Discriminating between copers and people with chronic ankle instability

Area of Science:

• Sports Medicine
• Orthopedics
• Rehabilitation Science

Background:

• Chronic ankle instability (CAI) and ankle sprains without residual symptoms (copers) exhibit distinct outcome measure differences.
• The diagnostic utility of these outcome measures in predicting CAI development is underexplored.
• Identifying predictive measures can refine rehabilitation and improve outcome assessment efficiency.

Purpose of the Study:

• To evaluate the diagnostic utility and establish cutoff scores for perceptual, mechanical, and sensorimotor measures in differentiating copers from individuals with CAI.
• Utilize receiver operating characteristic (ROC) curves to determine diagnostic accuracy.

Main Methods:

• A case-control study was conducted in a sports medicine research laboratory.
• Participants included 24 copers and 24 individuals with CAI, matched for sex.
• Outcome measures comprised self-reported disability questionnaires (Foot and Ankle Disability Index [FADI], FADI-Sport), radiographic assessment of talar position, and a single-legged hop stabilization test for sensorimotor evaluation.

Main Results:

• Perceptual outcomes, particularly self-assessed disability questionnaires, demonstrated high diagnostic accuracy (0.79–0.91).
• Sensorimotor outcomes showed moderate diagnostic accuracy (0.69–0.70) in discriminating between groups.
• Mechanical assessment of talar position yielded poor diagnostic accuracy (0.52).

Conclusions:

• Self-assessed disability questionnaires possess the highest diagnostic utility for predicting individuals who will become copers post-ankle injury.
• Perceptual outcomes are most effective in identifying individuals with a favorable recovery trajectory.
• The multifactorial nature of CAI is suggested by the diverse measures distinguishing copers from those with instability.