Author ORCID Identifier
https://orcid.org/0000-0002-2629-9771
Date Available
5-6-2026
Year of Publication
2025
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Health Sciences
Department/School/Program
Rehabilitation Sciences
Faculty
Matthew Hoch
Faculty
Gilson Capilouto
Abstract
Ankle sprains are among the most common musculoskeletal injuries in the United States. Approximately 2 million ankle sprains occur annually, with an estimated 46% of affected individuals experiencing residual symptoms and developing chronic ankle instability (CAI). In addition to physical impairments, individuals with CAI may exhibit lower physical and psychological health-related quality of life (HRQL). HRQL integrates the physical, psychological, and social domains of a person’s health and is influenced by their experiences, expectations, and perceptions.
Injury-related fear is a common psychological impairment in individuals with CAI and has been associated with decreased physical function, reduced physical activity, and greater disability. Despite its impact, treatment strategies targeting psychological impairments in individuals with CAI have not been thoroughly examined. Self-efficacy— an individual’s belief in their ability to complete tasks or manage challenging situations—is a modifiable factor that influences an individual’s ability to cope with injuries. Self-efficacy is domain-specific, meaning an individual’s perceived self-efficacy may vary depending on the affected body area or situation.
Self-efficacy has been studied across various musculoskeletal conditions, including low back pain and anterior cruciate ligament injuries. Higher levels of self- efficacy are associated with improved HRQL outcomes, reduced psychological distress, and enhanced functional recovery in these populations. Despite this evidence, self- efficacy has not yet been examined in individuals with a history of ankle sprains. To accurately assess self-efficacy and understand its role in this population, a valid and reliable patient-reported outcome measure is needed. Establishing such an assessment will allow researchers and clinicians to develop a more comprehensive understanding of ankle sprain recovery and create targeted treatment strategies that address psychological factors.
Current evidence suggests a gap between best-practice recommendations for psychologically informed clinical care and athletic trainers’ confidence in implementing these interventions. Therefore this dissertation sought to understand the role self-efficacy plays in rehabilitation and recovery from ankle sprains through three primary purposes. The first purpose was to develop an ankle-specific self-efficacy assessment tool and assess the psychometric properties of this tool in individuals with an ankle sprain history. The second purpose was to determine if athletic trainers utilize self-efficacy targeted interventions in the management of individuals with ankle sprains. The third purpose was to determine athletic trainers’ perceptions of self-efficacy and its role in ankle sprain rehabilitation.
The findings of this dissertation will contribute to improving the clinical management of ankle sprains. Additionally, they will help researchers better understand the discrepancies between best-practice recommendations and current clinical behaviors among athletic trainers.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2025.71
Funding Information
This study was funded by the Endowed University Professor in Health Sciences fund in 2024.
Recommended Citation
Walsh, Bridget M., "The Role of Self-Efficacy in Rehabilitation and Recovery from Ankle Sprains" (2025). Theses and Dissertations--Rehabilitation Sciences. 111.
https://uknowledge.uky.edu/rehabsci_etds/111
