Development of the Quick-FAAM: A Preliminary Shortened Version of the Foot and Ankle Ability Measure for Chronic Ankle Instability

2016 ◽  
Vol 21 (4) ◽  
pp. 45-50 ◽  
Author(s):  
Matthew C. Hoch ◽  
Johanna M. Hoch ◽  
Megan N. Houston
Keyword(s):  
Internal Consistency ◽  
Ankle Instability ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Chronic Ankle Instability ◽  
Foot And Ankle ◽  
Study Objective ◽  
Patient Reported ◽  
Administration Time ◽  
Ability Measure

The study objective was to develop a shortened version of the Foot and Ankle Ability Measure (FAAM) for individuals with chronic ankle instability (CAI). Forty individuals with CAI completed the FAAM Activities of Daily Living and Sport subscales and the Short Form-12. Analyses were completed for item reduction followed by dimensionality, coverage redundancy, and internal consistency of a reduced-item instrument. Validity was examined through correlations with the original FAAM and Short Form-12. A 12-item FAAM was created which demonstrated strong internal consistency and convergent/divergent validity. The Quick-FAAM may provide an alternative patient-reported outcome for CAI which requires less administration time.

scholarly journals Exercise-Based Rehabilitation and Manual Therapy Compared With Exercise-Based Rehabilitation Alone in the Treatment of Chronic Ankle Instability: A Critically Appraised Topic

2020 ◽  
Vol 29 (5) ◽  
pp. 684-688 ◽  
Author(s):  
Bridget M. Walsh ◽  
Katherine A. Bain ◽  
Phillip A. Gribble ◽  
Matthew C. Hoch
Keyword(s):  
Manual Therapy ◽  
Ankle Instability ◽  
Patient Reported Outcome ◽  
Chronic Ankle Instability ◽  
Current Evidence ◽  
Bottom Line ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Difference ◽  
Improve Patient

Clinical Scenario: Patients with chronic ankle instability (CAI) commonly display lower levels of self-reported function and health-related quality of life. Several rehabilitation interventions, including manual therapy, have been investigated to help CAI patients overcome these deficits. However, it is unclear if the addition of manual therapy to exercise-based rehabilitation is more effective than exercise-based rehabilitation alone. Clinical Question: Does incorporating manual therapy with exercise-based rehabilitation improve patient-reported outcomes when compared with exercise-based rehabilitation alone? Summary of Key Findings: The literature was searched for articles that examined the difference in outcomes for patients with CAI between manual therapy with exercise-based rehabilitation and exercise-based rehabilitation alone. A total of 3 peer-reviewed randomized controlled trials were identified. Two articles demonstrated improved patient-reported outcome scores following the incorporation of manual therapy with exercise-based rehabilitation, whereas one study found no statistically significant differences between interventions. Clinical Bottom Line: The current evidence suggests that incorporating manual therapy in addition to exercised-based rehabilitation may improve patient-reported outcome scores in patients with CAI. Strength of Recommendation: In accordance with the Strength of Recommendation Taxonomy, the grade of A is recommended due to consistent evidence from high-quality studies.

scholarly journals The Effect of Peroneal Muscle Strength on Functional Outcomes After the Modified Broström Procedure for Chronic Ankle Instability

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0019
Author(s):  
Byung-Ki Cho ◽  
Seung-myung Choi
Keyword(s):  
Muscle Strength ◽  
Functional Outcomes ◽  
Ankle Instability ◽  
Peak Torque ◽  
Chronic Ankle Instability ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Patient Reported ◽  
Functional Outcome Measures ◽  
Modified Broström Procedure

Category: Sports Introduction/Purpose: Although the peroneal muscle is known to be a major dynamic lateral stabilizer of the ankle, few informations are available regarding the changes of muscle strength and relationship with the outcomes after lateral ligaments repair surgery. The purpose of this study was to identify the effects of peroneal strength on the validated functional outcome measures after the modified Broström procedure(MBP) for chronic ankle instability. Methods: Forty-one patients (41 ankles) underwent MBP using suture anchors were eligible and followed up to 2 years postoperatively. Functional evaluation consisted of the Foot and Ankle Outcome Score(FAOS), Foot and Ankle Ability Measure(FAAM). The changes of peroneal strength were evaluated using isokinetic dynamometer. Differences in the functional outcomes between the 3 groups divided according to recovery rate of peroneal strength were analysed. Results: Peak torque and total work for eversion in 60º/sec angular velocity significantly improved from a mean 8.1 Nm, 5.2 Nm preoperatively to 11.4 Nm, 6.9 Nm at postoperative 2 years, respectively (P < .001, P = .038). Deficit ratio of peak torque for eversion significantly improved from a mean 38.6% to 17.4%, and a significant side to side difference was found (P = .011). There were no significant differences in FAOS, FAAM, and measurements of stress radiograph between the 3 groups. Conclusion: Although restoration of peroneal strength postoperatively was about 82.6% of unaffected ankle, patient-reported function in daily and sport activities were satisfactorily improved. Postoperative isokinetic strength of the peroneus demonstrated no statistically significant effects on the functional outcomes after MBP.

