Concord: 02 9736 3950
St. Marys: 02 9623 2220
Mt Druitt: 02 9188 2552
precisionsupport@precisionphysio.com.au
FREE PHYSIO ADVICE

The Foot & Ankle Disability Index (FADI) Score


Clinician's name (or ref)(Required)
Patient's name (or ref)(Required)
MM slash DD slash YYYY
Please answer every question with one response that most closely describes your condition within the past week. If the activity in question is limited by something other than your foot or ankle, mark N/A
No difficulty at allSlight difficultyModerate difficultyExtreme difficultyUnable to do
1. Standing
2. Walking on even ground
3. Walking on even ground without shoes
4. Walking up hills
5. Walking down hills
6. Going up stairs
7. Going down stairs
8. Walking on uneven ground
9. Stepping up and down curves
10. Squatting
11. Sleeping
12. Coming up to your toes
13. Walking initially
14. Walking 5 minutes or less
15. Walking approximately 10 minutes
16. Walking 15 minutes or greater
17. Home responsibilities
18. Activities of daily living
19. Personal care
20. Light to moderate work (standing, walking)
21. Heavy work (push/pulling, climbing, carrying)
22. Recreational activities
NO PAINMILDMODERATESEVEREUNBEARABLE
23. General level of pain
24. Pain at rest
25. Pain during your normal activity
26. Pain first thing in the morning

Thank you for completing this questionnaire. It will be sent to your Clinician at Precision Physio.