Foot and Ankle Ability Measure

What are foot and ankle disorders?

Foot and ankle problems are prevalent conditions that can significantly impact an individual’s mobility and quality of life. These issues can arise from various causes, including injuries, overuse, and chronic diseases. Common foot and ankle problems include sprains, fractures, plantar fasciitis, Achilles tendinitis, and arthritis. Each condition presents unique challenges, ranging from pain and swelling to difficulty walking and performing daily activities. These problems are part of a broader category known as musculoskeletal disorders, which affect physical function in patients with conditions impacting the feet, ankles, and legs.

For instance, sprains and fractures often result from sudden trauma or accidents, leading to immediate pain and mobility limitations. Chronic conditions like plantar fasciitis, Achilles tendonitis, and chronic ankle instability typically develop over time due to repetitive stress and overuse, causing persistent discomfort and affecting daily routines. Additionally, arthritis in the foot and ankle joints can lead to chronic pain and stiffness, significantly impacting one’s ability to engage in physical or usual sports related activities.  

What physical function is affected by these disorders?

Foot and ankle problems can disrupt various activities of daily living, making it difficult for individuals to maintain their usual routines. These activities include:

• Walking: Foot and ankle issues can cause pain and instability, making it challenging to walk even short distances.
• Standing: Prolonged standing may become uncomfortable or painful, affecting tasks requiring long standing periods.
• Climbing stairs: Ascending and descending stairs can be particularly difficult due to the increased pressure on the foot and ankle joints.
• Running and jumping: High-impact activities like running and jumping may exacerbate pain and increase the risk of further injury. These problems often significantly impact usual sports activities.
• Household chores: Simple cleaning, cooking, and gardening tasks can become strenuous and painful.
• Work-related activities: Jobs that require standing, walking, or lifting can be significantly impacted, leading to decreased productivity and potential job-related challenges.

What is the Foot and Ankle Ability Measure?

The Foot and Ankle Ability Measure (FAAM) is a comprehensive assessment tool designed to evaluate the functional limitations and disabilities associated with foot and ankle conditions. Developed by Martin et al. (2005), the FAAM consists of two crucial components: the Activities of Daily Living (ADL) and the Sports subscales. These subscales collectively assess the impact of foot and ankle disorders and problems on various activities, ranging from routine daily tasks to more demanding sports activities.

In thi scale, patients rate their difficulty in performing specific activities on a scale from “no difficulty” to “unable to do.” This structured approach provides healthcare professionals valuable insights into the severity of the patient’s condition and its impact on their daily lives. The daily living subscale is particularly important in assessing daily activities, presenting data correlating scores on the ADL subscale with global functional ratings among athletes. The FAAM helps clinicians monitor patient progress over time and tailor interventions to improve functional outcomes. Additionally, the FAAM evaluates the physical function and pain interference in surgically operated patients with chronic foot conditions, highlighting its interrelationship with pain and function outcomes (foot ankle surg).

When patients undergo the FAAM assessment, they can expect to answer questions about their ability to perform various activities related to daily living and sports. The results provide a detailed understanding of how foot and ankle problems affect physical function and functionality, guiding effective treatment plans and rehabilitation strategies.

The ADL and sports subscales are beneficial in comparing scores between healthy individuals and those with chronic ankle instability (CAI), demonstrating differences in functionality and responsiveness to treatment over time.

Scoring and interpretation

Scoring the FAAM involves calculating two scores for the ADL and Sports subscale. Each item in the subscales is rated on a 5-point scale, where 4 indicates no difficulty, 3 indicates slight difficulty, 2 indicates moderate difficulty, 1 indicates extreme difficulty, and 0 indicates unable to do. Responses of “N/A” are not counted.

To calculate the ADL score, sum the ratings of all items, divide by the highest possible score (the number of items answered multiplied by 4), and then multiply by 100 to get a percentage. The exact process is used to calculate the Sports subscale score. Higher percentages indicate better functional abilities.

Higher scores on the ADL subscale reflect greater ability to perform daily activities. In comparison, higher scores on the Sports subscale reflect better performance in sports and physical therapy-related tasks. These scores help clinicians understand the patient’s functional limitations and guide appropriate treatment interventions. Compared to other measures like the Foot and Ankle Outcome Score (FAOS), the FAAM provides a comprehensive assessment of both daily and sports-related functional abilities.

Furthermore, selecting reliable patient-reported outcome measures based on their measurement properties, such as validity and reliability, is crucial to better understanding the impact of musculoskeletal disorders on patients' daily lives.

How to use our Foot and Ankle Ability Measure template

Our FAAM template is straightforward and designed to facilitate efficient assessment and documentation of foot and ankle function. Follow these steps to use the template effectively:

Step 1: Download the template

Begin by downloading our Foot and Ankle Ability Measure template. Ensure you have the latest version to access all necessary sections and scoring guidelines.

Step 2: Explain the assessment to the patient

Before starting the assessment, explain the purpose and process of the FAAM to the patient. Ensure they understand how to rate their difficulty with each activity accurately.

Step 3: Administer the ADL subscale

Guide the patient through the ADL subscale, asking them to rate their difficulty in performing daily activities over the past week. Record their physical function responses in the provided sections.

Step 4: Administer the Sports subscale

Next, administer the Sports subscale, focusing on the patient’s difficulty with sports-related activities. Ensure all responses are accurately recorded.

Step 5: Calculate and interpret the scores

After completing the assessment, calculate the ADL and Sports subscale scores using the provided scoring instructions. Interpret the results to determine the patient's functional ability and guide subsequent treatment plans.

Benefits of using our template

The FAAM plays a significant role in measuring chronic ankle instability by providing reliable, valid, and responsive patient-reported outcome measures (PROMs). Self-reported outcome instruments are crucial in capturing subjective information that aids clinicians in understanding patients' perceived limitations and treatment efficacy over time.

Using our FAAM template offers the following advantages for healthcare professionals and patients:

Easy to administer

Our template simplifies the assessment process, making it easy for clinicians to administer and for patients to understand. This helps quickly gather reliable data on functional abilities.

Comprehensive evaluation

The FAAM template thoroughly assesses foot and ankle disorders in daily living and sports activities, ensuring that foot and ankle aspects of action are evaluated. This comprehensive approach helps identify specific areas that need attention.

Track progress over time

Using our FAAM template regularly, clinicians can track changes in a patient’s functional status over time. This is valuable for monitoring the effectiveness of interventions and making necessary adjustments to treatment plans.

Reference

Martin, R. L., Irrgang, J. J., Burdett, R. G., Conti, S. F., & Swearingen, J. M. V. (2005). Evidence of validity for the foot and ankle ability measure (FAAM). Foot & Ankle International, 26(11), 968–983. https://doi.org/10.1177/107110070502601113