Psychological factors including self-efficacy, global mental health, and kinesiophobia (TSK-11) are key predictors of dynamic balance performance in individuals with chronic ankle instability, explaining up to 44% of variance in balance scores.
Key Findings
Results
Self-efficacy, global mental health, and kinesiophobia (TSK-11) together significantly predicted the SEBT composite score in individuals with chronic ankle instability.
The regression model explained 40% of the variance in SEBT composite scores
F-value = 7.82, p < 0.01
Study included 40 individuals with CAI (17 men, 23 women) in a cross-sectional observational design
Psychological profiles assessed included kinesiophobia, self-reported mental health, self-efficacy, global mental health, and functional status via FAAM-Sport
Results
Posterior-medial reach direction was best predicted by self-efficacy, global mental health, and TSK-11, accounting for the largest proportion of variance among all directional scores.
The model explained 44% of the variance in posterior-medial reach
F-value = 9.05, p < 0.01
This direction showed the strongest predictive model of all individual SEBT directions examined
Results
Posterior-lateral reach was significantly predicted by self-efficacy and global mental health in individuals with CAI.
The model explained 28% of the variance in posterior-lateral reach
F-value = 6.92, p = 0.003
TSK-11 was not retained as a predictor for this direction, unlike for other directions
Results
Anterior reach performance was most strongly associated with self-efficacy and TSK-11.
The model explained 36% of the variance in anterior reach
F-value = 10.26, p < 0.01
Global mental health was not retained as a predictor for this direction
This direction had the highest F-value among all individual directional models
Discussion
Psychological deficits in individuals with CAI were identified as key predictors of dynamic balance performance across multiple SEBT directions.
Psychological factors explained between 28% and 44% of variance depending on SEBT direction
The study is described as the first to explore the impact of psychological deficits on dynamic balance in CAI
Authors conclude that 'incorporating mental health assessments into physical rehabilitation may enhance treatment outcomes for individuals with CAI'
What This Means
This research suggests that mental and psychological factors play a meaningful role in how well people with chronic ankle instability (CAI) — a condition involving repeated ankle sprains and ongoing instability — are able to balance dynamically. The study tested 40 people with CAI using the Star Excursion Balance Test (SEBT), which measures how far someone can reach in different directions while standing on one foot, as well as psychological questionnaires measuring fear of movement (kinesiophobia), self-efficacy (belief in one's ability to perform tasks), and overall mental health.
The findings show that psychological factors — particularly self-efficacy, overall mental health, and fear of movement — predicted 28% to 44% of the variation in balance performance depending on the direction tested. This means that people who had lower confidence, poorer mental health, or greater fear of re-injury tended to perform worse on balance tests, independent of physical factors alone. Different directions of balance reach were associated with slightly different combinations of psychological predictors.
This research suggests that treating only the physical aspects of chronic ankle instability may be insufficient for full recovery. Rehabilitation programs that also screen for and address psychological factors — such as fear of movement and low self-confidence — could potentially lead to better balance outcomes for people with this condition. This highlights a broader connection between mental health and physical performance in musculoskeletal rehabilitation.
Jaffri A. (2026). Mental Health Predictors of Dynamic Balance in Individuals With Chronic Ankle Instability.. Journal of foot and ankle research. https://doi.org/10.1002/jfa2.70152