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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2018

01-07-2018 | Ankle

Measurement properties of the most commonly used Foot- and Ankle-Specific Questionnaires: the FFI, FAOS and FAAM. A systematic review

Authors: I. N. Sierevelt, R. Zwiers, W. Schats, D. Haverkamp, C. B. Terwee, P. A. Nolte, G. M. M. J. Kerkhoffs

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2018

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Abstract

Purpose

In the foot and ankle literature, a wide range of patient-reported outcome measures (PROMs) is used, however, consensus as to which PROMs are preferred is lacking. Selection of a PROM is among other reasons, often based on measurement properties without considering the methodological quality of the studies that evaluate these measurement properties. The aim of current study was first to identify the most frequently used foot and ankle-specific PROMs in recent orthopaedic foot and ankle literature, and second to conduct a systematic review to synthesize and critically appraise the measurement properties of these PROMS.

Methods

Six PubMed indexed journals focussing on foot and ankle research were screened to identify most commonly used foot and ankle-specific PROMs over a 2 year period (2015–2016). Subsequently, a systematic literature search was performed in PubMed, EMBASE, SPORTDiscus and Scopus to identify relevant studies on their measurement properties. Methodological quality assessment was performed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, criteria for good measurement properties were applied, and a level of evidence was determined for the measurement properties of each domain of the questionnaires.

Results

The three most frequently reported PROMs were the Foot Function Index (FFI), the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Activity Measure (FAAM). Among 2046 unique citations, 50 studies were included evaluating these PROMs. Evidence to support the measurement properties of the FFI was mainly lacking due to poor methodological quality. More evidence was available for the measurement properties of the FAOS and the FAAM, but overall evidence supporting all measurement properties is not yet sufficient.

Conclusion

The best available evidence retrieved in this review showed that the FAOS and the FAAM are promising outcome measures for evaluation of patients with foot and ankle conditions, but their shortcomings should be taken into account when interpreting results in clinical setting or trials.

