Clinical Tests Have Limited Predictive Value for Chronic Ankle Instability When Conducted in the Acute Phase of a First-Time Lateral Ankle Sprain Injury

Abstract

Objective: To evaluate whether a battery of clinical assessments for acute lateral ankle sprain (LAS) can be used to predict long-term recovery.

Design: Cohort study.

Setting: University biomechanics laboratory.

Participants: Individuals (N=82) were assessed using a clinical test battery within 2 weeks of incurring a first-time LAS.

Interventions: Not applicable.

Main outcome measures: The clinical test battery included scores on the talar glide test (degrees), the anterior drawer, talar tilt, figure of 8 for swelling (millimeters) and knee to wall (millimeters) tests, and handheld goniometric range of motion (inversion, eversion, and plantarflexion [in degrees]). Scores on the Cumberland Ankle Instability Tool taken 12 months after the clinical test battery were used to classify participants as having chronic ankle instability (CAI) or as being LAS copers.

Results: Forty percent of participants were designated as having CAI, with 60% being designated as LAS copers. A logistic regression analysis revealed that a combined model using scores from the talar glide, talar tilt, and anterior drawer tests in addition to plantarflexion range of motion was statistically significant (P<.01) and correctly classified cases with moderate accuracy (68.8%). The final model had moderate sensitivity (64%) and good specificity (72%).

Conclusions: The clinical tests used in this investigation have limited predictive value for CAI when conducted in the acute phase of a first-time LAS injury.

Keywords: Ankle; Diagnosis; Joint instability; Rehabilitation; Sprains and strains.