Development reliability of a standard rating system for outcome measurement of foot ankle disorders I: development of standard rating system

Abstract

BackgroundThe aim of this study was to report the five scales comprising the rating system that the Japanese Society for Surgery of the Foot (JSSF) devised (JSSF standard rating system) and the newly offered interpretations and criteria for determinations of each assessment item.MethodsWe produced the new scales for the JSSF standard system by modifying the clinical rating systems established by the American Orthopaedic Foot and Ankle Society (AOFAS scales) and the Japanese Orthopaedic Association’s foot rating scale (JOA scale). We also provided interpretations of each assessment item and the criteria of determinations in the new standard system.ResultsWe improved the ambiguous expressions and content in the conventional standard rating systems so they would be easily understood by Japanese people. The result was five scales in total. Four were designed for use specifically for ankle-hindfoot, midfoot, hallux metatarsophalangeal-interphalangeal, and lesser metatarsophalangeal-ineterphalangeal sites; and the fifth was for the foot and ankle with rheumatoid arthritis. Furthermore, we described interpretations and criteria for determinations with regard to evaluation items in each scale.ConclusionsConventionally, the AOFAS scales or the JOA scale have been separately applied depending on the sites or disorders concerned, but it was often difficult to decide on scores during practical evaluations because of differing expressions in different languages and also because of ambiguity in the interpretation of each evaluation item and in scoring standards as well. JSSF improved these scales and added definite interpretations of evaluation items as well as criteria for the rating (to be reported here in part I). Because these steps were expected to improve the reliability of outcomes assessed by each scale, we examined the reliability in scores of the newly developed scales, which are reported in part II (in this issue).

Fall incidence and risk factors in patients after total knee arthroplasty

“…To assess limitations of ankle mobility we used a modified Niki's method [23,24]. This method evaluates limitation of mobility in the talocalcaneal joint (inversion and eversion).…”

A Survey of Self-reported Outcome Instruments for the Foot and Ankle

“…55 Also omitted were instruments related to the outcome of treatment for patients with nail and skin disorders 9,20,50,51 and a questionnaire to assess the usability of orthopaedic shoes. 38 The clinical scoring system of the American Orthopaedic Foot and Ankle Society, 25,44 the rating scale of the Japanese Orthopaedic Association, 62,63 the Foot and Ankle Severity Scale, 52 and the Ankle Activity Scale 30 were excluded because they are primarily completed by clinicians. In addition, the Foot Disability Questionnaire 29 was omitted because it was not developed to measure change but rather was developed to identify and describe disability caused by foot pain.…”

Surgical reduction and ligament reconstruction for chronic dorsal dislocation of the lesser metatarsophalangeal joint associated with hallux valgus

“…In the present study, the JSSF score, which would be highly reliable in the clinical evaluation of the [13,14], improved significantly from an average of 50 points preoperatively to 93 points at the most recent follow-up. Although all feet had moderate or severe metatarsalgia preoperatively, 19 feet had no metatarsalgia, and the remaining 8 feet had mild metatarsalgia postoperatively.…”

“…The clinical assessment consisted of the Japanese Society for Surgery of the Foot hallux scale (JSSF scale) [13,14], metatarsalgia, range of motion of the second MTP joint, and patient satisfaction. The JSSF scale is a validated foot-rating system and assigns 40 points for pain, 45 points for function, and 15 points for alignment, with a possible maximum of 100 points.…”