Emily A Hall1, Andrea K Chomistek2, Jackie J Kingma3, Carrie L Docherty3. 1. Department of Orthopaedics and Sports Medicine, Morsani College of Medicine, University of South Florida, Tampa; Departments of. 2. Biostatistics and Epidemiology. 3. Kinesiology, School of Public Health, Indiana University, Bloomington.
Abstract
CONTEXT: Assessing global, regional, and fear-of-reinjury outcomes in individuals with chronic ankle instability (CAI) is critical to understanding the effectiveness of clinical interventions. OBJECTIVE: To determine the improvement of patient-reported outcomes after balance- and strength-training and control protocols among participants with CAI. DESIGN: Randomized controlled clinical trial. SETTING: Athletic training research laboratory. PATIENTS OR OTHER PARTICIPANTS: Thirty-nine volunteers with CAI who scored 11 or greater on the Identification of Functional Ankle Instability questionnaire were randomly assigned to 1 of 3 groups: balance-training protocol (7 males, 6 females; age = 23.5 ±6.5 years, height = 175.0± 8.5 cm, mass = 72.8 ± 10.9 kg), strength-training protocol (8 males, 5 females; age = 24.6 ± 7.7 years, height = 173.2± 9.0 cm, mass = 76.0 ± 16.2 kg), or control (6 males, 7 females; age = 24.8 ± 9.0 years, height = 175.5 ± 8.4 cm, mass = 79.1 ± 16.8 kg). INTERVENTION(S): Each group met for 20 minutes, 3 times each week, for 6 weeks. The control group completed a mild to moderately strenuous bicycle workout. MAIN OUTCOME MEASURE(S): Global patient-reported outcomes, regional ankle function, and perceived instability were measured using the Disablement in the Physically Active Scale, the Fear-Avoidance Beliefs Questionnaire, the Foot and Ankle Ability Measure, and a visual analog scale for perceived instability. Participants completed the questionnaires at pretest and 6 weeks posttest. A multivariate repeated-measures analysis of variance with follow-up univariate analysis was conducted. The α level was set a priori at .05. RESULTS: No time-by-group interaction was found ( P = .78, η2 = 0.09). However, we observed a main effect for time ( P = .001, η2 = 0.49). Follow-up univariate analyses revealed differences between the pretest and posttest for the Disablement in the Physically Active Scale ( P = .02, η2 = 0.15), Fear-Avoidance Beliefs Questionnaire ( P = .001, η2 = 0.27), Foot and Ankle Ability Measure-Activities of Daily Living subscale ( P = .003, η2 = 0.22), Foot and Ankle Ability Measure-Sport subscale ( P = .001, η2 = 0.36), and visual analog scale ( P = .008, η2 = 0.18). CONCLUSIONS: Statistically, after the 6-week intervention, all groups improved in global and regional health-related quality of life. Clinicians should compare patient-reported outcomes with clinical measures to have a better understanding of progression during rehabilitation.
RCT Entities:
CONTEXT: Assessing global, regional, and fear-of-reinjury outcomes in individuals with chronic ankle instability (CAI) is critical to understanding the effectiveness of clinical interventions. OBJECTIVE: To determine the improvement of patient-reported outcomes after balance- and strength-training and control protocols among participants with CAI. DESIGN: Randomized controlled clinical trial. SETTING: Athletic training research laboratory. PATIENTS OR OTHER PARTICIPANTS: Thirty-nine volunteers with CAI who scored 11 or greater on the Identification of Functional Ankle Instability questionnaire were randomly assigned to 1 of 3 groups: balance-training protocol (7 males, 6 females; age = 23.5 ± 6.5 years, height = 175.0 ± 8.5 cm, mass = 72.8 ± 10.9 kg), strength-training protocol (8 males, 5 females; age = 24.6 ± 7.7 years, height = 173.2 ± 9.0 cm, mass = 76.0 ± 16.2 kg), or control (6 males, 7 females; age = 24.8 ± 9.0 years, height = 175.5 ± 8.4 cm, mass = 79.1 ± 16.8 kg). INTERVENTION(S): Each group met for 20 minutes, 3 times each week, for 6 weeks. The control group completed a mild to moderately strenuous bicycle workout. MAIN OUTCOME MEASURE(S): Global patient-reported outcomes, regional ankle function, and perceived instability were measured using the Disablement in the Physically Active Scale, the Fear-Avoidance Beliefs Questionnaire, the Foot and Ankle Ability Measure, and a visual analog scale for perceived instability. Participants completed the questionnaires at pretest and 6 weeks posttest. A multivariate repeated-measures analysis of variance with follow-up univariate analysis was conducted. The α level was set a priori at .05. RESULTS: No time-by-group interaction was found ( P = .78, η2 = 0.09). However, we observed a main effect for time ( P = .001, η2 = 0.49). Follow-up univariate analyses revealed differences between the pretest and posttest for the Disablement in the Physically Active Scale ( P = .02, η2 = 0.15), Fear-Avoidance Beliefs Questionnaire ( P = .001, η2 = 0.27), Foot and Ankle Ability Measure-Activities of Daily Living subscale ( P = .003, η2 = 0.22), Foot and Ankle Ability Measure-Sport subscale ( P = .001, η2 = 0.36), and visual analog scale ( P = .008, η2 = 0.18). CONCLUSIONS: Statistically, after the 6-week intervention, all groups improved in global and regional health-related quality of life. Clinicians should compare patient-reported outcomes with clinical measures to have a better understanding of progression during rehabilitation.
Entities:
Keywords:
disability; health-related quality of life; questionnaires; rehabilitation
Authors: M Spencer Cain; Rebecca J Ban; Yu-Ping Chen; Mark D Geil; Benjamin M Goerger; Shelley W Linens Journal: J Athl Train Date: 2020-08-01 Impact factor: 2.860
Authors: Kyung-Min Kim; María D Estudillo-Martínez; Yolanda Castellote-Caballero; Alejandro Estepa-Gallego; David Cruz-Díaz Journal: Int J Environ Res Public Health Date: 2021-05-18 Impact factor: 3.390