Level of evidence

I.
Appendix
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Literature
1.
Eechaute C, Vaes P, Van Aerschot L, Asman S, Duquet W (2007) The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: a systematic review. BMC Musculoskelet Disord 8:6CrossRefPubMedPubMedCentral
2.
Patrick DL, Burke LB, Powers JH, Scott JA, Rock EP, Dawisha S, O’Neill R, Kennedy DL (2007) Patient-reported outcomes to support medical product labeling claims: FDA perspective. Value Health 10(Suppl 2):125–137CrossRef
3.
Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ (2010) The routine use of patient reported outcome measures in healthcare settings. BMJ 340:c186CrossRefPubMed
4.
Nelson EC, Eftimovska E, Lind C, Hager A, Wasson JH, Lindblad S (2015) Patient reported outcome measures in practice. BMJ 350:g7818CrossRefPubMed
5.
Recinos PF, Dunphy CJ, Thompson N, Schuschu J, Urchek JL, Katzan IL (2016) Patient satisfaction with collection of patient-reported outcome measures in routine care. Adv Ther 34:1–14
6.
Rolfson O, Eresian Chenok K, Bohm E, Lübbeke A, Denissen G, Dunn J, Lyman S, Franklin P, Dunbar M, Overgaard S, Garellick G, Dawson J, Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries (2016) Patient-reported outcome measures in arthroplasty registries. Acta Orthop 87 Suppl 1:3–8CrossRefPubMedPubMedCentral
7.
Rolfson O, Bohm E, Franklin P, Lyman S, Denissen G, Dawson J, Dunn J, Eresian Chenok K, Dunbar M, Overgaard S, Garellick G, Lübbeke A (2016) Patient-reported outcome measures in arthroplasty registries Report of the Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries Part II. Recommendations for selection, administration, and analysis. Acta Orthop 87(Suppl 1):9–23CrossRefPubMedPubMedCentral
8.
9.
Haywood KL, Hargreaves J, Lamb SE (2004) Multi-item outcome measures for lateral ligament injury of the ankle: a structured review. J Eval Clin Pract 10:339–352CrossRefPubMed
10.
Hunt KJ, Hurwit D (2013) Use of patient-reported outcome measures in foot and ankle research. J Bone Joint Surg Am 95:e118CrossRefPubMed
11.
Kearney RS, Achten J, Lamb SE, Plant C, Costa ML (2011) A systematic review of patient-reported outcome measures used to assess Achilles tendon rupture management: what’s being used and should we be using it? Br J Sports Med 46:1102–1109CrossRefPubMed
12.
Martin RL, Irrgang JJ, Lalonde KA, Conti S (2006) Current concepts review: foot and ankle outcome instruments. Foot Ankle Int 27:383–390CrossRefPubMed
13.
Naal FD, Impellizzeri FM, Rippstein PF (2010) Which are the most frequently used outcome instruments in studies on total ankle arthroplasty? Clin Orthop Relat Res 468:815–826CrossRefPubMed
14.
Jackowski D, Guyatt G (2003) A guide to health measurement. Clin Orthop Relat Res 413:80–89CrossRef
15.
Smith PC, Street AD (2013) On the uses of routine patient-reported health outcome data. Health Econ 22:119–131CrossRefPubMed
16.
Terwee CB, Jansma EP, Riphagen II, De Vet HCW (2009) Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments. Qual Life Res 18:1115–1123CrossRefPubMedPubMedCentral
17.
18.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, De Vet HCW (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual life Res 19:539–549CrossRefPubMedPubMedCentral
19.
Terwee CB, Mokkink LB, Knol DL, Ostelo RWJG, Bouter LM, de Vet HCW (2012) Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual life Res 21:651–657CrossRefPubMed
20.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HCW (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737–745CrossRefPubMed
21.
Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, De Vet HCW (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42CrossRefPubMed
22.
Schellingerhout JM, Heymans MW, Verhagen AP, de Vet HC, Koes BW, Terwee CB (2011) Measurement properties of translated versions of neck-specific questionnaires: a systematic review. BMC Med Res Methodol 11:87CrossRefPubMedPubMedCentral
23.
