Considerations in the selection of patient-reported outcome measures for assessing function related to chronic ankle instability

Lijiang Luan^1,2Jeremy Witchalls³Phil Newman³Adrian Pranata⁴Charlotte Ganderton^4,5Oren Tirosh⁴Doa El-Ansary^4,6Roger David Adams^3,7Gordon Waddington^3,8Jia Han^1,2,3,4,9*

• ¹Jiangwan Hospital of Hongkou District, Shanghai, China
• ²School of Exercise and Health, Shanghai University of Sport, Shanghai, China
• ³Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
• ⁴School of Health and Biomedical Sciences, STEM College, Royal Melbourne Institute of Technology (RMIT University), Melbourne, Australia
• ⁵Department of Nursing and Allied Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
• ⁶Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
• ⁷Discipline of Physiotherapy, School of Health Sciences, The University of Sydney, Sydney, Australia
• ⁸Faculty of Health, University of Canberra, Canberra, Australia
• ⁹College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China

Patient-reported outcome measures (PROMs) are essential tools in evaluating chronic ankle instability (CAI), capturing subjective experiences such as "giving way" and instability. However, no standardized guidelines exist for selecting PROMs in CAI, resulting in limited comparability across studies and clinical settings. This paper highlights four key considerations for selecting PROMs in assessing CAI: recalibration in populations including individuals with CAI, identifiability of ankle instability, detectability of CAI characteristics, and cross-cultural adaptability. It emphasizes that CAI-specific PROMs should demonstrate high pertinence, accurately distinguishing CAI from other conditions, and effectively detecting symptom changes over time.Furthermore, widely adopted PROMs may offer greater credibility and applicability.Addressing these considerations is crucial for improving CAI diagnosis, treatment evaluation, and advancing patient-centered care.