Health-related quality of life among middle-aged adults with chronic ankle instability, copers, and uninjured controls

Abstract

Context: People with chronic ankle instability (CAI) display a lower regional and global health-related quality of life (HRQoL). Examinations of HRQoL outcomes associated with CAI have addressed younger adults, restricting our understanding of the long-term consequences of CAI. Objective: To compare ankle regional and global HRQoL in middle-aged participants with and those without CAI. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 59 middle-aged volunteers, consisting of 18 with CAI (age ¼ 50.2 6 9.3 years), 17 who were ankle-sprain copers (age ¼ 54.5 6 8.7 years), and 24 uninjured controls (age ¼ 56.7 6 10.0 years). Main Outcome Measure(s): Participants completed the Foot and Ankle Disability Index (FADI) and the Patient-Reported Outcomes Measurement Information System Adult Profile. Regional HRQoL was assessed using the FADI Activities of Daily Living and Sport subscales. Global HRQoL was measured using the 43-item Patient-Reported Outcomes Measurement Information System Adult Profile, which contains 7 short forms—Physical Function, Pain Interference, Fatigue, Depression, Sleep Disturbance, Anxiety, and Ability to Participate in Social Roles and Activities. Separate Kruskal-Wallis tests were used to determine between-groups differences. Results: Middle-aged participants with CAI had lower scores on both subscales of the FADI than the coper and control groups (all P values,.001). Participants with CAI scored lower on the Physical Function (U ¼ 116.0, z ¼-2.78, P ¼ .005) and Ability to Participate in Social Roles and Activities (U ¼ 96.0, z ¼-3.09, P ¼ .002) subscales but higher on the Pain Interference (U ¼ 144.0, z ¼-2.36, P ¼ .02), Fatigue (U ¼ 110.0, z ¼-2.72, P ¼ .006), and Depression (U ¼ 110.5, z ¼-2.91, P ¼ .004) subscales than the control group. Participants with CAI also scored lower on the Physical Function (U ¼ 74.5, z ¼ -2.79, P ¼ .005) and Ability to Participate in Social Roles and Activities (U ¼ 55.0, z ¼ -3.29, P ¼ .001) subscales but higher on the Fatigue (U ¼ 90.0, z ¼-2.09, P ¼ .04) and Depression (U ¼ 96.5, z ¼ -1.97, P ¼ .048) subscales than the coper group. Conclusions: Middle-aged participants with CAI displayed worse ankle regional and global HRQoL than their age-matched healthy counterparts and copers. These results demonstrated that CAI can affect HRQoL outcomes in middle-aged adults.