Download PDF
Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2020; 30(04): 230-236
DOI: 10.1055/a-1128-6424
Original Article

Comparison of Health-Related Quality of Life in Different Types of Chronic Ankle Instability

Vergleich der gesundheitsbezogenen Lebensqualität bei verschiedenen Arten chronischer Sprunggelenksinstabilitäten
Mohammad Hadadi
1   Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Iran
2   Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Farzaneh Heghighat
3   Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
,
Iman Hossein
3   Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
› Author Affiliations Financial support: This work was supported by Shiraz University of Medical Sciences (grant number 1396–01–51–14895).
› Further Information
Also available at
    Permissions and Reprints

Abstract

Introduction People with chronic ankle instability (CAI) have decreased health-related quality of life (HRQOL), but the differences in HRQOL status between subgroups of CAI have not been determined. This observational, cross-sectional study aimed to evaluate and compare physical, social and psychological aspects of HRQOL in subgroups of patients with CAI.

Methods Ninety patients with CAI and 30 healthy participants were included. The patients were assigned to 3 subgroups with functional ankle instability (FAI), mechanical ankle instability (MAI), or mixed functional and mechanical instability (MIX), based on the talar tilt test, anterior drawer test, and Cumberland Ankle Instability Tool score. Participants completed the self-assessed Foot and Ankle Ability Measure (FAAM), Tampa Scale of Kinesophobia-11 (TSK-11), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short-Form Health Survey (SF‑36).

Results Significant differences were observed between healthy participants and each CAI subgroup in regional (FAAM), psychological (TSK-11 and FABQ) and global (SF-36) measures (p<0,05). The MIX subgroup had a significantly lower score on the FAAM-sport component, and a higher score on the TSK-11 and FABQ (p<0,05), than the FAI subgroup. There were no diffirences between other CAI subgroups in quality of life measures.

Conclusions Patients with MAI and FAI had similar functional deficits in activities of daily living and sport activities, and greater fear of re-injury. The MIX subgroup had greater deficits in sport activities and greater fear of re-injury than the FAI subgroup.

Zusammenfassung

Einführung Menschen mit chronischer Sprunggelenkinstabilität (CAI) haben die gesundheitsbezogene Lebensqualität (HRQOL) verringert, die Unterschiede im HRQOL-Status zwischen den Untergruppen der CAI wurden jedoch nicht festgestellt. Diese beobachtende Querschnittsstudie zielte darauf ab, physische, soziale und psychologische Aspekte von HRQOL in Untergruppen von Patienten mit CAI zu bewerten und zu vergleichen.

Methoden Neunzig Patienten mit CAI und 30 gesunden Teilnehmern wurden eingeschlossen. Die Patienten wurden drei Untergruppen mit funktioneller Knöchelinstabilität (FAI), mechanischer Knöchelinstabilität (MAI) oder gemischter funktioneller und mechanischer Instabilität (MIX) zugeordnet, basierend auf dem Talar-Tilt-Test, dem vorderen Schubladentest und dem Cumberland-Knöchelinstabilitäts Tool Score. Messung der Leistungsfähigkeit von Fuß und Sprunggelenk (FAAM), De Tampa schaal voor Kinesiofobie-11 (TSK-11), de Fear Avoidance Beliefs Questionnaire (FABQ) und Der Short-Form-36 Health Survey (SF-36).

Ergebnisse Signifikante Unterschiede zwischen gesunden Teilnehmern und jeder CAI-Untergruppe wurden in regionalen (FAAM), psychologischen (TSK-11 und FABQ) und globalen (SF-36) Bewertungsskalen beobachtet (p<0,05). Die MIX-Untergruppe hatte einen signifikant niedrigeren Wert für die FAAM-Sport-Komponente und einen höheren Wert für die TSK-11 und FABQ (p<0,05) als die FAI-Untergruppe. Es gab keine Unterschiede zwischen anderen CAI-Untergruppen in Bezug auf die Lebensqualität.

Schlussfolgerungen Patienten mit MAI und FAI hatten ähnliche funktionelle Defizite bei Aktivitäten des täglichen Lebens und bei sportlichen Aktivitäten und größere Angst vor einer erneuten Verletzung. Die MIX-Untergruppe wies größere Defizite bei sportlichen Aktivitäten und größere Angst vor erneuten Verletzungen auf als die FAI-Untergruppe.

Key words

Chronic ankle instability - Mechanical ankle instability - Functional ankle instability - Health-related quality of life

Schlüsselwörter

Chronische Sprunggelenksinstabilität - Mechanische Sprunggelenksinstabilität - Funktionelle Sprunggelenksinstabilität, Gesundheitsbezogene Lebensqualität


