Evaluation of Chronic Lateral Ankle Instability With an Ankle Sprain Simulator: A Controlled Study in Physically Active Subjects

Matthieu Lalevée; Marie-Anne Melone; Maxime l'Hermette; Julien Beldame; Cesar de Cesar Netto; Eli Schmidt; Jason Wilken

doi:10.1002/jfa2.70182

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Evaluation of Chronic Lateral Ankle Instability With an Ankle Sprain Simulator: A Controlled Study in Physically Active Subjects

Journal article

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Evaluation of Chronic Lateral Ankle Instability With an Ankle Sprain Simulator: A Controlled Study in Physically Active Subjects

Matthieu Lalevée, Marie-Anne Melone, Maxime l'Hermette, Julien Beldame, Cesar de Cesar Netto, Eli Schmidt and Jason Wilken

Journal of foot and ankle research, Vol.19(3), e70182

07/15/2026

DOI: 10.1002/jfa2.70182

PMID: 42458962

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Abstract

Chronic lateral ankle instability (CLAI), categorized by repetitive ankle sprains, has previously been studied utilizing either questionnaires or ankle sprain simulators. However, a quantitative tool that safely creates an unexpected ankle sprain during gait has not been proposed. This study aimed to determine if a novel ankle sprain simulator differentiates between CLAI and healthy controls and compare findings to known measures of impaired function. Thirty-two feet were assigned to the CLAI group or the control group. Participants walked on a treadmill wearing boots designed to induce unexpected ankle inversion. To do so, the device was triggered randomly during swing to induce instability during loading response. Maximal inversion velocities (MIV) were measured immediately after initial contact. A Ratio MIV was determined by dividing the MIV of the simulated sprain by the average MIV of the 5 steps preceding the simulated sprain. Also, Identification of Functional Ankle Instability (IdFAI) and the Foot Ankle Ability Measurement (FAAM) questionnaires were collected. Mean MIV in the CLAI and Control groups were 213.5 ± 54.7°/s and 177.0 ± 64.2°/s (p = 0.02), while mean Ratio MIV were 1.22 ± 0.13 and 1.08 ± 0.08 (p < 0.001), respectively. The area under the curve to predict CLAI was 0.83 (95% CI; [0.73; 0.93]) for Ratio MIV with a value greater than 1.15 showing 68% sensitivity and 93.8% specificity. Ratio MIV was moderately correlated with IdFAI (ρ = 0.50; p < 0.0001) and weakly correlated with impairments in activities of daily living (ρ = -0.45; p < 0.001) and sports (ρ = -0.43; p < 0.001). Inversion velocities caused by the ankle sprain simulator differentiated CLAI from healthy controls. Ratio MIV was associated with measurements of functional CLAI, impairments in ADLs and sports.

ankle inversion

ankle kinematics

ATFL

CFL

instability

inversion velocity

UIOWA OA Agreement

Details

Title: Subtitle: Evaluation of Chronic Lateral Ankle Instability With an Ankle Sprain Simulator: A Controlled Study in Physically Active Subjects
Creators: Matthieu Lalevée - Université de Rouen Normandie
Marie-Anne Melone - Department of Pulmonary, Thoracic Oncology and Respiratory Intensive Care, Rouen University Hospital, Univ Rouen, Rouen, France
Maxime l'Hermette - CETAPS-UR 3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen, Mont Saint Aignan, Normandy, France
Julien Beldame - Générale de Santé
Cesar de Cesar Netto - Duke University
Eli Schmidt - University of Iowa
Jason Wilken - University of Iowa
Resource Type: Journal article
Publication Details: Journal of foot and ankle research, Vol.19(3), e70182
DOI: 10.1002/jfa2.70182
PMID: 42458962
NLM abbreviation: J Foot Ankle Res
ISSN: 1757-1146
eISSN: 1757-1146
Publisher: Wiley
Language: English
Date published: 07/15/2026
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9985183130202771

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