Evaluation of the Cumberland Ankle Instability Tool as a predictor of ankle re-injury in collegiate athletes
Date
2015
Authors
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Publisher
University of Delaware
Abstract
Context: Lateral ankle sprains (LAS) are one of the most commonly occurring injuries amongst the athletic population, with as high as 70% suffering from residual symptoms and going on to develop chronic ankle instability (CAI). The Cumberland Ankle Instability Tool (CAIT) has been proposed to detect the presence and severity of CAI; yet its use as a predictor of future ankle sprains has not been examined. Objective: The primary purpose of this study was to evaluate the CAIT as a predictor of ankle re-injury following one or more LAS in a group of collegiate athletes over time. Design: Cross-sectional survey design. Setting: All participants were asked to complete a follow-up CAIT and Ankle History Questionnaire electronically at their own convenience. Patients or Other Participants: A total of 40 male and 26 female student-athletes from an NCAA Division I institution participated in this study. Main Outcome Measures: All follow-up CAIT scores were distributed and collected electronically via Qualtrics Survey Software. Self-report injury history was cross-referenced manually with official documentation through the University's sports medicine department. Sensitivity and specificity were both calculated using an online software program. A Spearman rank correlation was used to assess the relationship between initial and follow-up CAIT scores over time in addition to the relationship between initial CAIT score and the number of subsequent re-injuries that followed. Results: Overall, sensitivity was much higher when using a CAIT cut-off score of ≤27, while specificity was much higher with a cut-off score of ≤25. A strong relationship was seen between initial CAIT and follow-up CAIT scores within groups and across all subjects (r=.492; p<.001). A slightly higher correlation was seen between initial CAIT score and number of subsequent re-injuries when using self-report of injury (r=.267; p=.010) as compared to an official documentation method of reporting (r=.245; p=.018). Conclusions: The CAIT was not a good predictor of ankle re-injury in this cohort of collegiate athletes. A positive relationship was seen between self-report and official documentation methods of previous injury history, suggesting an accurate recall of injuries through self-report. Initial and follow-up CAIT scores were found to have a strong relationship, suggesting a potential lasting effect of CAIT scores. These results warrant future research examining the various methods of reporting of injury history, as well as further analysis of internal reliability and consistency of CAIT questions in an effort to better refine the instrument for use as an ankle re-injury predictor.