Reliability and Recalibration of the Persian Version of Cumberland Ankle Instability Tool Cut-off Score in Athletes with Functional Ankle Instability
Introduction: The Cumberland Ankle Instability Tool (CAIT) is a valid instrument for determining the presence and severity of functional ankle instability. This questionnaire was recently cross-culturally adapted into Persian; however, the reliability of the Persian version has not been examined in athletes. CAIT has also been used with various independently-selected cut-off scores to determine instability. Objective: The present study was conducted to evaluate the psychometric properties of the Persian version of CAIT and to determine its optimal cut-off score in athletic populations. Method: One-hundred and sixteen athletes (volleyball, basketball and track and field players) over 18 years old both with and without ankle instability completed the Persian version of the CAIT. The internal consistency, test-retest reliability and discriminative ability of the tool were assessed. A receiver operating characteristic (ROC) curve was drawn to confirm the cut-off point of the Persian version of CAIT using the Youden index. Results: The average CAIT score was 25.14±4.98 for the right and 25.76±4.94 for the left ankle. The Persian version of CAIT had a good internal consistency (Cronbach's α of 0.78 for the right ankle and 0.79 for the left ankle) and substantial reliability (ICC2, 1 = 0.88; 95% CI: 0.86 – 0.90) in athletes. No ceiling or floor effects were observed. The optimal cut-off score for discriminating between athletes with and without FAI was 24. Conclusion: The Persian version of CAIT was shown to be a reliable tool for assessing functional ankle instability among Iranian athletes.
2. Cruz-Díaz D, Hita-Contreras F, Lomas-Vega R, Osuna-Perez M.C, Martinez-Amat A. Cross-cultural adaptation and validation of the Spanish version of the Cumberland Ankle Instability Tool (CAIT): an instrument to assess unilateral chronic ankle instability. Clin Rheumatol. 2013;32(1):91-8.
3. Ho Y-H, Lin C-F, Chang C-H, Wu H-W. Effect of ankle kinesio taping on vertical jump with run-up and countermovement jump in athletes with ankle functional instability. J Phys Ther Sci. 2015;27(7):2087-90.
4. Hiller CE, Refshauge KM, Bundy AC, Herbert RD, Kilbreath SL. The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil. 2006;87(9):1235-41.
5. Wright CJ, Arnold BL, Ross SE, Linens SW. Recalibration and validation of the cumberland ankle instability tool cutoff score for individuals with chronic ankle instability. Arch Phys Med Rehabil. 2014;95(10):1853-9.
6. De Noronha M, Refshauge KM, Crosbie J, Kilbreath SL. Relationship between functional ankle instability and postural control. J Orthop Sports Phys Ther. 2008;38(12):782-9.
7. De Noronha M, Refshauge KM, Kilbreath SL, Crosbie J. Loss of proprioception or motor control is not related to functional ankle instability: an observational study. Aust J Physiother. 2007;53(3):193-8.
8. Kunugi S, Masunari A, Noh B, Mori T, Yoshida N, Miyakawa S. Cross-cultural adaptation, reliability, and validity of the Japanese version of the Cumberland ankle instability tool. Disabil Rehabil. 2017;39(1):50-8.
9. De Noronha M, Refshauge KM, Kilbreath SL, Figueiredo VG. Cross-cultural adaptation of the Brazilian-Portuguese version of the Cumberland Ankle Instability Tool (CAIT). Disabil Rehabil. 2008;30(26):1959-65.
10. Hadadi M, Ebrahimi Takamjani I, Ebrahim Mosavi M, Aminian G, Fardipour S, Abbasi F. Cross-cultural adaptation, reliability, and validity of the Persian version of the Cumberland Ankle Instability Tool. Disabil Rehabil. 2017;39(16):1644-9.
11. Haji-Maghsoudi M, Naseri N, Nouri-Zadeh S, Jalayi S. Evidence of Reliability for Persian Version of the “Cumberland Ankle Instability Tool (CAIT)” in Iranian Athletes with lateral Ankle Sprain. J Rehabil. 2016;16(4):304-11.
12. Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med. 2014;48(13):1014-8.
13. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J. Quality criteria were proposed for measurement properties of health status questionnaires. J clin Epidemiol. 2007;60(1):34-42.
14. Hiller CE, Refshauge KM, Herbert RD, Kilbreath SL. Balance and recovery from a perturbation are impaired in people with functional ankle instability. Clin J Sport Med. 2007;17(4):269-75.
15. Sawkins K. Refshauge K, Kilbreath S, Raymond J.The placebo effect of ankle taping on ankle instability. Med Sci Sports Exerc. 2007;39(5):781-7.
16. Sesma AR, Mattacola CG, Uhl TL, Nitz AJ, McKoen PO. Effect of foot orthotics on single-and double-limb dynamic balance tasks in patients with chronic ankle instability. Foot Ankle Spec. 2008;1(6):330-7.
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