Balance- and Strength-Training Protocols to Improve Chronic Ankle Instability Deficits, Part II:Assessing Patient-Reported Outcome Measures

作者：Hall Emily A^*; Chomistek Andrea K; Kingma Jackie J; Docherty Carrie L

来源：Journal of Athletic Training, 2018, 53(6): 578-583.

DOI：10.4085/1062-6050-387-16

• rehabilitation
• questionnaires
• health-related quality of life
• disability

Context: Assessing global, regional, and fear-of-reinjury outcomes in individuals with chronic ankle instability (CAI) is critical to understanding the effectiveness of clinical interventions. Objective: To determine the improvement of patient-reported outcomes after balance-and strength-training and control protocols among participants with CAI.
Design: Randomized controlled clinical trial.
Setting: Athletic training research laboratory.
Patients or Other Participants: Thirty-nine volunteers with CAI who scored 11 or greater on the Identification of Functional Ankle Instability questionnaire were randomly assigned to 1 of 3 groups: balance-training protocol (7 males,+/- females; age = 23.5+/-6.5 years, height = 175.0+/-8.5 cm, mass = 72.8+/-10.9 kg), strength-training protocol (8 males, 5 females; age = 24.6 6 7.7 years, height = 173.2+/-9.0 cm, mass = 76.0+/-16.2 kg), or control (6 males, 7 females; age = 24.8+/-9.0 years, height = 175.5+/-8.4 cm, mass = 79.1+/-16.8 kg).
Intervention(s): Each group met for 20 minutes, 3 times each week, for+/-weeks. The control group completed a mild to moderately strenuous bicycle workout.
Main Outcome Measure(s): Global patient-reported outcomes, regional ankle function, and perceived instability were measured using the Disablement in the Physically Active Scale, the Fear-Avoidance Beliefs Questionnaire, the Foot and Ankle Ability Measure, and a visual analog scale for perceived instability. Participants completed the questionnaires at pretest and+/-weeks posttest. A multivariate repeated-measures analysis of variance with follow-up univariate analysis was conducted. The a level was set a priori at.05.
Results: No time-by-group interaction was found (P =.78, eta(2) = 0.09). However, we observed a main effect for time (P =.001, eta(2) = 0.49). Follow-up univariate analyses revealed differences between the pretest and posttest for the Disablement in the Physically Active Scale (P =.02, eta(2) = 0.15), FearAvoidance Beliefs Questionnaire (P =.001, eta(2) = 0.27), Foot and Ankle Ability Measure-Activities of Daily Living subscale (P =.003, eta(2) = 0.22), Foot and Ankle Ability Measure-Sport subscale (P =.001, eta(2) = 0.36), and visual analog scale (P =.008, eta(2) = 0.18).
Conclusions: Statistically, after the 6-week intervention, all groups improved in global and regional health-related quality of life. Clinicians should compare patient-reported outcomes with clinical measures to have a better understanding of progression during rehabilitation.

• 出版日期2018-6