Reliability and validation of the Thai version of the Cumberland Ankle Instability Tool (CAIT-THA)

Abstract

Purpose

This study aimed to provide a version of Cumberland Ankle Instability Tool (CAIT) for the Thai younger adult population and examine psychometric properties and determine the cut-off score.

Methods

CAIT-Youth Thai version was modified to CAIT Thai version (CAIT-THA). To validate the CAIT-THA psychometric properties, 72 with chronic ankle instability (CAI) and 72 without (age 23.45 ± 4.45 years) were recruited. The validation was carried out by using internal consistency (Cronbach’s alpha), concurrent validity (Spearman’s rank correlation coefficient), discriminative validity (Receiver Operating Characteristic (ROC) curve), and test-retest reliability (intraclass correlation coefficient; ICC). A cut-off score was determined via Youden’s index.

Results

Validation showed good internal consistency (Cronbach’s alpha = 0.837), and concurrent validity (Spearman’s rank correlation coefficient = 0.762 and 0.731 for right ankle and left ankle, respectively). Test-retest reliability was excellent with ICC (2,1) of 0.945 (95% CI = 0.93–0.96). A cut-off score of ≤ 25, determined by ROC curve and Youden’s index, was distinguished between participants with and without CAI. CAIT-THA obtained 97.2% sensitivity, 94.4% specificity, 0.03 negative, and 17.5 positive likelihood ratios.

Conclusion

CAIT-THA is a validated tool that can be used in Thai younger adults. Clinicians and researchers can confidently use a score of ≤ 25 to determine the presence of CAI.

IMPLICATIONS FOR REHABILITATION

• The Cumberland Ankle Instability Tool Thai version (CAIT-THA) questionnaire is available for Thai young adults.

• The CAIT-THA had high sensitivity, specificity, and positive and negative likelihood cut-off ratio scores for discrimination between chronic ankle instability (CAI) and non-CAI.

• The CAIT-THA questionnaire may be used in rehabilitation and research settings for the identification and management of CAI conditions.

Keywords:

• Chronic ankle instability
• Cumberland ankle instability tool
• Thai adult
• validity
• reliability

Acknowledgements

The authors are very grateful to all participants, the College of sports science and technology, Mahidol University, and the Department of Physical Therapy, School of Integrative Medicine Mae Fah Luang University.

Disclosure statement

No potential conflict of interest was reported by the author(s).