Malasida That is usually the journal article where the information was first stated. M, Brandsson S, Karlsson J. If the subject answers all 21 items, the highest potential score is As anticipated, athletes who rated fawm ankles as normal scored higher than those who scored their iutcome as anything less than normal. The Foot and Ankle Ability Measure FAAM is a region-specific, non—disease-specific outcome instrument that possesses many of the clinimetric qualities recommended for an outcome instrument. Following screening, each participant completed the self-reported outcome instrument, which included the FAAM, 2 global ratings of function, and 1 overall categorical rating of function.

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Relationships were stronger when all athletes, rather than just those with CAI, were included in the analyses. Keywords: outcomes, evaluative instrument, self-report, ankle sprains Key Points Scores on the Foot and Ankle Ability Measure activities of daily living and sports subscales were greater in healthy athletes than in those with chronic ankle instability and were greater in the athletes who indicated that their ankles were normal than in those who indicated that their ankles were nearly normal or abnormal.

The Foot and Ankle Ability Measure may be used to detect self-reported functional deficits related to chronic ankle instability. Scores on the sports subscale of the Foot and Ankle Ability Measure and on the sports global rating of function had a strong relationship.

Junge et al 1 reported that lateral ankle sprains occur more frequently than any other musculoskeletal injury in sports. Once injured, athletes are more susceptible to recurrent injury associated with chronic ankle instability CAI. Subjective information from self-reported outcome instruments can provide valuable information for clinicians treating individuals with ankle instability.

Discriminative instruments can be used to identify individuals with a particular disorder eg, CAI. Information acquired from an evaluative instrument is useful only if evidence is available to support the interpretation of scores obtained in the specific population in which the instrument is intended to be used. Evidence of content validity is determined by the specific items on the instrument and what they measure.

Evidence for construct validity includes how the scores on the instrument relate to other measures of the construct. Hypothesis testing is used to determine if the instrument performs as expected and is a method that is capable of providing evidence for construct validity. In a systematic review of the literature, Eechaute et al 5 identified evaluative instruments for individuals with CAI and evidence to support their use.

The sports subscale may be particularly useful when addressing the limitations of athletes with CAI. Subsequently, the FADI underwent rigorous psychometric analysis, including analysis with item response theory. Four items related to pain and one related to sleeping were removed from the ADL subscale to improve psychometric properties of the instrument. The resulting new instrument, the FAAM, has evidence of content validity, construct validity, reliability, and responsiveness for athletes with a broad range of musculoskeletal disorders of the leg, ankle, and foot.

We hypothesized that FAAM scores 1 would be different between a group of athletes with CAI and a group of healthy athletes, 2 would be able to distinguish between a self-reported normal and abnormal level of function, and 3 would be related to the global rating of function values.

A total of 53 athletes expressed interest in the study. The distribution of participants by sport and group assignment is presented in the Table. Before data collection began, all subjects read and signed a consent form. Table Open in a separate window Procedures Each potential participant completed the screening questionnaire and provided a medical history. The same investigator J. At the time of the study, this investigator had 10 years of clinical athletic training experience and specialized in examination, evaluation, and rehabilitation of athletes with ankle instability.

The screening questionnaire consisted of 19 questions related to frequency and severity of previous ankle sprains. We excluded subjects from the CAI group if they reported ankle injury within the last 3 months, history of a lower extremity fracture on the same side as the affected ankle, concussion within the last 6 months, or current participation in a rehabilitation program for the affected ankle.

Participants were included in the healthy group if they did not have a history of ankle sprain, lower extremity fracture, or concussion within the last 6 months. Because athletes in this group had not sustained lateral ankle sprains, they were not specifically questioned about episodes of giving way, weakness, or swelling.

Following screening, each participant completed the self-reported outcome instrument, which included the FAAM, 2 global ratings of function, and 1 overall categorical rating of function. Item score totals, which range from 0 to 84 for the ADL subscale and from 0 to 32 for the sports subscale, are transformed to percentage scores.

On the categorical rating scale, participants rated their ankles as normal, nearly normal, abnormal, or severely abnormal. Statistical Analyses We used separate, independent t tests to determine whether differences existed in FAAM subscale scores between healthy and CAI groups and between volunteers who indicated a normal versus an abnormal categorical rating of function overall. We analyzed our data with SPSS version Results All athletes in the healthy group and 4 athletes in the CAI group categorically rated their ankles as normal.

Of the remaining athletes in the CAI group, 10 categorically rated their ankles as nearly normal, and 1 rated the ankle as abnormal. Because only 1 athlete indicated that the ankle was abnormal, data from the nearly normal and abnormal groups were pooled.



Developed in , FAAM and is only one of a handful of foot and ankle instruments in current use that displays the 4 clinimetric qualities -content validity, construct validity, reliability, and responsiveness [1]. These qualities have also led to FAAM being validated for use in populations with general orthopedic conditions, including pain, sprain and strain fractures, plantar fasciitis, bunions and achilles rupture [2]. The addition of each item produces a score total Range for the ADL sub-scale and for the Sports sub-scale that is converted to a percentage score. In a systematic review of the literature, FAAM was identified as one the most appropriate outcome instruments to quantify functional limitations in patients with varying leg, foot and ankle disorders [3]. It has also been validated for use in athletes with chronic ankle instability [4] and individuals with diabetes mellitus — a common comorbid disease in many orthopedic patients [5]. Put your best foot forward!


Foot and Ankle Ability Measure (FAAM)



Validity of the Foot and Ankle Ability Measure in Athletes With Chronic Ankle Instability


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