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Prevalence and impact of chronic ankle instability in female sport: a cross-sectional study

BMC Sports Sci Med Rehabil. 2025 Jul 8;17(1):183. doi: 10.1186/s13102-025-01211-5.

ABSTRACT

BACKGROUND: The prevalence and impact of chronic ankle instability (CAI) is underreported among females participating in sports that are considered high risk for lateral ankle sprains. Identifying the prevalence and contextualising the impact may help reinforce the necessity of targeted rehabilitation and injury risk reduction strategies. The primary aim was to conduct an international study identifying the prevalence of CAI and impact on ankle function and quality of life of females participating in high-risk sports.

METHODS: The cross-sectional study across Australia, New Zealand, the United Kingdom (UK), and United States of America (USA), invited females (≥ 18 years old) participating in netball, soccer, basketball, or volleyball to complete an online survey about their ankle health. A convenience sample was recruited online via each of the researchers covering their respective region. The survey comprised questions related to general demographic/health information, and validated questionnaires-Cumberland Ankle Instability Tool (CAIT)/Foot and Ankle Ability Measure-Sport (FAAM-S)/Health-Related Quality of Life Score (HRQOL). Participants were classified with CAI if an ankle sprain and CAIT score of < 25 were recorded on the same ankle. A CAIT score of > 24 identified either a potential coper (someone reporting a previous ankle sprain) or healthy participant (no previous ankle sprains). An alpha level of p < 0.05 denoted statistical significance.

RESULTS: Five-hundred seventy-eight responses were received. Of those, 258 had complete datasets from across the UK (44%,n = 170), Australia (27%,n = 106), New Zealand (19%,n = 75), and USA (7%,n = 29). Ankle sprains were the most common ankle injury (77%). 73% reported CAI of their left ankle and 54% reported CAI of their right ankle. The FAAM-S (p < 0.05) and HRQOL (p > 0.05) scores were reduced for the CAI group, compared to both the potential copers and individuals with no ankle injury. When stratified by sport there were no differences across outcome measures.

CONCLUSION: Chronic ankle instability is prevalent in females who participate in sports determined as high risk of ankle sprains. The results diversify knowledge of CAI in women across a broader participation level and distribution of sports than previously reported. Prevention strategies must be implemented globally to minimise the impact of CAI on performance and quality of life.

PMID:40629426 | DOI:10.1186/s13102-025-01211-5

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