Background

Chronic ankle instability (CAI) is associated with defective posture control and balance; thus, a proper assessment of these impairments is necessary for effective clinical decision-making. There is a need for portable, valid, and reliable methods to facilitate the easy collection of real-world data, such as mobile phones.

Research question: Is the smartphone “MyAnkle” application valid and reliable in assessing balance in patients with CAI and healthy volunteers?

Methods

This was a cross-sectional study. Sixty-five participants completed two assessment sessions, including 31 patients (n = 41 ankles with CAI and 21 asymptomatic ankles) and 34 healthy volunteers (n = 68 ankles). In each session, dynamic single-leg stance balance was measured simultaneously using the "MyAnkle" application and the Biodex balance system (BBS) version 3. Testing was conducted at three levels of BBS difficulty—4 (D4, hard, loose platform), 6 (D6, moderate), and 8 (D8, easy, stiffer platform)—and repeated with opened and closed eyes. Both limbs were tested in a random order by two independent blinded assessors.

Results

The two devices showed significant poor-to-moderate correlations when eyes were closed (p < 0.05). For discriminant validity, the application did not distinguish the two study groups in all tested conditions (p > 0.05), whereas the BBS weakly to moderately distinguished the dominant limbs in the two groups at all difficulty levels with eyes-open and at D8 with eyes-closed regardless to limb dominance. For reliability, a significantly poor to moderate inter-session reliability was noted for the two devices.

Significance

"MyAnkle" application is valid in assessing balance in patients with CAI when the eyes are closed. However, similarly to BBS, its one-week test-retest reliability may be insufficient for accurate follow-up of balance changes and need to be interpreted with caution. Future studies need to establish its inter-tester reliability and its usefulness in telerehabilitation.

中文翻译：

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使用智能手机评估慢性踝关节不稳患者和健康志愿者平衡的有效性和可靠性：一项横断面研究。

背景

慢性踝关节不稳（CAI）与姿势控制和平衡不佳相关；因此，对这些损伤的正确评估对于有效的临床决策是必要的。需要便携式，有效和可靠的方法来促进容易地收集诸如移动电话之类的现实世界数据。

研究问题：智能手机“ MyAnkle”应用程序在评估CAI患者和健康志愿者的平衡方面是否有效且可靠？

方法

这是一项横断面研究。65名参与者完成了两次评估会议，包括31例患者（n = 41例CAI脚踝和21例无症状的脚踝）和34名健康志愿者（n = 68脚踝）。在每节课中，使用“ MyAnkle”应用程序和Biodex平衡系统（BBS）版本3同时测量动态单腿姿势平衡。测试在BBS难度的三个级别上进行，即4级（D4，坚硬，松动的平台）， 6（D6，中等）和8（D8，简单，更硬的平台），然后睁开和闭上眼睛重复。两名独立的盲人评估者以随机顺序测试了四肢。

结果

闭眼时，这两种装置显示出明显的差到中度相关性（p <0.05）。为了判别有效性，该应用程序未在所有测试条件下区分两个研究组（p> 0.05），而BBS弱于在睁眼时和在D8时在所有难度下均能区分两组中的优势肢体。 -不考虑肢体优势而封闭。对于可靠性，注意到这两个设备的会话间可靠性非常差至中等。

意义

“ MyAnkle”应用程序在闭眼时可有效评估CAI患者的平衡。但是，与BBS相似，其为期一周的重测可靠性可能不足以准确跟踪余额变化，因此请谨慎解释。未来的研究需要确定其测试者间的可靠性以及其在远程康复中的实用性。