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Foot and Ankle Ability Measure (FAAM)

Foot and Ankle Ability Measure (FAAM) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Questionnaires


Foot and Ankle Ability Measure (FAAM)
Activities of Daily Living Subscale

Please Answer every question with one response that most closely describes your
condition within the past week.
If the activity in question is limited by something other than your foot or ankle mark “Not
Applicable” (N/A).
No Slight Moderate Extreme Unable N/A
Difficulty Difficulty Difficulty Difficulty to do

Standing � � � � � �

Walking on even � � � � � �
Ground

Walking on even ground � � � � � �
without shoes

Walking up hills � � � � � �

Walking down hills � � � � � �

Going up stairs � � � � � �

Going down stairs � � � � � �

Walking on uneven ground � � � � � �

Stepping up and down curbs � � � � � �

Squatting � � � � � �

Coming up on your toes � � � � � �

Walking initially � � � � � �

Walking 5 minutes or less � � � � � �

Walking approximately � � � � � �
10 minutes

Walking 15 minutes or � � � � � �
greater




Foot and Ankle Ability Measure (FAAM)
Activities of Daily Living Subscale
Page 2



Because of your foot and ankle how much difficulty do you have with:

No Slight Moderate Extreme Unable N/A
Difficulty Difficulty Difficulty Difficulty to do
at all

Home responsibilities � � � � � �

Activities of daily living � � � � � �

Personal care � � � � � �

Light to moderate work � � � � � �
(standing, walking)

Heavy work � � � � � �
(push/pulling,
climbing, carrying)

Recreational activities � � � � � �


How would you rate your current level of function during you usual activities of daily
living from 0 to 100 with 100 being your level of function prior to your foot or ankle
problem and 0 being the inability to perform any of your usual daily activities.

__ __ __ . 0 %




Martin, R; Irrgang, J; Burdett, R; Conti, S; VanSwearingen, J: Evidence of Validity for the Foot and Ankle Ability Measure. Foot and
Ankle International. Vol.26, No.11: 968-983, 2005.









Foot and Ankle Ability Measure (FAAM)
Sports Subscale

Because of your foot and ankle how much difficulty do you have with:

No Slight Moderate Extreme Unable N/A
Difficulty Difficulty Difficulty Difficulty to do
at all

Running � � � � � �


Jumping � � � � � �

Landing � � � � � �

Starting and � � � � � �
stopping quickly

Cutting/lateral � � � � � �
Movements

Ability to perform � � � � � �
Activity with your
Normal technique

Ability to participate � � � � � �
In your desired sport
As long as you like



How would you rate your current level of function during your sports related activities
from 0 to 100 with 100 being your level of function prior to your foot or ankle problem
and 0 being the inability to perform any of your usual daily activities?


__ __ __ . 0%


Overall, how would you rate your current level of function?

� Normal � Nearly Normal � Abnormal � Severely Abnormal


Martin, R; Irrgang, J; Burdett, R; Conti, S; VanSwearingen, J: Evidence of Validity for the Foot and Ankle Ability Measure. Foot and
Ankle International. Vol.26, No.11: 968-983, 2005.