Publication History

Received: 30 October 2019

Accepted: 28 February 2020

Article published online:
19 March 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Powden CJ. Response Shift and Functional Outcomes in Individuals with Chronic Ankle Instability. Doctor of Philosophy (PhD), dissertation, Health Services Research, Old Dominion University. 2016
    PubMedGoogle Scholar
  • 2 Konradsen L, Bech L, Ehrenbjerg M. et al. Seven years follow-up after ankle inversion trauma. Scand J Med Sci Sports 2002; 12: 129-135
    CrossrefPubMedGoogle Scholar
  • 3 Valderrabano V, Hintermann B, Horisberger M. et al. Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med 2006; 34: 612-620
    CrossrefPubMedGoogle Scholar
  • 4 Hubbard-Turner T, Turner MJ. Physical activity levels in college students with chronic ankle instability. J Athl Train 2015; 50: 742-747
    CrossrefPubMedGoogle Scholar
  • 5 Houston MN, Van Lunen BL, Hoch MC. Health-related quality of life in individuals with chronic ankle instability. J Athl Train 2014; 49: 758-763
    CrossrefPubMedGoogle Scholar
  • 6 Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 2002; 37: 364
    PubMedGoogle Scholar
  • 7 Organization WH. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001
    Google Scholar
  • 8 Snyder AR, Valovich McLeod TC. Selecting patient-based outcome measures. Athl Ther Today 2007; 12: 12-15
    CrossrefPubMedGoogle Scholar
  • 9 Snyder AR, Parsons JT, Valovich McLeod TC. et al. Using disablement models and clinical outcomes assessment to enable evidence-based athletic training practice, part I: disablement models. J Athl Train 2008; 43: 428-436
    CrossrefPubMedGoogle Scholar
  • 10 Houston MN, Hoch JM, Hoch MC. Patient-reported outcome measures in individuals with chronic ankle instability: a systematic review. J Athl Train 2015; 50: 1019-1033
    CrossrefPubMedGoogle Scholar
  • 11 Arnold BL, Wright CJ, Ross SE. Functional ankle instability and health-related quality of life. In: National Athletic Trainers’ Association, Inc. 2011
    PubMedGoogle Scholar
  • 12 Wikstrom EA. Fear of re-injury does not differ between those with and without chronic ankle instability. J Sports Sci Med 2011; 10: 771
    PubMedGoogle Scholar
  • 13 Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train 2011; 46: 133-141
    CrossrefPubMedGoogle Scholar
  • 14 Terada M, Bowker S, Hiller C. et al. Quantifying levels of function between different subgroups of chronic ankle instability. Scand J Med Sci Sports 2017; 27: 650-660
    CrossrefPubMedGoogle Scholar
  • 15 Wexler R. The injured ankle. American Family Physician 1998; 57: 474-480
    PubMedGoogle Scholar
  • 16 Gribble PA, Delahunt E, Bleakley C. et al Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J Orthop Sports Phys Ther 2018; 585-591
    PubMedGoogle Scholar
  • 17 Martin RL, Irrgang JJ, Burdett RG. et al. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int 2005; 26: 968-983
    CrossrefPubMedGoogle Scholar
  • 18 Woby SR, Roach NK, Urmston M. et al. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain 2005; 117: 137-144
    CrossrefPubMedGoogle Scholar
  • 19 Waddell G, Newton M, Henderson I. et al. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993; 52: 157-168
    CrossrefPubMedGoogle Scholar
  • 20 Baumhauer JF, Alosa DM, Renström PA. et al. A prospective study of ankle injury risk factors. The Am J Sports Med 1995; 23: 564-570
    CrossrefPubMedGoogle Scholar
  • 21 McHorney CA, Ware Jr JE, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 247-263
    CrossrefPubMedGoogle Scholar
  • 22 Hiller CE, Refshauge KM, Bundy AC. et al. The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil 2006; 87: 1235-1241
    CrossrefPubMedGoogle Scholar
  • 23 Jacob T, Baras M, Zeev A. et al. Low back pain: reliability of a set of pain measurement tools. Arch Phys Med Rehabil 2001; 82: 735-742
    CrossrefPubMedGoogle Scholar
  • 24 Hadadi M, Ebrahimi Takamjani I, Ebrahim Mosavi M. et al. Cross-cultural adaptation, reliability, and validity of the Persian version of the Cumberland Ankle Instability Tool. Disabil Rehabil 2017; 39: 1644-1649
    CrossrefPubMedGoogle Scholar
  • 25 Mazaheri M, Salavati M, Negahban H. et al. Reliability and validity of the Persian version of Foot and Ankle Ability Measure (FAAM) to measure functional limitations in patients with foot and ankle disorders. Osteoarthritis Cartilage 2010; 18: 755-759
    CrossrefPubMedGoogle Scholar
  • 26 Askary-Ashtiani A, Ebrahimi-Takamejani I, Torkaman G. et al. Reliability and validity of the persian versions of the fear avoidance beliefs questionnaire and tampa scale of kinesiophobia in patients with neck pain. Spine 2014; 39: E1095-E1102
    CrossrefPubMedGoogle Scholar
  • 27 Montazeri A, Goshtasebi A, Vahdaninia M. et al. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of Life Research 2005; 14: 875-882
    CrossrefPubMedGoogle Scholar
  • 28 Croy T, Saliba S, Saliba E. et al. Differences in lateral ankle laxity measured via stress ultrasonography in individuals with chronic ankle instability, ankle sprain copers, and healthy individuals. J Orthop Sports Phys Ther 2012; 42: 593-600
    CrossrefPubMedGoogle Scholar
  • 29 Plante JE, Wikstrom EA. Differences in clinician-oriented outcomes among controls, copers, and chronic ankle instability groups. Phys Ther Sport 2013; 14: 221-226
    CrossrefPubMedGoogle Scholar
  • 30 Wikstrom EA, Tillman MD, Chmielewski TL. et al. Self-assessed disability and functional performance in individuals with and without ankle instability: a case control study. J Orthop Sports Phys Ther 2009; 39: 458-467
    CrossrefPubMedGoogle Scholar
  • 31 Wright CJ, Arnold BL, Ross SE. et al. Clinical examination results in individuals with functional ankle instability and ankle-sprain copers. J Athletic Train 2013; 48: 581-589
    CrossrefPubMedGoogle Scholar
  • 32 Brown C, Padua D, Marshall SW. et al. Individuals with mechanical ankle instability exhibit different motion patterns than those with functional ankle instability and ankle sprain copers. Clin biomech 2008; 23: 822-831
    CrossrefPubMedGoogle Scholar