Developing a framework for ankle function: a delphi study.

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Clinical outcomes after ankle injuries lack consensus on appropriate assessment.
• Repetitive lateral ankle sprains lead to functional ankle instability (FAI) or chronic ankle instability (CAI).
• FAI and CAI are inconsistently defined and assessed in practice and research.

Purpose of the Study:

• To establish consensus definitions for a healthy/normal/noninjured ankle, FAI, and CAI.
• To define the characteristics and assessment techniques for these ankle conditions.

Main Methods:

• A Delphi study involving 16 experts in ankle function, treatment, and research.
• Data collection via telephone interviews and electronic surveys.
• Consensus defined as 80% agreement among experts.

Main Results:

• Consensus was reached on definitions for a healthy/normal/noninjured ankle and FAI.
• Experts agreed on 11 characteristics for a healthy ankle, 32 for an unhealthy ankle, and 13 for FAI.
• No consensus was achieved on a definition or characteristics for CAI.

Conclusions:

• Definitions and characteristics for a healthy ankle and FAI were established, though FAI definition had limited agreed-upon characteristics.
• Experts could not agree on a definition or characteristics for CAI.
• Findings represent progress toward standardizing terminology and assessment for ankle instability.