A performance test protocol and scoring scale for the evaluation of ankle injuries.

The aim of the study was to introduce and evaluate a standardized test protocol and scoring scale for evaluation of ankle injuries. After evaluation of 11 different functional ankle tests, questionnaire answers, and results of clinical ankle examination, the final test protocol consisted of 3 simple questions describing the subjective assessment of the injured ankle, 2 clinical measurements (range of motion in dorsiflexion, laxity of the ankle joint), 1 ankle test measuring functional stability (walking down a staircase), 2 tests measuring muscle strength (rising on heels and toes), and 1 test measuring balance (balancing on a square beam). Each selected test showed excellent reproducibility when tested with a reference group of 100 uninjured persons. According to the test results of a population of 148 patients with an operatively treated grade III lateral ligament injury of the ankle, each test could significantly differentiate healthy controls and patients with excellent overall healing from those with poor or fair recovery. The final total test score correlated significantly with the isokinetic strength results of the ankle, subjective opinion about the recovery, and subjective-functional assessment. The scale presented is recommended for studies evaluating functional recovery after ankle injury.