Patient-Reported Outcomes and Perceived Confidence Measures in Athletes With a History of Ankle Sprain

in Journal of Sport Rehabilitation
Restricted access

Purchase article

USD $24.95

Student 1 year subscription

USD $74.00

1 year subscription

USD $99.00

Student 2 year subscription

USD $141.00

2 year subscription

USD $185.00

Context: Patient-reported outcome measures (PROs) and functional performance tests are recommended in the National Athletic Trainers’ Association’s position statement on the prevention and management of ankle sprains during the return-to-play process. Evaluating perceived confidence may be another valuable method to evaluate an athlete’s readiness to return-to-play following an ankle sprain. Objective: To evaluate the relationship between PROs and perceived confidence when performing functional performance tasks in high school athletes with a history of ankle sprain. Design: Descriptive study. Setting: Public high school. Patients or Other Participants: A total of 25 high school student-athletes (6 males and 19 females, age 16.2 [1.1] y, height 169.3 [7.7] cm, mass 63.2 [9.8] kg). Intervention(s): None. Main Outcome Measures: The Cumberland Ankle Instability Tool, visual analog scale (VAS) for pain, Identification of Functional Ankle Instability, and Tampa Scale of Kinesiophobia-11 were completed by all participants. Participants then completed the weight-bearing lunge test; star excursion balance test; lateral, up–down, and triple hop tests; the single-leg vertical jump; and Southeast Missouri agility test and were asked to report their confidence in completing each task using a VAS with anchors of “no confidence” and “complete confidence.” Pearson r correlations were calculated between the PROs and the confidence VAS scores of the functional tests. Results: Moderate to strong negative correlations were identified between pain VAS measures and confidence VAS measures for all functional tests except the star excursion balance test and vertical jump. Moderate negative correlations were found between Tampa Scale of Kinesiophobia-11 scores and perceived confidence during the star excursion balance test and vertical jump. Finally, a moderate positive correlation was identified between Cumberland Ankle Instability Tool scores and perceived confidence measures during the Southeast Missouri agility test. Conclusions: High school athletes with a history of ankle sprain demonstrated significant correlations between several PROs and perceived confidence during various functional performance tests. The value of perceived confidence measures when making return-to-play decisions after ankle sprains warrants further investigation.

Corbett and Hertel are with the Department of Kinesiology, University of Virginia, Charlottesville, VA. Hertel is also with the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA. Keith is with the University of Virginia, Charlottesville, VA.

Corbett (roc2ab@virginia.edu) is corresponding author.
Journal of Sport Rehabilitation
Article Sections
References
  • 1.

    Medina McKeon JMBush HMReed AWhittington AUhl TLMcKeon PO. Return-to-play probabilities following new versus recurrent ankle sprains in high school athletes. J Sci Med Sport. 2014;17(1):2328. PubMed ID: 23689105 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Nelson AJCollins CLYard EEFields SKComstock RD. Ankle injuries among United States high school sports athletes, 2005–2006. J Athl Train. 2007;42(3):381387. PubMed ID: 18059994

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Simon JEWikstrom EAGrooms DRDocherty CLDompier TPKerr ZY. Athletic training service characteristics for patients with ankle sprains sustained during high school athletics. J Athl Train. 2018;53(1):676683. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Doherty CBleakley CHertel JCaulfield BRyan JDelahunt E. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability. Am J Sports Med. 2015;44(4):9951003. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Kaminski TWHertel JAmendola Net al. National athletic trainers’ association position statement: conservative management and prevention of ankle sprains in athletes. J Athl Train. 2013;48(4):528545. PubMed ID: 23855363 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Martin RLIrrgang JJBurdett RGConti SFVan Swearingen JM. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26(11):968983. PubMed ID: 16309613 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Price DDMcGrath PARafii ABuckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):4556. PubMed ID: 6226917 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Hiller CERefshauge KMBundy ACHerbert RDKilbreath SL. The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil. 2006;87(9):12351241. PubMed ID: 16935061 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Simon JDonahue MDocherty C. Development of the Identification of Functional Ankle Instability (IdFAI). Foot Ankle Int. 2012;33(9):755763. PubMed ID: 22995264 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Buchanan ASDocherty CLSchrader J. Functional performance testing in participants with functional ankle instability and in a Healthy Control Group. J Athl Train. 2008;43(4):342346. PubMed ID: 18668180 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Caffrey EDocherty CLSchrader JKlossnner J. The ability of 4 single-limb hopping tests to detect functional performance deficits in individuals with functional ankle instability. J Orthop Sports Phys Ther. 2009;39(11):799806. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Madsen LPHall EADocherty CL. Assessing outcomes in people having chronic ankle instability: the ability of functional performance tests to measure deficits in physical function and perceived instability. J Orthop Sports Phys Ther. 2018;48(5):372380. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Hsu CJMeierbachtol AGeorge SZChmielewski TL. Fear of reinjury in athletes: implications for rehabilitation. Sports Health. 2017;9(2):162167. PubMed ID: 27590793 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Knapik ASaulicz EGnat R. Kinesiophobia—Introducing a new diagnostic tool. J Hum Kinet. 2011;28(1):2531. doi:

