Development of a valid Chinese version of the Cumberland Ankle Instability Tool in Chinese-speaking patients with chronic ankle instability disorders

Cross cultural adaptation, reliability and validity of the Polish version of the Cumberland Ankle Instability Tool

Purpose: The aim of this study was to develop a Polish version of the Cumberland Ankle Instability Tool (CAIT-PL) questionnaire and perform CAIT-PL cultural adaptation with assessment of its psychometric properties.Methods: The original CAIT was translated into the Polish language using standard guidelines. The CAIT-PL was completed on 2 occasions by 105 participants both with and without a history of ankle sprains. Psychometric evaluation of CAIT-PL included an assessment of internal consistency, test-retest reliability, standard error of measurement, convergent and construct validity.Results: The CAIT-PL was successfully translated and adapted into Polish culture with satisfactory internal consistency (Cronbach's α = 0.83) and adequate test-retest reliability resulting in ICC2,1 = 0.89 (95% CI: 0.84-0.92). Measurement error was low (SEM = 0.76 and MDC = 2.10). Convergent validity of the CAIT-PL ranged from weak to strong using Spearman's correlation coefficient between CAIT-PL and FAOS subscales (r = 0.39-0.67; p < 0.05). Construct validity was confirmed.Conclusion: The Polish version of the Cumberland Ankle Instability Tool is a valid and reliable questionnaire for assessment of functional ankle instability among the Polish population.

Effect of strength training with additional acupuncture on balance, ankle sensation, and isokinetic muscle strength in chronic ankle instability among college students

Purpose: The effects of the combination of strength training and acupuncture on chronic ankle instability have not been studied. This study examined effects of strength training combined with acupuncture on balance ability, ankle motion perception, and muscle strength in chronic ankle instability among college students. Methods: Forty-six chronic ankle instability college students were randomly categorized into the experimental group (n = 24, strength training + acupuncture) and the control group (n = 22, strength training) for an 8-week intervention. Results: For the results at 8 weeks, compared with the baseline, in the experimental group, the chronic Ankle Instability Tool (CAIT) score, ankle dorsiflexion, plantar flex, eversion peak torque (60°/s), and plantar flex peak torque (180°/s) increased by 13.7%, 39.4%, 13.7%, 14.2%, and 12.3%, respectively. Dorsiflexion, plantar flexion, inversion, and eversion kinesthetic sensation test angles decreased by 17.4%, 20.6%, 15.0%, and 17.2%, respectively. Anterior-posterior and medial-lateral displacement, and anterior-posterior and medial-lateral velocity decreased by 28.9%, 31.6%, 33.3%, and 12.4%, respectively. Anterior-posterior and medial-lateral displacement, and anterior-posterior and medial-lateral mean velocity decreased by 28.9%, 31.6%, 33.3%, and 12.4%, respectively. In the control group, the Cumberland Ankle Instability Tool score and the ankle dorsiflexion peak torque (60°/s) increased by 13.8% and 17.9%, respectively. The inversion kinesthetic sensation test angle decreased by 15.2%, whereas anterior-posterior and medial-lateral displacement, and anterior-posterior and medial-lateral mean velocity decreased by 17.1%, 29.4%, 12.3%, and 16.8%, respectively. 2) For the comparison between the groups after 8 weeks, the values of ankle dorsiflexion and plantar flex peak torque (60°/s) in the experimental group were greater than those in the control group. The values of ankle plantar flex kinesthetic sensation test angle, the anterior-posterior displacement, and anterior-posterior mean velocity in the experimental group were lower than those in the control group. Conclusion: Acupuncture treatment in conjunction with muscle strength training can further improve the balance ability of anterior-posterior, ankle dorsiflexion, and plantar flex strength and plantar flex motion perception in chronic ankle instability participants.

Development and Validation of the Companion's Satisfaction Questionnaire of Patient's Hospitalized in Intensive Care Units

Objective

The current study aimed to develop and validate of companions' satisfaction questionnaire of patients hospitalized in ICUs.

