title: Manual testing for ankle instability.
abstract: OBJECTIVE
  To assess inter-rater reliability of ankle manual tests. We also correlated the manual tests with the Cumberland Ankle Instability Tool (CAIT).
  
  
  METHODS
  One ankle from each of 60 participants was assessed using four different manual tests (anterior drawer in supine and crook lying, talar tilt, inversion tilt). Three different raters, varying in experience, tested each participant. The CAIT questionnaire was also administered. The study received ethics approval from the University of Sydney Human Research Ethics Committee. Intraclass correlation coefficients (ICC), standard error of the mean (SEM) and percent close agreement (PCA) were used to determine reliability of the four tests. Pearson's correlation coefficients were used to determine relationships between the manual tests and CAIT scores.
  
  
  RESULTS
  Inter-rater reliability for the four manual tests was poor regardless of therapist's experience (ICC([1,1]) -0.12 to 0.33; SEM 0.93-1.69). Correlations between the CAIT and manual tests were also low varying between r = -0.12 and -0.42.
  
  
  CONCLUSIONS
  Inter-rater reliability was poor for manual tests of ankle stability. Reliability may be improved by using a grading scale with fewer intervals. The CAIT scores and manual tests correlated poorly, potentially reflecting the variety of conditions leading to ankle instability.
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Cumberland Campus, C42, 75 East St., Lidcombe, NSW 2141, Australia.
authors.forename: Emily Jane
authors.initials: EJ
authors.lastname: Wilkin
authors.forename: Adrienne
authors.initials: A
authors.lastname: Hunt
authors.forename: Elizabeth Jean
authors.initials: EJ
authors.lastname: Nightingale
authors.forename: Joanne
authors.initials: J
authors.lastname: Munn
authors.forename: Sharon Lynne
authors.initials: SL
authors.lastname: Kilbreath
authors.forename: Kathryn Margaret
authors.initials: KM
authors.lastname: Refshauge
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000145:classification*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000145:classification*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult