Summary. The assessment of foot and ankle function still remains an actual issue of the modern orthopedics.
Objective: comparative qualitative analysis of the most common assessment systems of foot and ankle function.
Materials and Methods. The search from PubMed databases from 1946 to 2021 was done. 8898 publications were detected in which assessment systems of foot and ankle function have been used. 12 assessment systems presented in 5705 publications were selected for analysis (inclusion criterion – no less than 40 publications): AOFAS scale, VAS, SF-36 EQL, FFI, FAOS, FAAM, FADI, BFS, MOFAQ, FFI-R, Roles&Maudsley scale, VAS FA. The analysis predicted the assessment system philosophy: numerical estimate, VAS, Likert scale, patient- or investigatororiented, and reliability evidence.
Results. Most of the analized assessment systems meet criteria of reliability (r>0.8; Kronbach’s α≥0.9). For Roles&Maudsley scale and VAS, FA reliability has not been established. The validity fluctuates widely.
Conclusions. The choice of an assessment system must meet the research tasks. The consideration of strong and weak sides of assessment systems promotes their adequate combinations to avoid the bias effect.
Likert R. A technique for the measurement of attitudes. Arch Psychol. 1932; 22():5-55.
Kitaoka H. Clinical rating systems for the ankle – hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994; 15(7):349-353.
Brooks R. Euro QoL: the current state of play. Health Policy. 1996; 37(1):53-72.; EQ-5D value sets: inventory, comparative revieew and user guide. Ed. A. Szende, M. Opple, N. Devlin. Euro Qol. Group Monographs. Vol.2: Springer, 2006.
Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991; 44:561-570. DOI: 10.1016/0895-4356(91)90220-4.
Roos EM, Brandsson S, Karlsson J. Validation of the foot and ankle outcome score for ankle ligament reconstruction. Foot Ankle Int. 2001; 22:788–94. [PubMed: 11642530].
Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005 Nov;26(11):968-83. DOI: 10.1177/107110070502601113.
Budiman-Mak E, Conrad K, Stuck R, Matters M. Theoretical model and Rasch analysis to develop a revised Foot Function Index. Foot Ankle Int 2006, 27:519–527.
Dawson J, Coffey J, Doll H, et al. A patient-based questionnaire to assess outcomes of foot surgery: validation in the context of surgery for hallux valgus. Quol Life Res. 2006;15:1211-1222.
Roles NC, Maudsley RH. Radial tunnel syndrome: resistant tennis elbow as a nerve entrapment. J Bone Joint Surg Br. 1972 Aug;54(3):499-508. PMID: 434092.
Richter M, Zech S, Geerling J, Frink M, Knobloch K, Krettek C. A new foot and ankle outcome score: questionnaire based, subjective, Visual-Analogue-Scale, validated and computerized. Foot Ankle Surg. 2006;12(4):191-9. DOI: 10.1016/j.fas.2006.04.001.
da Conceicao CS, Netoa MG, Netoa AC, Selena M.D. Mendes SMD, Baptistad AF, Sáb KN. Analysis of the psychometric properties of the American Orthopaedic Foot and Ankle Society Score (AOFAS) in rheumatoid arthritis patients: application of the Rasch model. Rev Bras Reumatol. 2016;56(1):8-13.
Lakey E, Hunt KJ. Patient-reported outcomes in foot and ankle orthopedics. Foot Ankle Orthop. 2019; 1-8. DOI: 10.1177/2473011419852930.
Bijur PE, Silver W, Gallagher EJ. Reliability of the Visual Analog Scale for measurement of acute pain. Academ Emerg Med. 2001; 8(12):1153-57.
Eechaute С, Vaes P, Van Aerschot L, Asman S, Duquet W. The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: a systematic review. BMC Musculoskeletal Disorders. 2007;8:6. DOI: 10.1186/1471-2474-8-6.
Budiman-Mak E, Conrad KJ, Mazza J, Stuck RM. A review of the foot function index and the foot function index – revised. J Foot Ankle Res. 2013; 6:5.
Riskowski JL, Hagedorn TJ, Hannan MT. Measures of foot function, foot health, and foot pain. Arthritis Care Res. 2011; 63(11):S229–S239. DOI: 10.1002/acr.20554.
Morley D, Jenkinson C, Doll H, Lavis G, Sharp R, Cooke P, Dawson J. The Manchester–Oxford Foot Questionnaire (MOXFQ). Development and validation of a summary index score. Bone Joint Res 2013;2(4):66–9.
Gagnier JJ. Patient reported outcomes in orthopaedics. J Orthop Res. 2017;35(10):2098-2108. DOI: 10.1002/jor.23604.
Zwiers R, Weel H, Mallee WH, Kerkhoffs GMMJ, van Dijk CN. Ankle platform study collaborative – science of variation group. Large variation in use of patient-reported outcome measures: a survey of 188 foot and ankle surgeons. Foot Ankle Surg. 2018;24(3):246-251. DOI: 10.1016/j.fas.2017.02.013.
Hunt KJ, Hurwit D. Use of patient-reported outcome measures in foot and ankle research. J Bone Joint Surg Am. 2013;95(16):e118(1-e118(9. DOI: 10.2106/JBJS.L.01476.
Terwee CB, Prinsen CAC, Chiarotto A, et al. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27(5):1159-1170. DOI: 10.1007/s11136-018-1829-0.
Veltman ES, Hofstad CJ, Witteveen AGH. Are current foot- and ankle outcome measures appropriate for the evaluation of treatment for osteoarthritis of the ankle?: Evaluation of ceiling effects in foot- and ankle outcome measures. Foot Ankle Surg. 2017;23(3):168-172. DOI: 10.1016/j.fas.2016.02.006.
AOFAS Board of Directors. Position statement. Patient-Reported Outcomes Measures. 2018; September 14.
United States Food and Drug Administration. Guidance for industry. Patient reported outcome measures: use in medical product development to support labelling claims, 2009. http://www.fda.gov/downloads/Drugs/Guidances/ UCM193282.pdf (date last accessed 15 January 2013).
This work is licensed under a Creative Commons Attribution 4.0 International License.