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B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...
B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...
Background A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown. Purpose The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization. Study design Literature Review Methods PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data. Results Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use. Conclusion Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use. Level of evidence 3a
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