of QoL (AQoL-6D), and questions about ankle injury history. Results A total of 394 individuals (270 symptomatic and 124 asymptomatic) with mean age of 48.8 (standard deviation (SD): 12.1) years and body mass index of 28.7 (7.7) kgm− 2 completed the survey. Standardized mean differences (SMD) were large to very large (1.45 to 3.20) for greater disability (AOS) and instability (CAIT), and poorer function (FAAM) in symptomatic compared to asymptomatic individuals. Individuals with ankle symptoms had higher body mass index and lower QoL (medium effect: SMD > 1). There were no differences in self-report physical activity between groups. Lower activities of daily living (ADL) function (FAAM-ADL) best explained QoL in a multiple regression model (R2 = 0.66, p = 0.001). Conclusion Individuals with ankle symptoms reported ankle instability, greater disability, compromised function and worse QoL compared to asymptomatic individuals. There was a strong relationship between ankle function and QoL. Ankle-specific ability during ADL best explained the reduced QoL in individuals with ankle symptoms. Clinicians and researchers should consider ankle function as an antecedent to poorer QoL in patients who have ankle symptoms.

Cognition and Pain: A Review

“…Although chronic pain has long been shown to alter cognitive outcomes, emerging studies over the past decade have drawn particular attention to the multi-dimensional effects of pain on various cognitive domains (Nadar et al, 2016). Apart from the psycho-social influences of pain, it can also impact the functional domains and the quality of life in general (Al Mahrouqi et al, 2020). Further, chronic pain's economic impact costs $635 billion annually in direct medical costs, loss of productivity, and disability programs (Barrett et al, 2020).…”

Exploring the Relationship between Physical Activities and Health-Related Factors in the Health-Related Quality of Life among People with Disability in Korea

“…Studies on HRQoL for disabled people included: exploring factors that affect the lives of patients with specific diseases (e.g., strokes, schizophrenia, psoriasis, musculoskeletal pain, heart failure, multiple sclerosis, etc.) [33][34][35][36][37], older adults [38], specific patients (e.g., multiple sclerosis and chronic ankle symptom) and people with disabilities [39][40][41][42][43]; or exploring the extent of changes in HRQoL brought about by exercises or other interventions [38,44,45]. Studies on the HRQoL of disabled people, based on health-related factors (e.g., health behaviors such as drinking and smoking, degree of chronic disease, exercise participation, and health-related entities that affect HRQoL) were insufficient or lacking.…”

Association between early intensive care or coronary care unit admission and post-discharge performance of activities of daily living in patients with acute decompensated heart failure

“…Post-ADL of ADHF patients is closely related to short-and long-term mortality and readmission [24], and improvement in ADL levels leads to lower mortality in patients with impaired ADL at baseline [17]. No report has precisely described the minimal clinically important difference for heart failure patients while in stroke patients, it has been estimated to be 1.85 points [25]; therefore, a post-ADL difference between the ICU and GW groups of 6.7 points can be strongly considered as a clinically important difference with a notable impact on patient prognosis [14].…”

“…However, ADHF has a substantial impact on activities of daily living (ADL), and ADL performance levels at discharge (post-ADL) can provide additional prognostic value for long-term mortality and readmission [10][11][12]. In addition, as ADL level is closely related to the quality of life [13,14], the recovery of ADL is a significant goal for the social well-being of ADHF patients. Rapid recovery from ADHF via early intensive therapy might contribute to ADL recovery.…”