Department of Physical Therapy for Musculoskeletal Disorders and Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Gait Posture. 2020 Oct;82:26-32. doi: 10.1016/j.gaitpost.2020.08.116. Epub 2020 Sep 15.
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.
Is the smartphone "MyAnkle" application valid and reliable in assessing balance in patients with CAI and healthy volunteers?
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.
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.
"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.
慢性踝关节不稳定（CAI）与姿势控制和平衡缺陷有关；因此，为了做出有效的临床决策，需要对这些损伤进行适当的评估。需要使用便携、有效且可靠的方法来方便地收集真实世界的数据，例如使用手机。
智能手机“我的脚踝”（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和可靠？
这是一项横断面研究。65 名参与者完成了两次评估，包括 31 名患者（n = 41 只脚踝有 CAI，21 只无症状脚踝）和 34 名健康志愿者（n = 68 只脚踝）。在每次评估中，同时使用“MyAnkle”应用程序和 Biodex 平衡系统（BBS）版本 3 测量单腿动态站立平衡。测试在 BBS 三个难度级别进行-4 级（D4，难，松动平台）、6 级（D6，中，中等平台）和 8 级（D8，易，较硬平台）-并睁眼和闭眼重复测试。两名独立的盲法评估员以随机顺序测试两条腿。
当眼睛闭上时，两种设备之间的相关性很差到中度（p < 0.05）。在区分效度方面，应用程序在所有测试条件下都无法区分两个研究组（p > 0.05），而 BBS 在所有难度级别睁眼和闭眼时 D8 时，在两组中均以较弱到中度区分优势肢体，无论优势肢体如何。对于可靠性，两种设备的两次评估之间的可靠性明显较差到中度。
当眼睛闭上时，“我的脚踝”应用程序在评估 CAI 患者的平衡方面是有效的。然而，与 BBS 类似，其一周的测试-重测可靠性可能不足以准确跟踪平衡变化，需要谨慎解释。未来的研究需要建立其测试者间可靠性以及在远程康复中的实用性。