Van Tulder M, Furlan A, Bombardier C, Bouter L, Editorial Board of the Cochrane Collaboration Back Review Group (2003) Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group. Spine 28:1290–1299PubMed
24.
Hung M, Baumhauer JF, Brodsky JW, Cheng C, Ellis SJ, Franklin JD, Hon SD, Ishikawa SN, Latt LD, Phisitkul P, Saltzman CL, SooHoo NF, Hunt KJ (2014) Psychometric comparison of the PROMIS physical function CAT with the FAAM and FFI for measuring patient-reported outcomes. Foot Ankle Int 35:592–599CrossRefPubMed
25.
Landorf KB, Keenan A-M (2002) An evaluation of two foot-specific, health-related quality-of-life measuring instruments. Foot Ankle Int 23:538–546CrossRefPubMed
26.
Madeley NJ, Wing KJ, Topliss C, Penner MJ, Glazebrook MA, Younger AS (2012) Responsiveness and Validity of the SF-36, Ankle Osteoarthritis Scale, AOFAS Ankle Hindfoot Score, and Foot Function Index in End Stage Ankle Arthritis. Foot Ankle Int 33:57–63CrossRefPubMed
27.
Pinsker E, Inrig T, Daniels TR, Warminton K, Beaton D (2015) Reliability and validity of 6 measures of pain, function, and disability for ankle arthroplasty and arthrodesis. Foot Ankle Int 36:617–625CrossRefPubMed
28.
SooHoo NF, Vyas R, Samimi D (2006) Responsiveness of the foot function index, AOFAS clinical rating systems, and SF-36 after foot and ankle surgery. Foot Ankle Int 27:930–934CrossRefPubMed
29.
Kuyvenhoven MM, Gorter KJ, Zuithoff P, Budiman-Mak E, Conrad KJ, Post MWM (2002) The Foot Function Index with verbal rating scales (FFI-5pt): a clinimetric evaluation and comparison with the original FFI. J Rheumatol 29:1023–1028PubMed
30.
Naal FD, Impellizzeri FM, Huber M, Rippstein PF (2008) Cross-cultural adaptation and validation of the Foot Function Index for use in German-speaking patients with foot complaints. Foot Ankle Int 29:1222–1228CrossRefPubMed
31.
Saag KG, Saltzman CL, Brown CK, Budiman-Mak E (1996) The Foot Function Index for measuring rheumatoid arthritis pain: evaluating side-to-side reliability. Foot Ankle Int 17:506–510CrossRefPubMed
32.
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535–b2535CrossRefPubMedPubMedCentral
33.
Budiman-Mak E, Conrad KJ, Roach KE (1991) The foot function index: a measure of foot pain and disability. J Clin Epidemiol 44:561–570CrossRefPubMed
34.
Agel J, Beskin JL, Brage M, Guyton GP, Kadel NJ, Saltzman CL, Sands AK, Sangeorzan BJ, SooHoo NF, Stroud CC, Thordarson DB (2005) Reliability of the Foot Function Index: a report of the AOFAS Outcomes Committee. Foot Ankle Int 26:962–967CrossRefPubMed
35.
Martinelli N, Scotto GM, Sartorelli E, Bonifacini C, Bianchi A, Malerba F (2014) Reliability, validity and responsiveness of the Italian version of the Foot Function Index in patients with foot and ankle diseases. Qual Life Res 23:277–284CrossRefPubMed
36.
Pourtier-Piotte C, Pereira B, Soubrier M, Thomas E, Gerbaud L, Coudeyre E (2015) French validation of the Foot Function Index (FFI). Ann Phys Rehabil Med 8:276–282CrossRef
37.
Venditto T, Tognolo L, Rizzo RS, Iannuccelli C, Di Sante L, Trevisan M, Maggiolini FR, Santilli V, Ioppolo F (2015) 17-Italian Foot Function Index with numerical rating scale: development, reliability, and validity of a modified version of the original Foot Function Index. Foot (Edinb) 25:12–18CrossRef
38.
Huh JW, Eun IS, Ko YC, Park MJ, Hwang KM, Park SH, Park T hong (2016) Reliability and validity of the Korean Version of the Foot Function Index. Park J hyung J Foot Ankle Surg 55:759–761CrossRef
39.
Wu SH, Liang HW, Hou WH (2008) Reliability and validity of the Taiwan Chinese version of the foot function index. J Formos Med Assoc 107:111–118CrossRefPubMed
40.
In Jung TS, Kim JH, Jung K, Cho KS HY (2017) The reliability and validity of the Korean version of the foot function index for patients with foot complaints. J Phys Ther Sci 29:53–56
41.
Jorgensen JE, Andreasen J, Rathleff MS (2015) Translation and validation of the Danish Foot Function Index (FFI-DK). Scand J Med Sci Sport 25:e408–e413CrossRef
42.
