Contributing factors to chronic ankle instability.
BACKGROUND
The development of repetitive ankle sprains and persistent symptoms after initial ankle sprain has been termed chronic ankle instability (CAI). There is no clear indication of which measures are most important in discriminating between individuals with and without CAI.


METHODS
Thirty subjects with unilateral CAI and controls had measures of ankle laxity and hypomobility, static and dynamic balance, ankle and hip strength, lower extremity alignments, and flexibility taken on both limbs.


RESULTS
Based on comparisons of CAI ankles and side-matched limbs in controls, the measures significantly predictive of CAI were increased inversion laxity (r(2) change = 0.203), increased anterior laxity (r(2) change = 0.11), more missed balance trials (r(2) change = 0.094), and lower plantarflexion to dorsiflexion peak torque (r(2) change = 0.052). Symmetry indices comparing the side-to-side differences of each measure also were calculated for each dependent variable and compared between groups. The measures significantly predictive of CAI were decreased anterior reach (r(2) change = 0.185), decreased plantarflexion peak torque (r(2) change = 0.099), decreased posterior medial reach (r(2) change = 0.094), and increased inversion laxity (r(2) change = 0.041).


CONCLUSIONS
The results of this study elucidate the specific measures that best discriminate between individuals with and without CAI. Both mechanical (anterior and inversion laxity) and functional (strength, dynamic balance) insufficiencies significantly contribute to the etiology of CAI. Prevention of CAI may be possible with proper initial management of the acute injury with rehabilitation aimed at those factors that best discriminate between individuals with and without CAI.
Hubbard
Tricia J
TJ
Kinesiology, University of North Carolina, Charlotte, NC 28223, USA. thubbar1@uncc.edu
Kramer
Lauren C
LC
Denegar
Craig R
CR
Hertel
Jay
J
D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies; D013180:Sprains and Strains / Q000150:complications