Use our readymade template to create your Cumberland Ankle Instability Tool (CAIT) for assessing the severity of functional ankle instability
Create your care assessments
| CAIT score | Ankle Instability Severity |
|---|---|
| 28-30 | None |
| 24-27 | Mild |
| 19-23 | Moderate |
| 0-18 | Severe |
- 9-item questionnaire that scores each item on a scale, with a total score ranging from 0 to 30
- Real-time calculation of CAIT Score based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of ankle instability
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1004 |
| Patient Name | John W |
| Patient Email | johnw@ymail.com |
| Patient Phone Number | 0987654321 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| 1. I have pain in my ankle | During sport |
| 2. My ankle feels UNSTABLE | Sometimes during sport (not every time) |
| 3. When I make SHARP turns, my ankle feels UNSTABLE | Somtimes when running |
| 4. When going down the stairs, my ankle feels UNSTABLE | If I go fast |
| 5. My ankle feels UNSTABLE when standing on ONE leg | On the ball of my foot |
| 6. My ankle feels UNSTABLE when | I hop from side to side |
| 7. My ankle feels UNSTABLE when | I run on uneven surfaces |
| 8. TYPICALLY, when I start to roll over (or “twist”) on my ankle, I can stop it | Immediately |
| 9. After a TYPICAL incident of my ankle rolling over, my ankle return to "normal" | Almost immediately |
| CAIT Score | 26 |
- Pre-populate patient details such as patient id, name, email etc in the CAIT assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their CAIT assessment form prior to their visit
- Allow patients to save their progress and complete their CAIT assessment form at a later time without losing any responses
- Set up an email template for your CAIT assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their CAIT score, diagnosis, next steps when they submit their CAIT assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | 1. I have pain in my ankle | During sport | 4 | 26 |
| 3 | John W | 2. My ankle feels UNSTABLE | Sometimes during sport (not every time) | 3 | 26 |
| 4 | John W | 3. When I make SHARP turns, my ankle feels UNSTABLE | Somtimes when running | 2 | 26 |
| 5 | John W | 4. When going down the stairs, my ankle feels UNSTABLE | If I go fast | 2 | 26 |
| 6 | John W | 5. My ankle feels UNSTABLE when standing on ONE leg | On the ball of my foot | 1 | 26 |
| 7 | John W | 6. My ankle feels UNSTABLE when | I hop from side to side | 2 | 26 |
| 8 | John W | 7. My ankle feels UNSTABLE when | I run on uneven surfaces | 3 | 26 |
| 9 | John W | 8. TYPICALLY, when I start to roll over (or “twist”) on my ankle, I can stop it | Immediately | 3 | 26 |
| 10 | John W | 9. After a TYPICAL incident of my ankle rolling over, my ankle return to "normal" | Almost immediately | 3 | 26 |
- Export patient responses including the calculated CAIT score to Google Sheets for easy record-keeping
- Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their ankle instability symptoms
- Receive a copy of the response and the calculated CAIT score by email whenever a patient submits their CAIT assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1004 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| 1. I have pain in my ankle : | During sport |
| 2. My ankle feels UNSTABLE: | Sometimes during sport (not every time) |
| 3. When I make SHARP turns, my ankle feels UNSTABLE: | Somtimes when running |
| 4. When going down the stairs, my ankle feels UNSTABLE: | If I go fast |
| 5. My ankle feels UNSTABLE when standing on ONE leg: | On the ball of my foot |
| 6. My ankle feels UNSTABLE when: | I hop from side to side |
| 7. My ankle feels UNSTABLE when: | I run on uneven surfaces |
| 8. TYPICALLY, when I start to roll over (or “twist”) on my ankle, I can stop it: | Immediately |
| 9. After a TYPICAL incident of my ankle rolling over, my ankle return to "normal": | Almost immediately |
| CAIT Score: | 26 |
| CAIT Score: | 26 |
- Create a HIPAA compliant CAIT assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting CAIT form responses to Google Sheets and sending them on email
- Prepopulate patient details in CAIT assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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