  • 15.

    Lentz TASutton ZGreenberg SBishop MD. Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology. Arch Phys Med Rehabil. 2010;91(4):557561. PubMed ID: 20382287 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Waddell GNewton MHenderson ISomerville DMain CJ. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52:157168. https://ac.els-cdn.com/030439599390127B/1-s2.0-030439599390127B-main.pdf?_tid=a501c00c-3eaa-450b-a6c3-9283a7686f10&acdnat=1521513662_3bbde73e15a7d3b4dd49f6652b0e76cc. Accessed March 19 2018. PubMed ID: 8455963 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Houston MNVan Lunen BLHoch MC. Health-related quality of life in individuals with chronic ankle instability. J Athl Train. 2014;49(6):758763. PubMed ID: 25299444 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Houston MNHoch JMHoch MC. Collegiate athletes with ankle sprain history exhibit greater fear-avoidance beliefs. J Sport Rehabil. 2018;27(5):419423. doi:

  • 19.

    Gribble PADelahunt EBleakley CMet al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle consortium. J Athl Train. 2014;49(1):121127. PubMed ID: 24377963 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Woby SRRoach NKUrmston MWatson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain. 2005;117(1–2):137144. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Bennell KTalbot RWajswelner HTechovanich WKelly DHall A. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44:175180. PubMed ID: 11676731 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Hertel JBraham RAHale SAOlmsted-Kramer LC. Simplifying the star excursion balance test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther. 2006;36:131137. https://www.jospt.org/doi/pdf/10.2519/jospt.2006.36.3.131. Accessed March 19 2018. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Gribble PAHertel JPlisky P. Using the star excursion balance test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. J Athl Train. 2012;47(3):339357. PubMed ID: 22892416 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Erlbaum; 1988.

  • 25.

    Hudson Z. Rehabilitation and return to play after foot and ankle injuries in athletes. Sports Med Arthrosc. 2009;17(3):203207. doi:

  • 26.

    Clanton TOMatheny LMJarvis HCJeronimus AB. Return to play in athletes following ankle injuries. Sports Health. 2012;4(6):471474. PubMed ID: 24179584 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008;27(3):353370. PubMed ID: 18503872 doi:

  • 28.

    Doherty CBleakley CHertel Jet al. Lower extremity coordination and symmetry patterns during a drop vertical jump task following acute ankle sprain. Hum Mov Sci. 2014;38:3446. PubMed ID: 25240177 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Doherty CBleakley CMHertel JCaulfield BRyan JDelahunt E. Laboratory measures of postural control during the star excursion balance test after acute first-time lateral ankle sprain. J Athl Train. 2015;50(6):651664. PubMed ID: 25811845 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Welton KLKraeutler MJPierpoint LABartley JHMcCarty ECComstock RD. Injury recurrence among high school athletes in the United States: a decade of patterns and trends, 2005–2006 through 2015–2016. Orthop J Sports Med. 2018;6(1):2325967117745788. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Swenson DMCollins CLFields SKComstock RD. Epidemiology of US high school sports-related ligamentous ankle injuries, 2005/06–2010/11. Clin J Sport Med. 2013;23(3):190196. PubMed ID: 23328403 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
Article Metrics
All Time Past Year Past 30 Days
Abstract Views 266 266 176
Full Text Views 12 12 5
PDF Downloads 11 11 3
Altmetric Badge
PubMed
Google Scholar