Foot and Ankle Ability Measure (FAAM)

The Foot and Ankle Ability Measure (FAAM) was developed to provide a universal tool for assessing changes in physical function among patients with foot, ankle, and lower-leg musculoskeletal conditions. It allows clinicians and researchers to compare treatment effectiveness and gather consistent data on functional limitations related to these disorders【1】.

Sammendrag

Foot and Ankle Ability Measure (FAAM) er et pålitelig og valid måleinstrument for å evaluere funksjon hos pasienter med fot-, ankel- og legglidelser. Det består av to delskalaer, Activities of Daily Living (ADL) og Sports Subscale, som gir innsikt i pasientens funksjonsnivå og behandlingsresultater. FAAM har høy reliabilitet og validitet og er responsivt for kliniske endringer over tid. Det er primært brukt i polikliniske settinger og gir verdifull informasjon for forskning og behandling.

Description

FAAM consists of two subscales:

• Activities of Daily Living (ADL): 21 items

• Sports Subscale: 8 items

Each item is rated on a 5-point Likert scale (0–4):

• 4 = No difficulty

• 3 = Slight difficulty

• 2 = Moderate difficulty

• 1 = Severe difficulty

• 0 = Unable to perform

Patients also rate their current functional level on a scale from 0 to 100, where 100 represents pre-injury or pre-condition function. In addition, they classify their overall function as normal, nearly normal, abnormal, or severely abnormal.

For results to be valid, at least 20 of 21 ADL items and 7 of 8 Sports items must be completed【2】.

Scoring and Use

1. Sum the scores of all completed items.

2. Divide by the maximum possible score (84 for ADL, 32 for Sports).

3. Multiply by 100 to obtain a percentage score.

Interpretation: Higher percentages reflect higher functional ability.

• MDC (Minimal Detectable Change): 5.7 (ADL) / 12.3 (Sports)

• MCID (Minimally Clinically Important Difference): 8 (ADL) / 9 (Sports)【3】

Psychometric Properties

Validity

• Content validity: Developed using input from experts and patients to ensure clinical relevance.

• Construct validity: Strong correlations with SF-36 Physical Function Subscale

  • ADL: r = 0.84

  • Sports: r = 0.78

• Moderate correlation with the physical component of SF-36 (r = 0.80).

• Low correlation with SF-36 Mental Health Subscale (ADL: r = 0.18; Sports: r = 0.11)【2】.

This confirms that FAAM primarily measures physical function rather than psychological health.

Reliability

• Test–retest reliability:

  • ICC = 0.89 (ADL)

  • ICC = 0.87 (Sports)【3】

• Internal consistency:

  • Cronbach’s α = 0.96 (ADL)

  • Cronbach’s α = 0.98 (Sports)【3】

Responsiveness

FAAM is highly sensitive to detecting meaningful clinical changes over time.

• MDC: 5.7 (ADL) / 12.3 (Sports)

• MCID: 8 (ADL) / 9 (Sports)

This makes FAAM a powerful tool for evaluating treatment effects in clinical practice.

Limitations

• Less validated outside orthopedic outpatient settings.

• Limited research across different time frames (> or < 4 weeks).

• Requires further validation across a wider range of functional levels【7】.

Conclusion

The FAAM is a reliable and validated self-report instrument for evaluating physical function in patients with foot, ankle, and lower-leg musculoskeletal disorders. It is especially valuable for measuring treatment outcomes and monitoring changes in function over time. FAAM is recommended for use in outpatient clinical settings and provides significant insights for both clinical care and research【8】.

Sources:

1. Martin, R.L., Irrgang, J.J., Burdett, R.G., et al. Evidence of validity for the foot and ankle ability measure (FAAM). Foot & Ankle International. 2005; 26(11): 968-83.

2. Rehabilitation Measures Database. Foot and Ankle Ability Measures. Shirley Ryan AbilityLab. Sist oppdatert: 15. desember 2015.

3. Eechaute, C., et al. The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability. BMC Musculoskeletal Disorders. 2007.

4. McPoil, T.G., et al. Clinical Guidelines, Heel Pain – Plantar Fasciitis. J Orthop Sports Phys Ther. 2008.

5. Walmsley, et al. The rheumatoid foot: a systematic literature review of patient-reported outcome measures. J Foot Ankle Res. 2010.

6. Christopher R. Carcia, et al. Validity of the Foot and Ankle Ability Measure in Athletes With Chronic Ankle Instability. J Athl Train. 2008.

7. Borloz, S., et al. Evidence for Validity and Reliability of a French Version of the FAAM. BMC Musculoskeletal Disorders. 2011.

8. Rehabilitation Measures Database. FAAM. Shirley Ryan AbilityLab. Sist oppdatert: 15. desember 2015.