Methodological Quality of Cross-Cultural Adaptations of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale.

BACKGROUND

The American Orthopaedic Foot and Ankle Society (AOFAS) scale is used to evaluate foot and ankle complaints, both in the general population and in athletes. The objective of this study was to review different versions of the AOFAS scale for hindfoot and ankle problems and to evaluate the methodological quality of studies published in this respect.

METHODS

The study design was a systematic review, and a search was conducted in five databases: PubMed, Scopus, CINAHL, PEDro: Physiotherapy Evidence Database, and PROSPERO from inception to January 2023. The following inclusion criteria were applied: validation studies of the AOFAS scale, in different languages, with no time limit, in a population aged 18 years and older. Two of us (J.G.-M. and S.S.-M.) independently assessed the quality of the studies located and extracted the relevant data. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) checklist was used to assess methodological quality.

RESULTS

Six instruments were analyzed in this review. In many cases, significant methodological flaws were detected, mostly regarding internal consistency and criterion validity.

CONCLUSIONS

The Dutch (ankle fractures) version of the AOFAS scale presents the best quality and is considered valid and reliable. Further studies, with greater methodological rigor, are required of the cultural adaptations of this measurement instrument.