Abstract
BackgroundThere are many approved patient-related outcome measurement tools regarding ankle pathologies. However, there is none incorporating the range of motion (ROM) as an objective parameter. Most instruments focus on subjective parameters such as pain and impairment at work or daily living. Furthermore, the majority is only applicable to a specific pathology. Therefore, the objective of our study was to develop and validate the Munich Ankle Questionnaire (MAQ) as a universal self-assessment score including subjective and objective items.MethodsThe established McGuire Score, Bray Score, Ankle Hindfoot Score (AOFAS) and Olerud and Molander Score were analyzed for relevant items and subscales. Items of interest were then condensed and allocated to the respective subscales of the MAQ. The final MAQ consists of 6 items addressing general and demographic data and 12 items addressing three domains: pain (3 items), work and daily living (5 items), movement and ROM (4 items). The evaluation of validity, reliability and responsiveness of the MAQ was performed in a prospective clinical study including traumatic as well as degenerative ankle pathologies.ResultsIn total, 148 patients (79 female, 69 male, median age 45 years) were included in the validation study. With intra-class correlation coefficients of at least 0.77, test–retest reliability was proven. Construct validity with a correlation coefficient of 0.82 and responsiveness with a correlation coefficient ranging from 0.42 to 0.47 were confirmed.ConclusionThe MAQ is a reliable and valid self-assessment measurement tool for the follow-up examination regarding subjective and objective parameters of traumatic and degenerative ankle pathologies. The MAQ has no limitation to specific disorders and allows a broad application.
Highlights
There are many approved patient-related outcome measurement tools regarding ankle pathologies
The McGuire Score was only used with patients who underwent ankle arthroplasty or ankle arthrodesis and the Olerud and Molander Score focuses on the postoperative function after treatment of multicomponent ankle fractures and has to be conducted by an investigator [4, 10]
Despite many available measurement tools, none of the scores include a scale to assess the range of motion (ROM), even though it serves as an important parameter to evaluate the postsurgical ankle function during rehabilitation and can be measured by the patient himself [12]
Summary
There are many approved patient-related outcome measurement tools regarding ankle pathologies. The objective of our study was to develop and validate the Munich Ankle Questionnaire (MAQ) as a universal self-assessment score including subjective and objective items. Patient-reported outcome measurement (PROM) tools have been used increasingly as they are useful additive tools in daily clinical routine and patient physician interaction. Despite many available measurement tools, none of the scores include a scale to assess the range of motion (ROM), even though it serves as an important parameter to evaluate the postsurgical ankle function during rehabilitation and can be measured by the patient himself [12]. There is no single tool that combines all relevant factors and is valid, reliable and sensitive to clinical change [13, 14]
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