Isometric Hip Strength and Patient-Reported Outcomes of Individuals With and Without Chronic Ankle Instability

2021 ◽  
pp. 1-7
Author(s):  
Katherine A. Bain ◽  
Paige A. Clawson ◽  
Stacey A. Slone ◽  
Phillip A. Gribble ◽  
Johanna M. Hoch ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Peak Torque ◽  
Group Differences ◽  
Foot And Ankle ◽  
Fear Avoidance ◽  
Hip Strength ◽  
Fear Avoidance Beliefs ◽  
Patient Reported ◽  
Ability Measure ◽  
Fear Avoidance Beliefs Questionnaire

Context: Strength deficits and decreased scores on generic, dimension-specific, and region-specific health-related quality of life (HRQL) PRO measures are commonly documented among individuals with chronic ankle instability (CAI). However, it is unknown if there is a relationship between hip strength and self-reported patient-reported outcome (PRO) scores. Objective: To compare isometric peak torque for hip-extension (H-EXT) and hip-abduction (H-ABD), as well as PRO scores between CAI, lateral ankle sprain copers (LAS copers), and uninjured controls (UC). The secondary purpose was to examine the relationship between isometric hip peak torque and PROs in participants with CAI. Design: Cross-sectional. Setting: Laboratory. Participants: Sixty-three individuals, 45 women (23.02 [3.83] y, 165.91 [7.55] cm, 67.28 [11.95] kg) and 18 men (26.28 [5.43] y, 179.28 [9.01] cm, 83.87 [13.26] kg), grouped as uninjured control (n = 26), LAS coper (n = 15), or CAI (n = 22). Main Outcome Measures: The Foot and Ankle Ability Measure was used to assess region-specific HRQL. The Fear Avoidance Beliefs Questionnaire was used to assess injury-related fear. The Disablement in Physically Active was used to assess global HRQL. Isometric peak torque was measured with a handheld dynamometer for H-EXT and H-ABD. Results: No group differences were observed for H-ABD (P = .34) or H-EXT (P = .35). The CAI group had significantly worse scores on all PROs compared with LAS coper (P < .001) and HC (P < .001). Moderate–weak correlations were found between H-ABD and Foot and Ankle Ability Measure—activities of daily living (P = .047; ρ = .392) and Foot and Ankle Ability Measure-Sport (P = .013; ρ = .482) and H- EXT and Fear Avoidance Beliefs Questionnaire-Work (P = .007; ρ = −.517). Conclusions: Individuals with CAI displayed lower HRQL based on worse scores on generic, dimension-specific, and region-specific PROs compared with LAS copers and uninjured controls. There were no significant between-group differences for H-EXT and H-ABD isometric peak torque production, but there was a moderate positive relationship between isometric H-ABD and self-reported ankle disability in individuals with CAI.

scholarly journals Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function

2017 ◽  
Vol 52 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Erik A. Wikstrom ◽  
Patrick O. McKeon
Keyword(s):  
Ankle Instability ◽  
Weight Bearing ◽  
Treatment Success ◽  
Chronic Ankle Instability ◽  
Response Analysis ◽  
Controlled Clinical Trial ◽  
Foot And Ankle ◽  
Minimally Clinically Important Difference ◽  
Medicine Research ◽  
Ability Measure

Context:  Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)–associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI. Objective:  To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI. Design:  Secondary analysis of a randomized controlled clinical trial. Setting:  Sports medicine research laboratories. Patients or Other Participants:  Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations. Intervention(s):  Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks. Main Outcome Measure(s):  Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure–Sport (FAAM–S). Results:  Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM–S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM–S improvements from AJM. Patients &lt;22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM–S improvement after PM. Also, those who made ≥2 single-limb–stance errors had a 98% probability of a meaningful FAAM–S improvement from PM. Patients with ≤53.1% on the FAAM–S had an 83% probability of a meaningful FAAM–S improvement after CS. Conclusions:  Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and &lt;5 previous sprains. Age, weight-bearing–dorsiflexion restrictions, and single-limb balance deficits identified patients with CAI who will respond well to PM. Assessing self-reported sport-related function can identify CAI patients who will respond positively to CS.

