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Related Concept Videos

Ankle Joint01:10

Ankle Joint

1.9K
The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
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Discrimination Between Mechanical and Functional Ankle Instability, and Copers: A Questionnaire-Based Analysis.

Dong Wook Lee1, Se Jong Kim1,2, Jiho Kang3

  • 1Department of Physical Education, Yonsei University, Seoul, Republic of Korea.

Journal of Sport Rehabilitation
|August 11, 2025
PubMed
Summary

This study differentiates chronic ankle instability (CAI) subtypes using validated questionnaires, establishing cutoff scores for mechanical ankle instability, functional ankle instability (FAI), and Copers. These findings aid in clinical decision-making and rehabilitation planning for ankle injuries.

Keywords:
chronic ankle instabilitymechanical ankle instabilitysurgical indicationtreatment criteria

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Area of Science:

  • Sports Medicine
  • Orthopedics
  • Rehabilitation Science

Background:

  • Chronic ankle instability (CAI) encompasses diverse patient subgroups with varying functional deficits.
  • Accurate classification of CAI subtypes, including mechanical ankle instability, functional ankle instability (FAI), and Copers, is crucial for effective management.
  • Existing classification methods may lack standardization, necessitating validated tools for precise differentiation.

Purpose of the Study:

  • To differentiate subgroups of chronic ankle instability (CAI), functional ankle instability (FAI), Copers, and healthy controls using a validated questionnaire set.
  • To establish a standardized scoring system for classifying CAI subtypes, Copers, and control participants.
  • To explore the utility of the Cumberland Ankle Instability Tool (CAIT), Identification of Functional Ankle Instability (IdFAI), and Ankle Instability Instrument (AII) in this classification.

Main Methods:

  • A case-control study involving 104 participants: 26 mechanical ankle instability, 26 functional ankle instability, 26 Copers, and 26 healthy controls.
  • Utilized a validated questionnaire set including CAIT, IdFAI, AII, and FAAM (Foot and Ankle Ability Measurement) for both ADL and Sports subscales.
  • Employed Kruskal-Wallis and Mann-Whitney tests for analysis, with Receiver Operating Characteristic (ROC) curves to confirm cutoff values.

Main Results:

  • Significant differences were found across CAI, Copers, and control groups for CAIT, IdFAI, AII, FAAM/ADL, and FAAM/Sports scores (P < .001 for all).
  • Established specific cutoff values for CAIT: 0-8.5 (mechanical ankle instability), 8.6-23 (FAI), 24-29.5 (Copers), and 29.6-30 (controls).
  • Validated these cutoff values using ROC curve analysis, confirming their utility in differentiating the groups.

Conclusions:

  • The CAIT, IdFAI, and AII are effective tools for classifying CAI subtypes and identifying Copers.
  • Questionnaire-based cutoff values provide valuable data for rehabilitation planning and clinical decision-making in CAI management.
  • A CAIT score below 8.5 may suggest the need for surgical consideration, contingent upon comprehensive clinical assessment.