Activity Levels in College Students With Chronic Ankle Instability

T & Turner TJ. J Athl Train. 2015; 50(7): 742-747.

Take Home Message: College students with chronic ankle
instability have lower activity levels and more symptoms than healthy
students.  Activity levels appear to be
related to the amount of ankle laxity.

sprains, one of the most common orthopedic injuries, can cause chronic ankle
instability (CAI), which can result in long-term pain, instability, and
potentially decreased quality of life.  Individuals
with CAI report lower function and more symptoms, but it is unknown if these
findings translate into functional differences. 
The authors of this study compared total weekly steps between 40 college
students with CAI and healthy control students. The authors also tested whether
physical activity level (steps) was associated with ankle laxity.  Students completed the Foot and Ankle Ability Measure
survey and the International Physical Activity Questionnaire to assess physical function and types/intensity of activity
levels, respectively.  Ankle laxity in
anterior-posterior and inversion-eversion was assessed by the investigators
through use of an ankle arthrometer. Students were given pedometers to record
their daily step count in logs over the course of 1 week.   CAI participants had overall lower activity
levels based on lower step counts, moderate activity level time, vigorous
activity level time, and metabolic equivalents in comparison to healthy
controls.  There were negative
correlations between ankle laxity measures and total daily step count, which
means that as laxity increases students tend to be less active. 

study is important because it is one of the first studies to demonstrate that
individuals with CAI are less physically active than healthy controls.  The lower activity levels may be related to
objective laxity or subjective symptoms that the CAI participants are
experiencing.  It would be interesting to
see if treatments that improve symptoms among patients with CAI also result in
increases in activity levels.  Research
on intervention programs or long-term changes after ankle sprains would provide
valuable information about this.  The
authors of this study followed physically active college participants over the
course of 1 week, but it may be interesting to follow students over longer time
periods or to follow college-aged athletes during a competitive season.  As participants recover from an ankle sprain,
a thorough rehabilitation program is key to avoiding long-term complications.  As clinicians return to physical
activity/function should not be our end goal. 
We should also focus on improving a patient’s perceived function and
symptoms as well as patient education in efforts to maintain long-term healthy

for Discussion:  Are there any
interventions or training programs that you clinically use to improve
subjective pain or function after an ankle sprain? 

by: Nicole Cattano
by: Jeffrey Driban


Hubbard-Turner, T., & Turner, M. (2015). Physical Activity Levels in College Students With Chronic Ankle Instability Journal of Athletic Training DOI: 10.4085/1062-6050-50.3.05