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Rating for
Ankle Motion Impairment - Rating Tip of the Week
The evaluation for ankle motion impairment is
not a complex process, but there are several
components to the exam where errors are
frequently committed. Here are tips to help you
complete your ankle impairment assessment
correctly as instructed in Chapter 17 of the
Guides:
1. Figure 17-5 on page 535 explains that ankle
plantar flexion and dorsiflexion (extension)
measurements are to be obtained both with the
knee in full extension and flexed to 45 degrees.
The average of the measurements obtained for
each plane of motion in the two knee positions
represents the actual value to be used for the
impairment rating. Apply these values to Table
17-11 on page 537 to determine impairment. Note
Figure 17-5 uses the term “Dorsiflexion” and
Table 17-11 uses the term “Extension”; they are
the same. (Plantar flexion is referenced
correctly.)
2. When assessing impairment for ankylosis of
the ankle joint, do not forget there is a
baseline 4% whole person impairment (10% lower
extremity, 14% foot) for ankylosis in a neutral
position. Any variation from the neutral
position as indicated in Tables 17-24 to 17-28
on page 541 will be additional impairment to
this 4% whole person. For example, an ankle
fused in 7 degrees of varus will result in a
final 14% whole person impairment. Remember,
these tables are used for determining impairment
of ankylosed joints only. For range of motion
measurements, use Tables 17-11, 12, and 13 on
page 537.
3. If you have impairments of both the Ankle and
the Hindfoot “combine these regional, lower
extremity impairments of the foot and convert
the combined foot impairment to a whole person”
as explained on page 528. (There is a convenient
conversion tool at
www.impairment.com/tools.)
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