Clinical rating system for the ankle and hindfoot

INSTRUCTIONS:

Please answer the following multiple choice questions.
During the past 4 weeks......

1. Pain

None Mild Occasional Moderate daily Severe, almost always present

2. Function-activity limitations/support requirements

No limitations, no support No limitation of daily activities, limitation of recreational activities, no support Limited daily and recreational activities, cane Severe limitation of daily and recreational activities, walker, crutches, wheelchair, brace

3. Maximum walking distance ( blocks)

Greater than 6 4-6 1-3 Less than 1

4. Walking surfaces

No difficulty on any surface Some difficulty on uneven terrain, stairs, inclines, ladders Severe difficulty on uneven terrain, stairs, inclines, ladders

5. Gait abnormality

None, slight Obvious Marked

6. Sagittal motion (flexion plus extension)

Normal or mild restriction (30° or more) Moderate restriction (15°-29°) Severe restriction (less than 15°)

7. Hindfoot motion (inversion plus eversion)

Normal or mild restriction (75%-100% normal) Moderate restriction (25%-74% normal) Marked restriction (less than 25% normal)

8. Alignment

Good, plantigrade foot, ankle-hindfoot well aligned Fair, plantigrade foot, some degree of ankle- hindfoot malalignment observed, no symptoms Poor, nonplantigrade foot, severe malalignment, symptoms

9. Ankle-hindfoot stability (anteroposterior, varus-valgus)

Stable Definitely unstable

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