College of Health Sciences


Ph.D. Kinesiology and Rehabilitation - School of Rehabilitation Sciences

Publication Date

Spring 2020




Interactions between sensory-perceptual and motor-behavioral impairments in individuals with chronic ankle instability (CAI) are important for successful assessment and treatment of CAI. One of the most consistently reported motor-behavioral impairments is poor reach performance in a dynamic balance task. Injury-related fear is recognized as an important sensory-perceptual impairment, and those with injury-related fears may engage in protective movement strategies found to be associated with reach deficits. Injury-related fear may also impact one’s perception of ability, or self-efficacy, which has demonstrated positive associations with balance performance in other populations, but these relationships have yet to be investigated in the CAI population. Objective: To examine the relationships between injury-related fear, self-efficacy, and dynamic balance performance in those with CAI. Methods: 33 individuals with CAI (F:18, M:15, 22.8±3.3yrs, 170.2±8.5cm, 78.0±13.6kg) reported their level of injury-related fear via the Tampa Scale of Kinesiophobia (TSK-11). The Self-Efficacy of Balance Scale (SEBS) was utilized to capture participants’ level of balance self-efficacy. Dynamic balance performance was assessed on the involved limb with the Star-Excursion Balance Test in the anterior, posteromedial (SEBT-PM), and posterolateral (SEBT-PL) directions and a composite (SEBT-COMP) score was calculated for overall performance. Pearson correlations were used to analyze associations between these outcomes with significance set at P PResults: Significant negative correlations were identified between TSK-11 and SEBS scores (r=-0.34, P=0.050), indicating those with higher levels of kinesiophobia demonstrated lower levels of balance self-efficacy. Significant positive correlations were identified between SEBS scores and SEBT-COMP (r=0.48, P=0.005), SEBT-PM (r=0.42, P=0.016), and SEBT-PL (r=0.48, P=0.005), indicating that individuals who perceived themselves as more confident in their balance ability demonstrated better balance performance. Conclusions: Injury-related fear did not have a direct relationship with dynamic reach performance in individuals with CAI, but may have an indirect relationship with dynamic balance performance by impacting one’s balance self-efficacy.


Sensory-perceptual impairments, Motor-behavioral impairments, Injury-related fear, Chronic ankle instability, Balance performance, SEBS


Exercise Science | Kinesiotherapy | Motor Control



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Relationships Between Injury-Related Fear, Balance Self-Efficacy, and Dynamic Balance Performance in Those With Chronic Ankle Instability