Possible factors related to functional ankle instability

J Orthop Sports Phys Ther. 2008 Mar;38(3):150-7. doi: 10.2519/jospt.2008.2524.


Study design: Case control study.

Objectives: To classify individuals with functional ankle instability (FAI) into deficit and non-deficit categories based on the evaluation of the most common factors that have been proposed to be related to FAI.

Background: Recent studies have suggested that FAI may be secondary to a combination of factors including ankle proprioceptive deficit, muscular weakness, impaired balance, delayed neuromuscular reaction time, and joint laxity. However, only a few authors have investigated the prevalence and association among these factors in a single group of individuals.

Methods and measures: The above 5 factors were tested bilaterally in 21 individuals with FAI and in 16 healthy control subjects. Data were analyzed for (1) within- and between-group comparison, (2) classification of subjects with FAI into deficit and no-deficit categories, and (3) magnitude of association between factors in the subjects with FAI using Pearson bivariate correlation.

Results: Balance control and evertors' strength were significantly less on the affected side in comparison to the unaffected side in subjects with FAI. The evertors' strength was also significantly different between the side difference of the FAI group and the side difference of the control group. Passive ankle stiffness was significantly correlated to balance control, ankle proprioception, and evertor peak torque. Individuals with FAI demonstrated a large variation in the deficit categories ranging from multiple deficits to no noticeable deficits.

Conclusion: Mechanical alterations in the ankle joint may influence several aspects of the ankle's functional ability. Alterations in the afferent processes, represented in this study by ankle proprioception, may effect the evertors' strength or vice versa. More importantly, individuals with FAI might exhibit high variability in ankle deficits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ankle Injuries / etiology*
  • Ankle Injuries / physiopathology*
  • Ankle Joint / physiopathology*
  • Case-Control Studies
  • Female
  • Humans
  • Joint Instability / etiology*
  • Joint Instability / physiopathology*
  • Male
  • Muscle Weakness
  • Proprioception / physiology
  • Risk Factors
  • Sprains and Strains / physiopathology
  • Torque