Paley and Hall used a functional score to evaluate patients following injury and surgery to the hindfoot. This can be used to evaluate the patient initially and to monitor response to therapeutic interventions. The authors are from the University of Toronto in Canada.
Subjective parameters:
(1) pain
(2) activities of daily living and occupation
(3) sports and recreational activities
(4) walking surfaces
(5) walking distance
(6) walking aids
Objective parameters:
(7) range of motion for ankle
(8) range of motion for subtalar joint
(9) limp
|
Parameter |
Finding |
Points |
|
pain |
no pain |
20 |
|
|
occasional, mild pain |
18 |
|
|
moderate pain, necessitating occasional use of medication |
10 |
|
|
severe pain, necessitating regular use of medication |
5 |
|
|
pain at rest |
0 |
|
activities of daily living and occupation |
no change |
20 |
|
|
modified without difficulty |
15 |
|
|
same or modified, with difficulty |
10 |
|
|
disabled; cannot work or perform activities of daily living |
0 |
|
sports and recreational activities |
no change |
10 |
|
|
modified without difficulty |
8 |
|
|
same or modified, with difficulty |
5 |
|
|
disabled; cannot participate in sports or recreational activities |
0 |
|
walking surfaces |
normal walking on any surface |
10 |
|
|
slight difficulty or discomfort on uneven ground, stairs, ladders and inclines |
5 |
|
|
moderate difficulty or discomfort on uneven ground, stairs, ladders and inclines |
2 |
|
|
severe difficulty or discomfort on uneven ground, stairs, ladders and inclines |
0 |
|
walking distance |
same |
5 |
|
|
less than before but more than 6 blocks |
4 |
|
|
less than 6 blocks |
2 |
|
|
around the house only |
0 |
|
walking aids |
no new walking aid or shoe insert or modification since the time of the injury |
5 |
|
|
insoles, heel cushions, wedges, insets or special shoes since the time of the injury |
3 |
|
|
cane, crutches, walker, or wheelchair since the time of the injury |
1 |
|
|
both of the 2 previous categories |
0 |
|
range of ankle motion |
50 – 75 degrees (66 – 100%) |
10 |
|
|
25 – 49 degrees (33 – 65%) |
5 |
|
|
0 – 24 degrees (0 – 32%) |
0 |
|
range of subtalar joint motion |
31 - 45 degrees (66-100%) |
15 |
|
|
16 - 30 degrees (33 – 65%) |
10 |
|
|
3 - 15 degrees (5 – 32%) |
5 |
|
|
0 – 2 degrees (0 – 4%) |
0 |
|
limp |
none |
5 |
|
|
slight |
2 |
|
|
moderate |
0 |
|
|
severe |
0 |
subtotal for subjective findings =
= SUM(points for the 6 subjective measures)
subtotal for objective findings =
= SUM(points for the 3 subjective measures)
total score =
= (subscore for subjective findings) + (subscore for objective findings)
Interpretation:
• minimum score: 0
• maximum subjective subscore: 70
• maximum objective subscore: 30
• maximum total score: 100
• The higher the score, the better the hindfoot function.
|
Score |
Interpretation |
Result |
|
90 – 100 |
excellent |
satisfactory |
|
72 – 89 |
good |
satisfactory |
|
41 – 71 |
fair |
unsatisfactory |
|
1 – 40 |
poor |
unsatisfactory |
Specialty: Surgery, orthopedic