scholarly journals Changes in Patient-Reported Outcome Measures From the Time of Injury to Return to Play in Adolescent Athletes at Secondary Schools With an Athletic Trainer

2019 ◽  
Vol 54 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Janet E. Simon ◽  
Alison R. Snyder Valier ◽  
Zachary Y. Kerr ◽  
Aristarque Djoko ◽  
Stephen W. Marshall ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Knee Injury ◽  
Outcome Measure ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Return To Play ◽  
Foot And Ankle ◽  
Adolescent Athletes ◽  
Patient Reported ◽  
Ability Measure

Context Typically, athletic trainers rely on clinician-centered measures to evaluate athletes' return-to-play status. However, clinician-centered measures do not provide information regarding patients' perceptions. Objective To determine whether clinically important changes in patient-reported outcomes were observed from the time of lower extremity injury to the time of return to play in adolescent athletes. Design Cross-sectional study. Setting The National Athletic Treatment, Injury and Outcomes Network (NATION) program has captured injury and treatment data in 31 sports from 147 secondary schools across 26 states. A subsample of 24 schools participated in the outcomes study arm during the 2012−2013 and 2013−2014 academic years. Patients or Other Participants To be included in this report, student-athletes must have sustained a knee, lower leg, ankle, or foot injury that restricted participation from sport for at least 3 days. A total of 76 initial assessments were started by athletes; for 69 of those, return-to-play surveys were completed and analyzed. Main Outcome Measure(s) All student-athletes completed generic patient-reported outcome measures (Patient-Reported Outcomes Measurement Information System [PROMIS] survey, Global Rating of Change scale, and Numeric Pain Rating Scale) and, depending on body region, completed an additional region-specific measure (Knee Injury and Osteoarthritis Outcome Score or Foot and Ankle Ability Measure). All applicable surveys were completed at both the initial and return-to-play time points. Means and standard deviations for the total scores of each patient-reported outcome measure at each time point were calculated. Change scores that reflected the difference from the initial to the return-to-play time points were calculated for each participant and compared with established benchmarks for change. Results The greatest improvement in patient-reported outcomes was in the region-specific forms, with scores ranging from 9.92 to 37.73 on the different region-specific subscales (Knee Injury and Osteoarthritis Outcome Score or Foot and Ankle Ability Measure; scores range from 0−100). The region-specific subscales on average still showed a 21.8- to 37.5-point deficit in reported health at return to play. The PROMIS Lower Extremity score increased on average by 13 points; all other PROMIS scales were within normative values after injury. Conclusions Adolescent athletes who were injured at a high school with an athletic trainer may have shown improvement in patient-reported outcomes over time, but when they returned to play, their outcome scores remained lower than norms from comparable athlete groups.

Arthroscopic Versus Open Broström-Gould Repair for Chronic Ankle Instability

2020 ◽  
Vol 41 (6) ◽  
pp. 647-653 ◽  
Author(s):  
Bo Jun Woo ◽  
Mun Chun Lai ◽  
Kevin Koo
Keyword(s):  
Clinical Outcomes ◽  
Ankle Instability ◽  
Short Form ◽  
Perioperative Period ◽  
Operative Management ◽  
Chronic Ankle Instability ◽  
Foot And Ankle ◽  
Open Technique ◽  
Level Of Evidence

Background: The open Broström-Gould procedure for the repair of lateral ankle ligament remains the gold standard in operative management of chronic ankle instability. Nevertheless, the arthroscopic technique has been gaining attention among foot and ankle surgeons in the past decade. Our study aimed to compare the clinical outcomes of patients who underwent the arthroscopic and open Brostom-Gould technique over a 12-month follow-up period. Methods: We retrospectively reviewed the database in a tertiary hospital foot and ankle registry from 2015 to 2019. We then performed a 1:1 matching of 26 ankles that underwent the arthroscopic Broström-Gould technique to 26 ankles with the open technique, all performed by a fellowship-trained foot and ankle surgeon, for age, sex, and body mass index. To assess clinical outcomes, visual analog scale scores, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scores, and Short Form 36 Health Survey scores were collected at the preoperative and 6- and 12-month follow-up visits, respectively. Results: The arthroscopic group demonstrated significantly less pain in the perioperative period (arthroscopic, 1.0 ± 1.2; open, 2.4 ± 2.2; P = .015) and had higher AOFAS scores at 6 months (arthroscopic, 87.2 ± 11.1; open, 73.5 ± 21.9; P = .028) and 12 months (arthroscopic, 94.2 ± 10.0; open, 70.9 ± 33.1; P = .020). No complications were reported in either group. Twenty patients (76.9%) in the arthroscopic group had preoperative intra-articular abnormalities compared with 24 patients (92.3%) in the open group. Conclusion: The arthroscopic Broström-Gould technique produced better clinical outcomes than the open technique at 12 months of follow-up. Level of Evidence: Level III, retrospective comparative series.