Methods

This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability.

Results

In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability.

Conclusion

The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs.

Translation and validation of a simplified Chinese version of the psychosocial assessment tool

BACKGROUND

The Psychosocial Assessment Tool (PAT2.0) is widely used to assess psychosocial risk in families of children with cancer. Our study aims to apply PAT2.0 to Chinese patients and assess the reliability, content validity, and construct validity of the Chinese version.

METHODS

A total of 161 participants completed the study, each with only one child diagnosed with cancer. Psychometric evaluations, including internal consistency, score distribution, test-retest reliability, and construct validity, were conducted.

RESULTS

Cronbach's alpha values ranged from 0.732 to 0.843, indicating good internal consistency. Additionally, intraclass correlation coefficient values ranged from 0.869 to 0.984, indicating excellent test-retest reliability. The Simplified Chinese version of PAT2.0 demonstrated high construct validity in factor analyses and correlations with the General Functioning Subscale of the Family Assessment Device.

CONCLUSION

The translation process of the Chinese version of PAT2.0 was successful, proving its applicability for psychosocial evaluation and interventions in families of children with cancer in China.

Reliability and validation of the Thai version of the Cumberland Ankle Instability Tool (CAIT-THA)

PURPOSE

This study aimed to provide a version of Cumberland Ankle Instability Tool (CAIT) for the Thai younger adult population and examine psychometric properties and determine the cut-off score.

METHODS

CAIT-Youth Thai version was modified to CAIT Thai version (CAIT-THA). To validate the CAIT-THA psychometric properties, 72 with chronic ankle instability (CAI) and 72 without (age 23.45 ± 4.45 years) were recruited. The validation was carried out by using internal consistency (Cronbach's alpha), concurrent validity (Spearman's rank correlation coefficient), discriminative validity (Receiver Operating Characteristic (ROC) curve), and test-retest reliability (intraclass correlation coefficient; ICC). A cut-off score was determined via Youden's index.

RESULTS

Validation showed good internal consistency (Cronbach's alpha = 0.837), and concurrent validity (Spearman's rank correlation coefficient = 0.762 and 0.731 for right ankle and left ankle, respectively). Test-retest reliability was excellent with ICC (2,1) of 0.945 (95% CI = 0.93-0.96). A cut-off score of ≤ 25, determined by ROC curve and Youden's index, was distinguished between participants with and without CAI. CAIT-THA obtained 97.2% sensitivity, 94.4% specificity, 0.03 negative, and 17.5 positive likelihood ratios.

CONCLUSION

CAIT-THA is a validated tool that can be used in Thai younger adults. Clinicians and researchers can confidently use a score of ≤ 25 to determine the presence of CAI.IMPLICATIONS FOR REHABILITATIONThe Cumberland Ankle Instability Tool Thai version (CAIT-THA) questionnaire is available for Thai young adults.The CAIT-THA had high sensitivity, specificity, and positive and negative likelihood cut-off ratio scores for discrimination between chronic ankle instability (CAI) and non-CAI.The CAIT-THA questionnaire may be used in rehabilitation and research settings for the identification and management of CAI conditions.

Acute effects of kinesiology tape on dynamic balance control in chronic ankle instability: An exploratory study

OBJECTIVE

To investigate the acute effect of the four-strip kinesiology taping (KT) technique on dynamic balance control in the Y Balance Test (YBT), and to explore the relationship between the YBT and Cumberland Ankle Instability Tool (CAIT) scores in individuals with and without chronic ankle instability (CAI).

METHODS

16 CAI and 16 non-CAI participants were involved. Two groups completed the YBT in the no-tape barefoot and the KT condition at random. The CAIT was completed on the first day. Bonferroni test was used to analyze YBT scores in three directions for post hoc analysis. Spearman's correlation was used to analyze the relationship between YBT scores in the no-tape barefoot condition and CAIT scores.

