Cross-cultural Adaptation, Reliability and Validity of the Cantonese-Chinese Cumberland Ankle Instability Tool (CAIT-HK)

Abstract

Acute ankle sprains are common amongst athletes, and screening is essential in preventing these long-term sequelae. Self-reported questionnaires, such as the Cumberland Ankle Instability Tool (CAIT), may help identify individuals with chronic ankle instability. To date, a Cantonese-Chinese version of the CAIT does not exist. Although several studies have cross-culturally adapted the CAIT into Chinese and Taiwan-Chinese, there are cultural differences in language use. A cross-cultural adaptation and validation of the CAIT were carried out: 46 individuals who were native in Cantonese completed the Cantonese-Chinese version of the CAIT and Chinese Foot and Ankle Outcome Score. For the test-retest analysis, the intraclass correlation coefficient was 0.874. Internal consistency showed a Cronbach's ɑ value of 0.726. Construct validity against the FAOS was fair but significant with a Spearman's correlation coefficient of 0.353, 0.460, 0.303, 0.369 and 0.493 for the categories of symptoms, pain, daily function, sports function, and quality of life respectively. A cut-off score of 20.5 was determined to differentiate healthy individuals from those with chronic ankle instability for this study population. The original English CAIT was successfully translated, cross-culturally adapted and validated into Cantonese-Chinese.

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“…A Cantonese-Chinese version (CAIT-HK) was cross-culturally adapted and validated for the Cantonese-speaking population (online supplemental file 1). 9 According to the International Ankle Consortium, the inclusion criteria for patients with CAI include (1) a selfreported history of at least one significant ankle sprain, in which the initial sprain occurred more than 12 months ago and (2) a history of recurrent 'feelings of instability', which may be defined as a CAIT score of less than or equal to 24. Based on CAIT-HK, a lower cut-off of 20.5 was used for this study.…”

“…12 The CAIT has been translated into Cantonese-Chinese (CAIT-HK) and validated in a previous study. 9 The Foot and Ankle Outcome Score (FAOS) was developed from the Knee Injury and Osteoarthritis Outcome Score and is a self-reporting instrument for measuring foot function. 13 The questionnaire is divided into five subscales, with each question scored on a Likert scale: pain, other symptoms, activities of daily living, function in sports and recreational activities, and foot and anklerelated quality of life (QoL).…”

“…A Cantonese-Chinese version (CAIT-HK) was cross-culturally adapted and validated for the Cantonese-speaking population (online supplemental file 1). 9…”

“…It is scored on a scale of 0 (severe instability) to 30 (no instability) 12. The CAIT has been translated into Cantonese-Chinese (CAIT-HK) and validated in a previous study 9…”