An evaluation of physiotherapists’ knowledge regarding the clinical assessment of an acute ankle sprain and chronic ankle instability

Abstract

INTRODUCTION: Previous research has shown that 40% of people who suffer an ankle sprain will develop chronic ankle instability (CAI). Both mechanical insufficiencies and functional insufficiencies contribute to the development of CAI. In order to reduce the incidence of CAI and to provide the highest standard of care to patients, physiotherapists must be able to identify these insufficiencies in order to develop an appropriate treatment pathway. METHODS: We designed an online survey which the Irish Society of Chartered Physiotherapists sent to members within particular subgroups. The survey allowed us to determine the competencies of Chartered Physiotherapists in conducting a comprehensive clinical ankle assessment, their knowledge of CAI and their self-rated confidence in treating and assessing an ankle injury. RESULTS: From the emails distributed, 263 people chose to take part. Of those, 87 people completed the survey, yielding a response rate of 33% . Of the 87 respondents, 49% could not identify any mechanical impairments, and 40% could only identify one. 47% could not identify any functional impairments, 21% identified one and 25% identified two. 62% of participants did not include ankle joints arthrokinematics in their clinical assessments of ankle injury, and 60% did not include patient reported outcome measures. Therefore the majority of Irish physiotherapist’s are not meeting the minimally accepted standards of ankle injury assessments. Despite this, 86% of participants rated themselves as 6/10 or greater in their own clinical assessment proficiency. CONCLUSION: Our results highlight that Irish physiotherapist have a limited understanding of the mechanical and functional insufficiencies contributing to the development of CAI.