Ankle Function Score (de Bie, 1997)

Objective

The Ankle Function Score (AFS), developed in 1997 by de Bie et al., is used to distinguish, in the acute stage, between a mild and a severe ankle injury. It assesses the functional stability of the ankle following a sprain. de Bie’s functional score was inspired by the Lysholm score (for knee problems) and adapted for ankle sprains.

Interpretation

The maximum score (100 points) indicates a complete recovery with no symptoms or disability. Conversely, the lower the score, the more incomplete the functional recovery. A score of more than 40 points (out of a total of 100 points) within five days of the injury characterizes a mild injury that leads to recovery of functional ability within two weeks (≥ 75 points on the AFS) (Van der Wees et al., 2012).

Execution

The functional score consists of 5 categories (pain, instability, weight-bearing, swelling, and gait pattern), in each of which a certain number of points can be obtained. The total score ranges from 0 to 100.

Duration

Approximately 5 minutes.

Equipment

None.

Clinical Value

Although this questionnaire has been criticized for its predictive value regarding functional recovery at two weeks, it remains a good tool for assessing the patient’s functional progress. It is easy to use, completed directly by the patient, and, most importantly, it provides a functional score in addition to the clinical assessment.

As a predictive tool, it has been found to have a sensitivity of 76% and a specificity of 57% (Van der Wees et al., 2012).

In summary, the AFS is a simple instrument based on basic functional outcomes and can be used, in addition to subjective clinical judgment, as a prognostic and evaluative tool for recovery following an acute ankle injury (Van der Wees et al., 2012).

Acknowledgements

We thank Rob de Bie for allowing us to make the Ankle Function Score of de Bie available on Fullphysio.

Bie, R. A. de, H. C. de Vet, F. A. van den Wildenberg, T. Lenssen, and P. G. Knipschild. “The Prognosis of Ankle Sprains.” International Journal of Sports Medicine 18, no. 4 (May 1997): 285–89.

Bonfanti S. et al. (2012), Scores de mesure fonctionnelle articulaire pour le praticien, Revue Médicale Suisse, 8, pp. 1501–1507.

Wees, P. van der, E. Hendriks, H. van Beers, R. van Rijn, J. Dekker, and R. de Bie. “Validity and Responsiveness of the Ankle Function Score after Acute Ankle Injury.” Scandinavian Journal of Medicine & Science in Sports 22, no. 2 (2012): 170–74.