Martinez BR, Staboli IM, Kamonseki DH, Budiman-Mak E, Yi LC (2016) Validity and reliability of the Foot Function Index (FFI) questionnaire Brazilian-Portuguese version. Springerplus 5:1810CrossRefPubMedPubMedCentral
43.
Paez-Moguer J, Budiman-Mak E, Cuesta-Vargas AI (2014) Cross-cultural adaptation and validation of the Foot Function Index to Spanish. Foot Ankle Surg 20:34–39CrossRefPubMed
44.
SooHoo NF, Samimi DB, Vyas RM, Botzler T (2006) Evaluation of the validity of the Foot Function Index in measuring outcomes in patients with foot and ankle disorders. Foot Ankle Int 27:38–42CrossRefPubMed
45.
Vetrano M, Vulpiani MC, Erroi D, Vadalà A, Ferretti A, Saraceni VM (2014) Cross-cultural adaptation and reliability of the Italian version of the Foot Function Index (FFI-I) for patients with plantar fasciitis. J Sports Med Phys Fitness 54:636–643PubMed
46.
Akker-Scheek van den I, Seldentuis, Reininga A, Stevens IHF M (2013) Reliability and validity of the Dutch version of the Foot and Ankle Outcome Score (FAOS). BMC Musculoskelet Disord 14:183CrossRefPubMedPubMedCentral
47.
Angthong C (2016) Validity and reliability of Thai version of the Foot and Ankle Outcome Score in patients with arthritis of the foot and ankle. Foot Ankle Surg 22:224–228CrossRefPubMed
48.
Bergen van CJA, Sierevelt IN, Hoogervorst P, Waizy H, Van Dijk CN, Becher C (2014) Translation and validation of the German version of the foot and ankle outcome score. Arch Orthop Trauma Surg 134:897–901CrossRefPubMed
49.
Chen L, Lyman S, Do H, Karlsson J, Adam SP, Young E, Deland JT, Ellis SJ (2012) Validation of Foot and Ankle Outcome Score for Hallux Valgus. Foot ankle Int 33:1145–1155CrossRefPubMed
50.
Golightly YM, DeVellis RF, Roos EM, Lohmander LS, Hannan MT, Nelson AE, Jordan JM (2011) Psychometric Properties of the Foot and Ankle Outcome Score (Faos) in a Community-Based Osteoarthritis Study. Osteoarthr Cartil 66:395–403
51.
52.
Karatepe AG, Günaydin R, Kaya T, Karlibaş U, Özbek G (2009) Validation of the Turkish version of the foot and ankle outcome score. Rheumatol Int 30:169–173CrossRefPubMed
53.
Lee KM, Chung CY, Kwon SS, Sung KH, Lee SY, Won SH, Lee DJ, Lee SC, Park MS (2013) Transcultural adaptation and testing psychometric properties of the Korean version of the Foot and Ankle Outcome Score (FAOS). Clin Rheumatol 32:1443–1450CrossRefPubMed
54.
Mani SB, Brown HC, Nair P, Chen L, Do HT, Lyman SL, Deland JT, Ellis SJ (2013) Validation of the Foot and Ankle Outcome Score in adult acquired flatfoot deformity. Foot Ankle Int 34:1140–1146CrossRefPubMed
55.
Mani SB, Do H, Vulcano E, Hogan MV, Lyman S, Deland JT, Ellis SJ (2015) Evaluation of the foot and ankle outcome score in patients with osteoarthritis of the ankle. Bone Joint J 97–B:662–667CrossRefPubMed
56.
Imote AM, Peccin MS, Rodrigues R, Mizusaki JM (2009) Translation, cultural adaptation and validation of Foot and Ankle Outcome Score (FAOS) questionnaire into portuguese. Acta Ortop Bras 17:232–235CrossRef
57.
Negahban H, Mazaheri M, Salavati M, Sohani SM, Askari M, Fanian H, Parnianpour M (2010) Reliability and validity of the foot and ankle outcome score: a validation study from Iran. Clin Rheumatol 29:479–486CrossRefPubMed
58.
Roos EM, Brandsson S, Karlsson J (2001) Validation of the foot and ankle outcome score for ankle ligament reconstruction. Foot Ankle Int 22:788–794CrossRefPubMed
59.
Sierevelt IN, Beimers L, van Bergen CJA, Haverkamp D, Terwee CB, Kerkhoffs GMMJ (2015) Validation of the Dutch language version of the Foot and Ankle Outcome Score. Knee Surg Sports Traumatol Arthrosc 23:2413–2419CrossRefPubMed
60.
Sierevelt IN, Van Eekeren ICM, Haverkamp D, Reilingh ML, Terwee CB, Kerkhoffs GMMJ (2016) Evaluation of the Dutch version of the Foot and Ankle Outcome Score (FAOS): responsiveness and minimally important change. Knee Surg Sports Traumatol Arthrosc 24:1339–1347 (Springer Berlin Heidelberg)CrossRefPubMed
61.
Arunakul M, Arunakul P, Suesiritumrong C, Angthong C, Chernchujit B (2015) Validity and reliability of Thai Version of the Foot and Ankle Ability Measure (FAAM) Subjective Form. J Med Assoc Thai 98:561–567PubMed
