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Assessment Procedures

Cross-cultural adaptation, reliability, and validation of the Taiwan-Chinese version of Cumberland Ankle Instability Tool

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Pages 781-787 | Received 13 Jan 2020, Accepted 24 May 2020, Published online: 15 Jun 2020
 

Abstract

Purpose

To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Taiwan-Chinese version (CAIT-TW), and to evaluate the validity, reliability and cutoff score of CAIT-TW for Taiwan-Chinese athletic population.

Materials and methods

The English version of CAIT was translated to CAIT-TW based on a guideline of cross-cultural adaptation. 77 and 58 Taiwanese collegial athletes with and without chronic ankle instability filled out CAIT-TW, Taiwan-Chinese version of Lower Extremity Functional Score (LEFS-TW) and Numeric Rating Scale (NRS). The construct validity, test-retest reliability, internal consistency and cutoff score of CAIT-TW were evaluated.

Results

In construct validity, the Spearman’s correlation coefficients were moderate (CAIT-TW vs LEFS-TW: Rho = 0.39, p < 0.001) and strong (CAIT-TW vs NRS: Rho= 0.76, p < 0.001). The test retest reliability was excellent (ICC2.1 = 0.91, 95% confidential interval = 0.87–0.94, p < 0.001) with a good internal consistency (Cronbach’s α: 0.87). Receiver operating characteristic curve showed a cutoff score of 21.5 (Youden index: 0.73, sensitivity: 0.87, specificity 0.85).

Conclusions

The CAIT-TW is a valid and reliable tool to differentiate between stable and instable ankles in athletes and may further apply for research or daily practice in Taiwan.

    Implications for rehabilitation

  • For athletes, chronic ankle instability is prevalent and causes negative sequela, such as lowered quality of daily life, affected functional performance, and may cause post traumatic osteoarthritis.

  • The psychometric properties of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool showed moderate to strong construct validity, excellent test retest reliability, a good internal consistency and a cutoff score of 21.5.

  • The validity and reliability of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool are to enable clinicians to evaluate and manage ankle instability in Taiwanese who speaks Mandarin Chinese.

Acknowledgements

We acknowledge Professor Chi-Huang Huang, Associate Professor Li-Lan Fu, and Associate Professor I-Hsin Kai from National Taiwan Sport University and translators, Yo-Rong Chen, Chia- Hung Lin, Michael Toy and Chen Lin, assisted to the translation process. We are also grateful to the coaches and athletes from National Taiwan Sport University and athletic trainer- Su Po-Wen from Chinese Culture University who kindly agreed to assist and participate in this study. We are thankful to Henry Robert Mumm to help with proofreading.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was granted by 2017 Studying Abroad Scholarship from Taiwan Ministry of Education.