RESULTS

This KT application significantly improved YBT performance. The YBT scores in the anterior direction (YBT-A), posteromedial direction (YBT-PM), and posterolateral direction (YBT-PL) for the CAI group were significantly improved after taping. However, in the non-CAI group, only YBT-PM score was significantly improved after taping. Three YBT scores were all moderately correlated with the CAIT score.

CONCLUSION

This KT technique can immediately improve dynamic balance in CAI patients. Dynamic balance performance was moderately related to the degree of self-perceived instability in individuals with and without CAI.

Translation and validation of the simplified Chinese version of the Chronic Pain Coping Inventory-42

BACKGROUND

The Chronic Pain Coping Inventory-42(CPCI-42) is mainly used for chronic pain management project, its original version is written in English and has been widely used in western countries. Therefore, the purpose of our study is to apply the CPCI-42 to Chinese patients and evaluate its responsiveness, reliability, and validity for Chinese patients with lumbar disc herniation (LDH).

METHODS

Translation and adaptation were carried out in accordance with the guidelines of the American Academy of Orthopedic Surgeons Outcome Committee. A total of 133 patients who were diagnosed with LDH were included in this study. Psychometric evaluations were then performed and included score distribution, internal consistency, test-retest reliability, construct validity, and responsiveness.

RESULTS

CPCI-42 is well adapted to the assessment of the cognitive and behavioral strategies of patients with LDH, and the scores of score distribution, internal consistency, test-retest reliability, construct validity, and responsiveness are excellent. Forward and reverse translation of the CPCI-42 to English from Chinese worked smoothly.

CONCLUSION

It is applicable to the assessment of quality of life of the cognitive and behavioral strategies of patients with LDH, and the scores of all indicators are excellent.

Translation and Validation of a Simplified Chinese Version of the Anterior Cruciate Ligament-Quality of Life Questionnaire

Background

The Anterior Cruciate Ligament-Quality of Life (ACL-QOL) questionnaire is a widely used and effective scale for quality of life in patients with chronic anterior cruciate ligament (ACL) injury.

Purpose

To translate and adapt the ACL-QOL questionnaire for Chinese patients and evaluate its reliability, validity, and responsiveness in this population.

Study Design

Cohort study (diagnosis); Level of evidence, 2.

Methods

Translation and adaptation were conducted in accordance with the guidelines of the A merican Academy of Orthopaedic Surgeons Outcome Committee. Included were 121 patients who were diagnosed with a chronic ACL injury and underwent ACL reconstruction between January 2020 and June 2021. Preoperatively, patients completed the simplified Chinese version of the ACL-QOL (ACL-QOL-C), the Knee injury and Osteoarthritis Outcome Score, and the 12-Item Short Form Health Survey. The ACL-QOL-C was also completed at 12- and 24-week follow-ups. Psychometric evaluations were then performed and included score distribution, internal consistency, test-retest reliability, construct validity, and responsiveness.

Results

The Cronbach alpha ranged from .905 to .975, indicating excellent internal consistency, and the intraclass correlation coefficient ranged from 0.864 to 0.985, indicating excellent test-retest reliability. The consistency between the above results and our a priori hypotheses was more than 70% (35/42), indicating good construct validity. The standard error of measurement and effect size of the total score and each item of the ACL-QOL-C were >0.8 at the final follow-up, indicating good responsiveness.

Conclusion

The English version of the ACL-QOL has been successfully translated into Chinese, and it has been shown to be applicable for the assessment of the quality of life in Chinese patients with chronic ACL injury.

Cross-cultural adaptation and validation of the Chinese version of the ankle joint functional assessment tool (AJFAT) questionnaire

BACKGROUND

Ankle joint functional assessment tool (AJFAT) is gradually becoming a popular tool for diagnosing functional ankle instability (FAI). However, due to the lack of standard Chinese versions of AJFAT and reliability and validity tests, the use of AJFAT in the Chinese population is limited. This study aimed to translate and cross-culturally adapt the AJFAT from English into Chinese, and evaluate the reliability and validity of the Chinese version of AJFAT and to investigate its psychometric properties.