62.
Borloz S, Crevoisier X, Deriaz O, Ballabeni P, Martin RL, Luthi F (2011) Evidence for validity and reliability of a French version of the FAAM. BMC Musculoskelet Disord 12:40CrossRefPubMedPubMedCentral
63.
Carcia CR, Martin RL, Drouin JM (2008) Validity of the foot and ankle ability measure in athletes with chronic ankle instability. J Athl Trai 43:179–183CrossRef
64.
Celik D, Malkoc M, Martin RR (2016) Evidence for reliability, validity and responsiveness of Turkish Foot and Ankle Ability Measure (FAAM). Rheumatol Int 36:1469–1476CrossRefPubMed
65.
González-Sánchez M, Li GZ, Ruiz Muñoz M, Cuesta-Vargas AI (2016) Foot and ankle ability measure to measure functional limitations in patients with foot and ankle disorders: a Chinese cross-cultural adaptation and validation. Disabil Rehabil 6:1–8
66.
Kivlan BR, Martin RL, Wukich DK (2011) Responsiveness of the foot and ankle ability measure (FAAM) in individuals with diabetes. Foot (Edinb) 21:84–87CrossRef
67.
Martin RLR, Irrgang JJJ, Burdett RG, Conti SF, Van Swearingen JM (2005) Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int 26:968–983CrossRefPubMed
68.
Martin RL, Hutt DM, Wukich DK (2009) Validity of the Foot and Ankle Ability Measure (FAAM) in Diabetes Mellitus. Foot Ankle Int 30:297–302CrossRefPubMed
69.
Mazaheri M, Salavati M, Negahban H, Sohani SM, Taghizadeh F, Feizi A, Karimi A, Parnianpour M (2010) Reliability and validity of the Persian version of Foot and Ankle Ability Measure (FAAM) to measure functional limitations in patients with foot and ankle disorders. Osteoarthr Cartil 18:755–759CrossRefPubMed
70.
Moreira TS, Magalhaes L, de C, Silva, Martin RD, Resende RL MA De (2016) Translation, cross-cultural adaptation and validity of the Brazilian version of the Foot and Ankle Ability Measure questionnaire. Disabil Rehabil 8288:1–12
71.
Nauck T, Lohrer H (2011) Translation, cross-cultural adaption and validation of the German version of the Foot and Ankle Ability Measure for patients with chronic ankle instability. Br J Sports Med 45:785–790CrossRefPubMed
72.
Sartorio F, Vercelli S, Bravini E, Bargeri S, Moroso M, Plebani G, Ferriero G (2014) [Foot and ankle ability measure: cross-cultural translation and validation of the Italian version of the ADL module (FAAM-I/ADL)]. Med Lav 105:357–365PubMed
73.
Uematsu D, Suzuki H, Sasaki S, Nagano Y, Shinozuka N, Sunagawa N, Fukubayashi T (2015) Evidence of validity for the Japanese version of the foot and ankle ability measure. J Athl Train 50:65–70CrossRefPubMedPubMedCentral
74.
Weel H, Zwiers R, Azim D, Sierevelt IN, Haverkamp D, Van Dijk CN, Kerkhoffs GMMJ (2014) Validity and reliability of a Dutch version of the Foot and Ankle Ability Measure. Knee Surg Sport Traumatol Arthrosc 24:1348–1354CrossRef
75.
Budiman-Mak E, Conrad K, Stuck R, Matters M (2006) Theoretical model and Rasch analysis to develop a revised Foot Function Index. Foot Ankle Int 27:519–527CrossRefPubMed
76.
Kleinlugtenbelt YV, Nienhuis RW, Bhandari M, Goslings JC, Poolman RW, Scholtes VAB (2016) Are validated outcome measures used in distal radial fractures truly valid? A critical assessment using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Bone Joint Res 5:153–161CrossRefPubMedPubMedCentral
77.
Easterbrook PJ, Gopalan R, Berlin JA, Matthews DR (1991) Publication bias in clinical research. The Lancet 337:867–872CrossRef
78.
Buscemi N, Hartling L, Vandermeer B, Tjosvold L, Klassen TP (2006) Single data extraction generated more errors than double data extraction in systematic reviews. J Clin Epidemiol 59:697–703CrossRefPubMed
Metadata
Title
Measurement properties of the most commonly used Foot- and Ankle-Specific Questionnaires: the FFI, FAOS and FAAM. A systematic review
Authors
I. N. Sierevelt
R. Zwiers
W. Schats
D. Haverkamp
C. B. Terwee
P. A. Nolte
G. M. M. J. Kerkhoffs
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4748-7

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