Cumberland Ankle Instability Tool

A validated 9-item questionnaire designed to measure the severity of functional ankle instability in individuals with chronic ankle instability.

What is the Cumberland Ankle Instability Tool?

The Cumberland Ankle Instability Tool (CAIT) is a widely-used, validated questionnaire specifically designed to assess the severity of functional ankle instability. Developed through rigorous psychometric testing, the CAIT evaluates multiple aspects of ankle function including pain, instability, and activity limitations. It is particularly valuable for identifying individuals with chronic ankle instability and monitoring their progress through rehabilitation. The questionnaire has demonstrated excellent reliability and validity in both athletic and general populations, making it a standard assessment tool in sports medicine and physiotherapy practices worldwide.

Scoring System

The CAIT uses a variable scoring system across 9 items. Each question has different response options with associated point values. The total score ranges from 0 to 30, where higher scores indicate better ankle stability and function. Scores are calculated by summing the point values from all 9 items. A score of 27 or less (out of 30) is generally considered indicative of functional ankle instability, while a score below 24 strongly suggests chronic ankle instability. The questionnaire does not use subscales; rather, it provides a single total score representing overall ankle stability.

General Information

Importance:
Common
Scoring:
Higher is Better
Time to Complete:
5 minutes
Pages:
1
Questions:
9
Licensed:
No

Clinical Information

Medical Specialties:
orthopaedics sports medicine physiotherapy
Anatomic Areas:
ankle foot
Indications:
Chronic ankle instability assessment Functional ankle instability evaluation Post-ankle sprain rehabilitation Lateral ankle ligament injury assessment Recurrent ankle sprain history

Instructions

Please answer all 9 questions based on your ankle condition and experiences over the past month. For each question, select the response that best describes your situation. Consider your most affected ankle when answering. The questionnaire takes approximately 3-5 minutes to complete.

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Cumberland Ankle Instability Tool

A validated 9-item questionnaire designed to measure the severity of functional ankle instability in individuals with chronic ankle instability.

Instructions:

Please answer all 9 questions based on your ankle condition and experiences over the past month. For each question, select the response that best describes your situation. Consider your most affected ankle when answering. The questionnaire takes approximately 3-5 minutes to complete.

Ankle Stability Assessment

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Patient Watch Form - 10/31/2025

Detailed Scoring Methodology

The CAIT uses a variable scoring system across 9 items. Each question has different response options with associated point values. The total score ranges from 0 to 30, where higher scores indicate better ankle stability and function. Scores are calculated by summing the point values from all 9 items. A score of 27 or less (out of 30) is generally considered indicative of functional ankle instability, while a score below 24 strongly suggests chronic ankle instability. The questionnaire does not use subscales; rather, it provides a single total score representing overall ankle stability.

Assessment Subscales

Total Ankle Stability Score

Overall measure of ankle stability and functional capacity

Questions: 9
Score Range: 0-30

Meaningful Change Threshold

A change of 3 points or more in the CAIT total score is considered clinically meaningful and represents a noticeable improvement or decline in ankle stability. Changes of 5 points or greater indicate substantial functional improvement.

About the Developers

The Cumberland Ankle Instability Tool was developed by Claire E. Hiller and colleagues at the University of Sydney, Australia. The questionnaire was published in 2006 following extensive validation studies with athletes and individuals experiencing chronic ankle instability. The development process included item generation, expert review, and psychometric testing to ensure comprehensive assessment of functional ankle instability.

Copyright Information

The CAIT is freely available for clinical and research use without licensing fees. While the questionnaire is copyrighted by the original authors, it can be used, reproduced, and distributed without permission for non-commercial purposes. Proper citation of the original validation study (Hiller et al., 2006) is requested when using the tool in research or publications.

Administration Instructions

Please answer all 9 questions based on your ankle condition and experiences over the past month. For each question, select the response that best describes your situation. Consider your most affected ankle when answering. The questionnaire takes approximately 3-5 minutes to complete.

Limitations & Considerations

The CAIT is a self-reported questionnaire and may be influenced by patient recall bias or subjective perception of symptoms. It focuses specifically on functional ankle instability and does not assess structural instability or ligamentous laxity. The questionnaire may not be sensitive enough to detect subtle changes in highly functional individuals. Some questions reference specific activities that may not be relevant to all populations (e.g., non-athletes). The CAIT should be used in conjunction with clinical examination and other objective measures for comprehensive ankle assessment.

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