title: Developing a framework for ankle function: a delphi study.
abstract: BACKGROUND
  Addressing clinical outcomes is paramount to providing effective health care, yet there is no consensus regarding the appropriate outcomes to address after ankle injuries. Compounding the problem is the repetitive nature of lateral ankle sprains, referred to as functional (FAI) or chronic (CAI) ankle instability. Although they are commonly used terms in practice and research, FAI and CAI are inconsistently defined and assessed.
  
  
  OBJECTIVE
  To establish definitions of a healthy/normal/noninjured ankle, FAI, and CAI, as well as their characteristics and assessment techniques.
  
  
  METHODS
  Delphi study.
  
  
  METHODS
  Telephone interviews and electronic surveys.
  
  
  METHODS
  Sixteen experts representing the fields of ankle function and treatment, ankle research, and outcomes assessment and research were selected as panelists.
  
  
  METHODS
  A telephone interview produced feedback regarding the definition of, functional characteristics of, and assessment techniques for a healthy/normal/noninjured ankle, an unhealthy/acutely injured ankle, and FAI/CAI. Those data were compiled, reduced, and returned through electronic surveys and were either included by reaching consensus (80% agreement) or excluded.
  
  
  RESULTS
  The definitions of a healthy/normal/noninjured ankle and FAI reached consensus. Experts did not agree on a definition of CAI. Eleven functional characteristics of a healthy/normal/noninjured ankle, 32 functional characteristics of an unhealthy/acutely injured ankle, and 13 characteristics of FAI were agreed upon.
  
  
  CONCLUSIONS
  Although a consensus was reached regarding the definitions and functional characteristics of a healthy/normal/noninjured ankle and FAI, the experts could only agree on 1 characteristic to include in the FAI definition. Several experts did, however, provide additional comments that reinforced the differences in the interpretation of those concepts. Although the experts could not agree on the definition of CAI, its characteristics, or the preferred use of the terms FAI and CAI, our findings provide progress toward establishing consistency in those concepts.
authors.affiliation: Division of Athletic Training, University of Northern Iowa, Cedar Falls.
authors.forename: Kelli R
authors.initials: KR
authors.lastname: Snyder
authors.forename: Todd A
authors.initials: TA
authors.lastname: Evans
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Neibert
mesh_terms: D000842:Ankle / Q000503:physiopathology*; D016512:Ankle Injuries / Q000175:diagnosis / Q000503:physiopathology; D000843:Ankle Joint / Q000503:physiopathology; D032921:Consensus; D003625:Data Collection; D003697:Delphi Technique; D005104:Expert Testimony; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D062072:Patient Acuity; D012016:Reference Values; D013180:Sprains and Strains / Q000175:diagnosis / Q000503:physiopathology; D009626:Terminology as Topic
keywords: ankle instability; ankle sprains; outcomes