Effects Of Kinesiophobia On Dynamic Postural Control In Patients With Chronic Ankle Instability

Chronic ankle instability is a pathologic condition characterized by recurrent ankle sprains with a feeling of giving-way. Patients with CAI have higher levels of kinesiophobia, which is characterized as injury-related fear during movement. However, little is known about how kinesiophobia negatively affects dynamic postural control in the CAI population. PURPOSE: To identify the effects of kinesiophobia on dynamic postural control in patients with CAI (CAI-K) compared to CAI patients without kinesiophobia (CAI-N) and uninjured controls. METHODS: Fifty patients with CAI were divided into two subgroups based on their responses to the Tampa Scale of Kinesiophobia (TSK-11): CAI-K (10F, 15 M, TSK-11: 42.0 ± 3.6, 71.8 ± 14.4 kg, 1.76 ± 0.1 m), CAI-N (10F, 15 M, TSK-11: 33.0 ± 3.2, 71.5 ± 12.1 kg, 1.74 ± 0.1 m), and controls (10F, 10 M, 75.7 ± 15.8 kg, 1.74 ± 0.07 m). Each subject performed three trials of a single-leg hop stabilization test and star excursion balance test. One-way ANOVA were used to examine the differences among groups (CAI-K, CAI-N, and control). RESULTS: Table 1 shows that the CAI-K group displayed longer time to stabilization during a single-leg hop stabilization test compared with CAI-N and control groups. In addition, CAI-K group showed reduced reach distance in the anterior direction than CAI-N and control groups. CONCLUSIONS: Fear of movement negatively affects dynamic postural control in the CAI population. Specifically, the CAI-K group took longer to stabilize after jump-landing and showed less anterior reach distance than CAI-N and control groups. As previous research has been examined the association between dynamic balance and lower-extremity joint kinematics, altered joint positions during dynamic tasks may affect the fear of movement in the CAI population. Future research is required to examine the relationship between joint kinematics and kinesiophobia in this population. - Table 1. Dynamic postural variables for CAI-K, CAI-N, Control groups - Group Dynamic Balance Variables ANOVA Cohen' D(95% CI)CAI - Coper Cohen' D(95% CI)CAI – Control Cohen' D(95% CI)Coper-control DPSI CAI-K 0.63 ± 0.15 P = 0.71 0.11(-0.53, 0.75) -0.32(-0.95, 0.32) -0.43(-1.07, 0.22) CAI-N 0.63 ± 0.09 Control 0.65 ± 0.11 MLSI CAI-K 0.13 ± 0.03 P = 0.60 0.83(0.17, 1.48) 0.43(-0.21, 1.07) -0.39(-1.03, 0.25) CAI-N 0.13 ± 0.02 Control 0.13 ± 0.03 APSI CAI-K 0.14 ± 0.03 P = 0.35 0.50(-0.15, 1.13) 0.09(-0.55, 0.73) -0.41(-1.04, 0.24) CAI-N 0.16 ± 0.04 Control 0.15 ± 0.03 VSI CAI-K 0.49 ± 0.14 P = 0.42 -0.17(-0.80, 0.47) -0.46(-1.11, 0.18) -0.30(-0.93, 0.34) CAI-N 0.45 ± 0.07 Control 0.48 ± 0.10 TTS CAI-K a 5.07 ± 3.16 P < 0.01 0.01(-0.58, 0.69) 0.11(-0.53, 0.74) -0.16(-0.80, 0.47) CAI-N b 3.42 ± 1.68 Control 2.75 ± 1.02 Anterior SEBT CAI-Ka 0.61 ± 0.06 P < 0.01 0.11(-0.53, 0.75) -0.32(-0.95, 0.32) -0.43(-1.07, 0.22) CAI-Nb 0.67 ± 0.09 Control 0.72 ± 0.05 Posteromedial SEBT CAI-K 1.01 ± 0.09 P = 0.22 0.83(0.17, 1.48) 0.43(-0.21, 1.07) -0.39(-1.03, 0.25) CAI-N 1.06 ± 0.09 Control 1.06 ± 0.08 Posterolateral SEBT CAI-K 1.10 ± 0.11 P = 0.41 0.01(-0.58, 0.69) 0.11(-0.53, 0.74) -0.16(-0.80, 0.47) CAI-N 1.12 ± 0.10 Control 1.14 ± 0.11