The Foot and Ankle Ability Measure (FAAM) is a self-reported outcome tool designed to be a comprehensive assessment of physical performance amongst individuals with a range of leg, foot and ankle disorders. Unlike many patient-reported outcomes (PROs), FAAM is not a disease-specific tool but is instead region-specific.

Developed in 2005, 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 FAAM questionnaire is a 29-item survey that is divided into two sub-scales: Activities of Daily Living (ADL) (21 items) and the Sports sub-scale (8 items). The ADL sub-scale assess a patient’s ability to carry out everyday activities like standing, squatting or walking up the stairs, while the sports subscale assess more difficult tasks that are essential to sport and athletes such as running, jumping, landing etc.

Survey responses are given via a 5-point Likert scale (4 to 0) ranging from ‘No difficulty at all’ to ‘Unable to do’. Patients may also respond ‘Not applicable’ if an activity in question is limited by something other than their foot or ankle. The addition of each item produces a score total (Range 0-84 for the ADL sub-scale and 0-32 for the Sports sub-scale) that is converted to a percentage score. Higher scores represent higher levels of function with 100% representing no dysfunction.

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].

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Strengths

FAAM is considered to be a reliable, responsive, and valid measure of physical function for individuals who suffer from a variety of disorders of the lower leg. One of the main advantages of this tool is its versatility for use in those with all types of foot and ankle disorders. This versatility means that as an outcome tool it is not restricted to one subset of patients. Studies have shown it has good responsiveness to individuals with existing foot/ankle orthopedic dysfunction that is complicated by diabetes [5].

Additionally, FAAM is a PRO tool that is quick and easy to use with a grading system that healthcare providers will find simple to complete.

 

Weaknesses

Due to the fact that FAAM is a generalized survey, clinicians looking for pathology-specific PROs might consider using a more focused and tailored outcome tool. As the appropriate selection of an instrument for outcome measurement will depend on many factors including the psychometric properties of instrument and the characteristics of patient it is intended for, FAAM may not be ideal for clinicians who require pathology-specific tools with less specificity and greater sensitivity.

License

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References

  • 1:Martin RL, Irrgang JJ: A survey of self-reported outcome instruments for the foot and ankle. J Orthop Sports Phys Ther. 2007, 37 (2): 72-84. 10.2519/jospt.2007.2403.
  • 2:R.L. Martin, J.J. Irrgang, R.G. Burdett, S.F. Conti, J.M. Van Swearingen. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int, 26 (11) (2005), pp. 968–983
  • 3: C. Eechaute, P. Vaes, L. Van Aerschot, S. Asman, W. Duquet. The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: a systematic review. BMC Musculoskelet Disord, 8 (2007), p. 6
  • 5:Kivlan, B. R., Martin, R. L., & Wukich, D. K. (2011). Responsiveness of the foot and ankle ability measure (FAAM) in individuals with diabetes. The Foot, 21(2), 84-87.