Foot and Ankle Ability Measure Scores in Patients with Chronic Ankle Instability Following Joint Mobilization

2013 ◽  
Vol 18 (2) ◽  
pp. 4-7 ◽  
Author(s):  
Megan N. Houston ◽  
Patrick O. McKeon ◽  
Matthew C. Hoch
Keyword(s):  
Outcome Measures ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Foot And Ankle ◽  
Functional Impairments ◽  
Talocrural Joint ◽  
Physically Active ◽  
Joint Mobilization ◽  
Heavy Work ◽  
Ability Measure

Context:Following joint mobilizations, individuals with chronic ankle instability (CAI) have reported increased self-reported function as measured by the Foot and Ankle Ability Measure (FAAM).Objective:To examine the effect of a 2-week talocrural joint mobilization intervention on individual items of the FAAM in physically active adults with CAI.Participants:Twelve adults with CAI.Intervention:Self-reported function was documented with the FAAM-ADL and FAAM-Sport at preintervention and at 1-week postintervention. The joint mobilization intervention consisted of six treatments over 2 weeks. During each treatment, subjects received 4 minutes of talocrural traction and 8 minutes of Maitland Grade-III anterior-to-posterior talocrural joint mobilization.Main Outcome Measures:Participants completed the 21-item FAAM-ADL and 8-item FAAM-Sport.Results:Signifcant changes were detected between preintervention and 1-week follow-up measures for “Walking on even ground” (p= 0.06), “Going down stairs” (p= 0.07), “Walking on uneven ground” (p= 0.03), “Light to moderate work” (p= 0.06), “Heavy work” (p= 0.03), “Recreational activity” (p= 0.07), “Landing” (p= 0.03), “Low impact activities” (p= 0.07), and “Cutting” (p= 0.02). No signifcant changes were identifed in the other 20 items (p> 0.10).Conclusion:The fndings suggest talocrural joint mobilization may address specifc mechanical and functional impairments associated with the aforementioned tasks during physical activity.

The Effect of Peroneal Muscle Strength on Functional Outcomes After the Modified Broström Procedure for Chronic Ankle Instability

2017 ◽  
Vol 39 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Byung-Ki Cho ◽  
Ji-Kang Park ◽  
Seung-Myung Choi ◽  
Nelson F. SooHoo
Keyword(s):  
Muscle Strength ◽  
Functional Outcomes ◽  
Ankle Instability ◽  
Case Series ◽  
Peak Torque ◽  
Chronic Ankle Instability ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Patient Reported ◽  
Modified Broström Procedure

Background: Although the peroneal muscles are known to be the major dynamic lateral stabilizers of the ankle, little information is available regarding the change in muscle strength and relation with the outcomes after lateral ligament repair surgery. The purpose of this study was to identify the effects of peroneal strength on the validated functional outcome measures after the modified Broström procedure (MBP) for chronic ankle instability. Methods: Forty-one patients (41 ankles) who underwent MBP using suture anchors were eligible and followed up to 2 years postoperatively. Functional evaluation consisted of the Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). The changes of peroneal strength were evaluated using an isokinetic dynamometer. Differences in the functional outcomes between the 3 groups divided according to the recovery rate of peroneal strength were analyzed. Results: Peak torque and total work for eversion in 60 degrees/s angular velocity significantly improved from a mean 8.1 and 5.2 Nm preoperatively to 11.4 and 6.9 Nm at postoperative 2 years, respectively ( P < .001, P = .038). The deficit ratio of peak torque for eversion significantly improved from a mean 38.6% to 17.4%, and a significant side-to-side difference was found ( P = .011). There were no significant differences in FAOS, FAAM, and measurements of stress radiograph between the 3 groups. Conclusions: Although restoration of peroneal strength postoperatively was about 82.6% of the unaffected ankle, patient-reported function in daily and sport activities were satisfactorily improved. Postoperative isokinetic strength of the peroneals demonstrated no statistically significant effects on the functional outcomes after MBP. Level of Evidence: Level III, prospective comparative case series.

Sign in / Sign up

Export Citation Format

Share Document