BALANCE SCORE FROM KR BALANCE KIT TO IDENTIFY A RISK OF CHRONIC ANKLE INSTABILITY

Authors

  • Tiwa KOSOL Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand
  • Anchana ANANTI Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand
  • Piyachat CHOMSRI Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand
  • Nitchanan POOLJAN Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand
  • Warisareya PHOTHITA Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand
  • Wisan TANGWONGCHAROEN Department of Computer Science, School of Science, King Mongkut’s Institute of Technology Ladkrabang, Bangkok, Thailand
  • Chorphaka DAMRONGTHAI Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand
  • Nalut UTSAHACHANT Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani, Thailand

Keywords:

Chronic ankle instability, Balance, KR Balance Kit, Cumberland Ankle Instability Tool

Abstract

Chronic Ankle Instability (CAI) is the most common injury among athletes and active population which may consequently impair balance and lead to falls. The KR balance kit, a device that has been developed for balance assessment, may be used to identify a risk of developing CAI conditions. Therefore, this study aimed to: 1) determine the KR balance cut-off score, a value that obtained from the KR balance kit to identify the risk of CAI conditions and 2) compare the KR balance score between individuals with and without CAI. A total of 114 participants were divided into 2 groups: 1) CAI (n=57) and 2) Non-Chronic Ankle Instability (NCAI) groups (n=57) by using the Cumberland Ankle Instability Tool (CAIT). Then, each participant was tested by the KR balance kit for 10 seconds, performing 3 times. The average KR balance scores were compared between groups. The KR balance cut-off score was subsequently calculated by applying the ROC curve and area under the curve (AUC). The results showed that the KR balance cut-off score > 2.96 referred to have the risk of CAI conditions (sensitivity = 0.702, specificity = 0.807, and accuracy = 81%). In addition, the CAI group was found statistical significantly greater sway than the NCAI group (p < 0.01). In accordance with the CAIT score, the KR balance kit could be utilized in identifying the risk of CAI conditions. To conclude, the KR balance kit may be an alternative device to assess the risk of CAI conditions for sports personnel and general population since it is practical and easy to use, especially in a fieldwork.


(Journal of Sports Science and Technology 2024; 24 ((Online Edition))
(Received: 9 September 2023, Revised: 16 March 2024, Accepted: 9 April 2024)

References

Attenborough AS, Hiller CE, Smith RM, Stuelcken M, Greene A, Sinclair PJ. Chronic ankle instability in

sporting populations. Sport Med. 2014;44(11):1545–56.

Tanen L, Docherty CL, Van Der Pol B, Simon J, Schrader J. Prevalence of chronic ankle instability in

high school and division I athletes. Foot Ankle Spec. 2014;7(1):37–44.

Gribble PA, Hertel J, Denegar CR, Buckley WE. The effects of fatigue and chronic ankle instability on

dynamic postural control. J Athl Train. 2004;39(4):321–9.

Pourkazemi F, Hiller CE, Raymond J, Nightingale EJ, Refshauge KM. Predictors of chronic ankle

instability after an index lateral ankle sprain: A systematic review. J Sci Med Sport. 2014;17(6):568–73.

Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA. The epidemiology of lateral

ligament complex ankle sprains in national collegiate athletic association sports. Am J Sports Med.

;45(1):201–9.

Martin RL, Davenport TE, Paulseth S, Wukich DK, Godges JJ. Ankle stability and movement

coordination impairments: Ankle ligament sprains. J Orthop Sports Phys Ther. 2013;43(9):A1–40.

Martin RRL, Davenport TE, Fraser JJ, Sawdon-Bea J, Carcia CR, Carroll LA, et al. Ankle stability and

movement coordination impairments: Lateral ankle ligament sprains revision 2021. J Orthop Sports Phys Ther.

;51(4):1–80.

McKeon JMM, McKeon PO. Evaluation of joint position recognition measurement variables associated

with chronic ankle instability: A meta-analysis. J Athl Train. 2012;47(4):444–56.

Munn J, Sullivan SJ, Schneiders AG. Evidence of sensorimotor deficits in functional ankle instability:

A systematic review with meta-analysis. J Sci Med Sport. 2010;13(1):2–12.

Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med.

;27(3):353–70.

