Clinical tests have limited predictive value for Chronic Ankle Instability when conducted in the acute phase of a first-time lateral ankle sprain injury

Publication date: Available online 21 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Cailbhe Doherty, Chris Bleakley, Jay Hertel, Brian Caulfield, John Ryan, Eamonn Delahunt
ObjectiveTo evaluate whether a battery of clinical assessments for acute lateral ankle sprain (LAS) can be used to predict long-term recovery.DesignCohort studySettingUniversity biomechanics laboratoryParticipantsEighty-two individuals were assessed using a clinical test battery within two-weeks of incurring a first-time LAS.Main Outcome MeasuresThe clinical test battery included scores on the 'talar-glide' (deg), anterior-drawer, talar-tilt, figure-of-eight [figure8] for swelling (mm), knee-to-wall (mm) and hand-held goniometric range-of-motion [inversion; eversion; plantar-flexion (in degrees)]. Scores on the the Cumberland Ankle Instability Tool (CAIT) taken 12-months after the clinical test battery were used to classify participants as having Chronic Ankle Instability (CAI) or as being LAS 'copers'ResultsForty percent of participants were designated as having CAI with 60% being designated as LAS copers. A logistic regression analysis revealed that a combined model using scores from the talar-glide, talar-tilt and anterior-drawer tests in addition to plantar-flexion ROM was statistically significant (p <0.01) and correctly classified cases with moderate accuracy (68.8%). The final model had moderate sensitivity (64%) and good specificity (72%).ConclusionsThe clinical tests utilised in this investigation have limited predictive value for CAI when conducted in the acute phase of a first-time lateral ankle sprain injury.



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