The Cumberland Ankle Instability Tool: A Report of Validity and Reliability Testing

• Published in: Archives of physical medicine and rehabilitation Vol. 87; no. 9; pp. 1235 - 1241
• Main Authors: Hiller, Claire E., Refshauge, Kathryn M., Bundy, Anita C., Herbert, Rob D., Kilbreath, Sharon L.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2006; Elsevier
• Subjects: Adult; Ankle; Ankle Injuries - classification; Biological and medical sciences; Cross-Sectional Studies; Diseases of the osteoarticular system; Humans; Injuries of the limb. Injuries of the spine; Injury Severity Score; Joint instability; Joint Instability - classification; Medical sciences; Miscellaneous; Questionnaires; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Reproducibility of Results; ROC Curve; Sprains and strains; Surveys and Questionnaires; Traumas. Diseases due to physical agents; Ankle; Joint instability; Rehabilitation; Questionnaires; Sprains and strains; Prognosis; Questionnaire; Volunteer; Diseases of the osteoarticular system; Lower extremity; Construct validity; Ankle joint; Specificity; Cross sectional study; Correlation coefficient; Human; Medical screening; Test reliability; Trauma; Sensitivity; Discrimination; Instability; Perception; Models; Reliability; Comparative study
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2006.05.022

Hiller CE, Refshauge KM, Bundy AC, Herbert RD, Kilbreath SL. The Cumberland Ankle Instability Tool: a report of validity and reliability testing. To test the Cumberland Ankle Instability Tool (CAIT), a 9-item 30-point scale, for measuring severity of functional ankle instability. Cross-sectional study. General community. Volunteer sample of 236 subjects. Not applicable. Concurrent validity by comparison with the Lower Extremity Functional Scale (LEFS) and a visual analog scale (VAS) of global perception of ankle instability by using the Spearman ρ. Construct validity and internal reliability with Rasch analysis using goodness-of-fit statistics for items and subjects, separation of subjects, correlation of items to the total scale, and a Cronbach α equivalent. Discrimination score for functional ankle instability by maximizing the Youden index and tested for sensitivity and specificity. Test-retest reliability by intraclass correlation coefficient, model 2,1 (ICC 2,1). There were significant correlations between the CAIT and LEFS (ρ=.50, P<.01) and VAS (ρ=.76, P<.01). Construct validity and internal reliability were acceptable (α=.83; point measure correlation for all items, >0.5; item reliability index, .99). The threshold CAIT score was 27.5 (Youden index, 68.1); sensitivity was 82.9% and specificity was 74.7%. Test-retest reliability was excellent (ICC 2,1=.96). CAIT is a simple, valid, and reliable tool to measure severity of functional ankle instability.