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Cross-cultural adaptation and validation of the Spanish version of the Cumberland Ankle Instability Tool (CAIT): an instrument to assess unilateral chronic ankle instability

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Abstract

The Cumberland Ankle Instability Tool (CAIT) is a valid instrument to determine the presence of chronic ankle instability (CAI) and to assess its severity. Self-report test is very useful for researchers and clinical practice, and CAI is a widespread tool. Nevertheless, there is lack of measurement instruments validated into Spanish, which represents a major difficulty for research dealing with a Spanish-speaking population. The questionnaire was cross-culturally adapted into Spanish. The psychometric properties tested in the Spanish version of the CAIT were measured for internal consistency, test–retest reliability, construct validity, criterion validity, and responsiveness in 108 participants who were recruited from several fitness centers. The Spanish version of the CAIT had high internal consistency (Cronbach's α = 0.766) and reliability (intraclass correlation coefficient = 0.979, 95 % confidence interval (CI) = 0.958–0.990). Correlation with the 36-item Short-Form Health Survey (SF-36) physical component summary score (rho = 0.241, p = 0.012) was greater than the SF-36 mental component summary score (rho = −0.162, p = 0.094). The construct validity shows three different factors in the questionnaire and good responsiveness with a mean change of −2.43 (95 % CI = −3.12 to 1.73, p < 0.0001) and a size effect of Cohen's d = 1.07. The Spanish version of the CAIT has been shown to be a valid and reliable instrument for measuring chronic ankle instability and constitutes a useful instrument for the measurement of CAI in the clinical setting in Spain.

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Acknowledgments

The authors wish to express their gratitude to Medicarim Centro Company for their logistic support, Mr. Agustín Pérez-Barroso for his help with technical and practical issues in this study, Dr. Valentín Rocandio-Cilveti for his collaboration in the theoretical framework of this study, and every athlete who kindly agreed to take part in this research.

Disclosures

Cross-cultural adaptation to spanish speaker population of CAIT.

Author information

Authors and Affiliations

  1. Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain

    David Cruz-Díaz, Fidel Hita-Contreras, Rafael Lomas-Vega, M. C. Osuna-Pérez & Antonio Martínez-Amat

  2. Institute of Biopathology and Regenerative Medicine (IBIMER), Departmento de Anatomía y Embriología, Facultad de Medicina, University of Granada, 18071, Granada, Spain

    Fidel Hita-Contreras & Antonio Martínez-Amat

Authors
  1. David Cruz-Díaz
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  2. Fidel Hita-Contreras
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  3. Rafael Lomas-Vega
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  4. M. C. Osuna-Pérez
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  5. Antonio Martínez-Amat
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Corresponding author

Correspondence to Antonio Martínez-Amat.

Appendices

Appendix 1. Cumberland Ankle Instability Tool

Please tick the statement that best describes your ankles.

figure a

Note: The scoring scale is on the right. The scoring system is not visible on the subject's version

Appendix 2. Spanish version of the CAIT

Por favor, marque en cada pregunta la ÚNICA afirmación que describa mejor sus tobillos

figure b

NOTA. La escala de puntuación está en la derecha. El sistema de puntuación no está visible en la versión del participante

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Cruz-Díaz, D., Hita-Contreras, F., Lomas-Vega, R. et al. Cross-cultural adaptation and validation of the Spanish version of the Cumberland Ankle Instability Tool (CAIT): an instrument to assess unilateral chronic ankle instability. Clin Rheumatol 32, 91–98 (2013). https://doi.org/10.1007/s10067-012-2095-0

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  • DOI: https://doi.org/10.1007/s10067-012-2095-0

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