METHODS

The translation and cross-cultural adaptation of AJFAT was performed according to guidelines for cross-cultural adaptation of self-report measures. 126 participants with a history of ankle sprain completed the AJFAT-C twice within 14 days and completed the Cumberland ankle instability tool (CAIT-C) once. Test-retest reliability, internal consistency, ceiling and floor effects, convergent and structure validity and discriminative ability were investigated.

RESULTS

The test-retest reliability (ICC = 0.91, 95%CI = 0.87-0.94) and internal consistency (Cronbach's alpha = 0.87) of the AJFAT-C were excellent. No ceiling or floor effects were detected. A moderate correlation between the AJFAT-C and the CAIT-C suggested a moderate convergent validity. The AJFAT-C had a two-factor structure: 1. function of the unstable side of the ankle joint (9 items) and 2. symptoms of the unstable side of the ankle (2 items). The ideal cut-off point of the AJFAT-C was calculated as 26 points.

CONCLUSION

The Chinese version of AJFAT can be considered as a valid and reliable ankle joint function evaluation tool that can be applied in clinical and research work.

Kinesiophobia, self-reported ankle function, and sex are associated with perceived ankle instability in college club sports athletes with chronic ankle instability

OBJECTIVE

To investigate the association between sex, self-reported ankle function, pain intensity, kinesiophobia, and perceived ankle instability in athletes with chronic ankle instability (CAI).

DESIGN

Cross-Sectional Study.

SETTING

University.

PARTICIPANTS

College club sports athletes with CAI (n = 42).

MAIN OUTCOME MEASURES

Relationships with the Cumberland Ankle Instability Tool (CAIT) score and the Tampa Scale for Kinesiophobia-11 (TSK-11), the Foot and Ankle Ability Measure (FAAM), sex (0: male, 1: female), and ankle pain intensity by the Numeric Rating Scale were explored with multiple regression analysis.

RESULTS

The regression model explained 50.3% of the variance of the CAIT score (P < 0.001), and the TSK-11 score (B = -0.382, P = 0.002), the FAAM sports subscale score (B = 0.122, P = 0.038), and sex (B = -2.646, P = 0.031) were significant independent variables for the CAIT score (P < 0.001), while pain intensity was not significant (B = -0.182, P = 0.504). These results indicated that higher TSK-11 score, lower FAAM sports subscale score, and being female were related to lower CAIT score.

CONCLUSIONS

Kinesiophobia related to perceived instability along with self-reported function and sex in athletes with CAI. Clinicians should assess the psychological aspects of athletes with CAI.

The Prevalence and Characteristics of Chronic Ankle Instability in Elite Athletes of Different Sports: A Cross-Sectional Study

BACKGROUND

Ankle sprains are one of the most common injuries in athletic populations. Misdiagnosed and untreated ankle sprains will cause chronic ankle instability (CAI), which can significantly affect the performance of athletes. This study aimed to investigate the prevalence and characteristics of CAI in elite athletes of different sports.

METHOD

This cross-sectional study included 198 elite athletes from Guangdong provincial sports teams. All participants answered a questionnaire about ankle sprains and ankle instability. The severity of their ankle instability was evaluated by the Cumberland Ankle Instability Tool (CAIT). Participants further underwent clinical examinations from sports medicine doctors to determine the presence and characteristics of ankle instability. The datasets were analyzed to determine the differences in prevalence between age, gender, sports teams, and sports categories.

RESULTS

In 198 athletes, 39.4% (n = 78) had bilateral CAI while 25.3% (n = 50) had unilateral CAI. Female athletes had a higher prevalence of CAI than male athletes in the study (p = 0.01). Prevalence showed differences between sports categories, and were significantly higher in acrobatic athletes than non-contact athletes (p = 0.03).

CONCLUSIONS

CAI was highly prevalent among elite athletes in this study, with female athletes and athletes in acrobatic sports being associated with a higher risk of developing CAI in their professional careers. Therefore, extra precautions need to be taken into account when applying ankle protections for these athletes.