Mckeon PO, Hertel J. Systematic review of postural control and lateral ankle instabilit, part I: Can

deficits be detected with instrumented testing? J Athl Train. 2008;43(3):293–304.

Thompson C, Schabrun S, Romero R, Bialocerkowski A, van Dieen J, Marshall P. Factors contributing

to chronic ankle instability: a systematic review and meta-analysis of systematic reviews. Sport Med.

;48(1):189–205.

Song K, Burcal CJ, Hertel J, Wikstrom EA. Increased visual sse in chronic ankle instability: a metaanalysis.

Med Sci Sports Exerc. 2016;48(10):2046–56.

Hiller CE, Nightingale EJ, Lin CWC, Coughlan GF, Caulfield B, Delahunt E. Characteristics of people

with recurrent ankle sprains: A systematic review with meta-analysis. Br J Sports Med. 2011;45(8):660–72.

Hertel J, Corbett RO. An updated model of chronic ankle instability. J Athl Train. 2019;54(6):572–88.

Richie J. Functional instability of the ankle and the role of neuromuscular control: A comprehensive

review. J Foot Ankle Surg. 2001;40(4):240–51.

Wenning M, Gehring D, Mauch M, Schmal H, Ritzmann R, Paul J. Functional deficits in chronic

mechanical ankle instability. J Orthop Surg Res. 2020;15(1):1–8.

Lin JZ, Lin YA, Lee HJ. Are landing biomechanics altered in elite athletes with chronic ankle instability.

J Sport Sci Med. 2019;18(4):653–62.

Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DTP, et al. Evidence review

for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term

consequences of lateral ankle sprains. Br J Sports Med. 2016;50(24):1496–505.

Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA. Epidemiology of ankle sprains and chronic ankle

instability. J Athl Train. 2019;54(6):603–10.

Haas BM, Burden AM. Validity of weight distribution and sway measurements of the Balance

Performance Monitor. Physiother Res Int. 2000;5(1):19–32.

Uehlbauer T, Roth R, Mueller S, Granacher U. Intra and intersession reliability of balance measures

during one-leg standing in young adults. J strength Cond Res. 2011;25(8):2228–34.

Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test:

A reliability study involving multiple raters. Mil Med. 2013;178(11):1264–70.

Fusco A, Giancotti GF, Fuchs PX, Wagner H, Varalda C, Cortis C. Wobble board balance assessment

in subjects with chronic ankle instability. Gait Posture. 2019;68:352–6.

Silva P de B, Oliveira AS, Mrachacz-Kersting N, Laessoe U, Kersting UG. Strategies for equilibrium

maintenance during single leg standing on a wobble board. Gait Posture. 2016;44:149–54.

Yingyongsaksri S, Hiller CE, Tharawadeepimuk K, Nanbancha A. Reliability and validation of the Thai

version of the Cumberland Ankle Instability Tool (CAIT-THA). Disabil Rehabil. 2022;0(0):1–6.

Mehta J, Sinha AGK. Prevalence of functional ankle instability and its association with risk factors in

basketball players of punjab. Int J Phys Educ Sports Health 2015;1(6):3–7.

Wright CJ, Arnold BL, Ross SE, Linens SW. Recalibration and validation of the Cumberland ankle

instability tool cutoff score for individuals with chronic ankle instability. Arch Phys Med Rehabil. 2014;95(10)

:1853–9.

Hiller CE, Refshauge KM, Bundy AC, Herbert RD, Kilbreath SL. The Cumberland ankle instability tool:

a report of validity and reliability testing. Arch Phys Med Rehabil. 2006;87(9):1235–41.

Bantis LE, Nakas CT, Reiser B. Construction of confidence regions in the ROC space after the

estimation of the optimal Youden index-based cut-off point. Biometrics. 2014;70(1):212–23.

Udompanich N, Thanasootr KO, Chanavirut R, Chatchawan U, Hunsawong T. The cut-off score of

four clinical tests to quantify balance impairment in individuals with chronic ankle instability. Malaysian J Med

Sci. 2021;28(4):87–96.

Hertel J, Olmsted-Kramer LC. Deficits in time-to-boundary measures of postural control with chronic

ankle instability. Gait Posture. 2007;25(1):33–9.

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Published

2024-05-07

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