Related Experiment Video
Updated: Aug 6, 2026
Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
The Test-Retest Association Between Perceived Ankle Instability and Lower-Limb Proprioception Measures
Jeremy Witchalls1, Michal Shenhar2, Gordon Waddington1
1Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT, Australia.
Context:
To examine the association between unilateral and bilateral perceived ankle instability and proprioceptive acuity and the stability of the measures over a time period of 1 week.
Design:
Repeated-measures study.
Methods:
We categorized 134 physical education students into "no," "unilateral," or "bilateral" perceived ankle instability groups based on Cumberland Ankle Instability Tool (CAIT) scores and assessed ankle proprioception using Active Movement Extent Discrimination Assessment for each leg at 2 time points (T1 and T2) 1 week apart. The lower limbs for each participant were identified as "more unstable" for the lower CAIT score and "less unstable" for the leg with the higher CAIT score.
Results:
Two-way analysis of variance showed significant main instability effect (P < .001), with the bilateral group demonstrating the lowest proprioceptive acuity overall. In the more unstable leg, the no instability group scored significantly higher than the unilateral instability (mean difference [MD]: 0.043; 95% CI, 0.015 to 0.071) and bilateral instability groups (MD: 0.059; 95% CI, 0.024 to 0.094). In the less unstable leg, the no instability group performed better than the bilateral instability group (MD: 0.057; 95% CI, 0.022 to 0.091), whereas there was no significant difference versus the unilateral instability group (MD: 0.019; 95% CI, -0.009 to 0.047). A significant main time effect (P = .019 less unstable leg; P = .034 more unstable leg) showed a mean improvement of 0.015 in both limbs upon retesting.
Conclusion:
We found a significant association between bilateral perceived ankle instability and reduced proprioceptive acuity in both legs. The lack of variance between the less unstable and the more unstable legs in either group suggests that these deficits are not localized to a peripheral joint. Consequently, rehabilitation strategies should consider a holistic, bilateral approach, addressing both ankles regardless of which side is perceived as unstable.
