The Cumberland Ankle Instability Tool (CAIT) is a specialized questionnaire used to assess the presence and severity of functional ankle instability. It functions as a patient-reported outcome measure, gathering information directly from individuals about their perceived ankle function and symptoms. This tool helps healthcare professionals gain insight into how ankle instability impacts a person’s daily activities and overall quality of life.
Purpose of the CAIT
The CAIT was developed to address the challenges of objectively quantifying chronic ankle instability (CAI), a condition characterized by persistent symptoms following an initial ankle sprain. Individuals with CAI often experience recurrent ankle sprains, a sensation of the ankle “giving way,” and ongoing pain or weakness. Unlike some other medical conditions, CAI lacks a single objective diagnostic test, such as an MRI, making patient-reported tools like the CAIT particularly useful. The CAIT provides clinicians with a standardized method to measure the subjective experience of ankle instability, allowing for consistent assessment of symptom severity and differentiation between stable and unstable ankles. It has been translated and validated in numerous languages, demonstrating its wide applicability in clinical practice globally.
Administering the CAIT
The CAIT is structured as a questionnaire containing nine specific questions. These questions delve into various aspects of ankle function, including the presence of pain, feelings of instability during different activities, and confidence in the ankle. Patients are asked to rate their perceived difficulty or experience with various physical activities related to their ankle. The questionnaire is designed to be self-administered, allowing patients to complete it independently for both the left and right ankles, providing a comprehensive view of a person’s ankle stability. While patients complete the form, a qualified healthcare professional, such as a physical therapist or orthopedic surgeon, must interpret the scores and provide a diagnosis.
Understanding CAIT Scores
The CAIT employs a scoring system that ranges from 0 to 30 points. A higher score on the CAIT indicates greater ankle stability (e.g., 30 points), while a lower score suggests more significant functional ankle instability (e.g., 0 points). The original research that introduced the CAIT suggested a cutoff score of 27 or less to indicate chronic ankle instability. However, more recent studies have proposed a lower cutoff point of 25 or less for improved accuracy in distinguishing individuals with and without CAI. It is important to remember that these cutoff scores serve as indicators and should be considered within a broader clinical evaluation.
What Happens After a CAIT Assessment
Completing the CAIT is typically one component of a thorough evaluation for ankle instability, serving as a screening tool that provides valuable patient-reported data but is not a standalone diagnostic test. After completing the CAIT, it is important to discuss the results with a healthcare professional, such as a physical therapist or an orthopedic specialist. The healthcare professional will consider the CAIT score alongside other findings from a physical examination, medical history, and potentially other diagnostic tests. Based on this comprehensive assessment, a personalized management plan can be developed. This plan might include recommendations for physical therapy to improve strength, balance, and proprioception, the use of ankle braces for support, or other tailored treatment strategies to address the individual’s specific ankle condition.