Patient Questionnaire
Holsman Physical Therapy & Wellness · NJ & NYC clinics + in-home therapy
holsmanwellness.com · 1-855-465-7626
Holsman Physical Therapy & Wellness · NJ & NYC clinics + in-home therapy
holsmanwellness.com · 1-855-465-7626
23 questions on foot pain, walking and everyday activities, scored from 0 to 100.
The Foot Function Index (FFI) is a 23-question form about foot pain, difficulty with walking and stairs, and how often foot problems limit your activities. Physical therapists and foot specialists use it to measure a foot problem and track progress. It takes about 5 to 10 minutes.
You can fill this in yourself; your physical therapist scores and interprets it with you. If you have a foot wound that is not healing, or sudden swelling, redness, warmth or numbness in your foot or leg, contact your doctor promptly. In an emergency, call 911.
Instructions
Answer each question about your feet during the past week. Choose a number from 0 to 10 for each item. Choose N/A if you did not perform this activity in the past week.
The level of pain you experienced in each situation. 0 is no pain and 10 is the worst pain you can imagine. Choose the number that shows the severity of your foot pain during the past week in the following situations.
How severe is your foot pain:
How much difficulty you experienced when performing these activities in the past week. 0 is no difficulty and 10 is so much difficulty that you were unable to perform the activity. Choose the number that shows how much difficulty you experienced because of your feet.
How much difficulty did you have:
How often you did something in the past week. 0 is never (none of the time) and 10 is always (all of the time). Choose the number that shows how often you did the following because of your feet.
How much of the time do you:
This is a questionnaire, not a diagnosis. The FFI shows how much a foot problem affects pain, walking and daily activities. It can’t tell you what is causing it or what treatment you need. Review your result with your physical therapist, your doctor or another licensed health care provider.
There are no official severity bands; the FFI is most useful for comparing your own scores over time.
Sources. Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44(6):561-570 (subscales and scoring). Item wording from the developers’ US English form distributed by Mapi Research Trust (ePROVIDE); the marked line is shown as 0–10 numbers and “mark” changed to “choose” for on-screen use. 0–10 number version as described by the Shirley Ryan AbilityLab RehabMeasures FFI summary. Budiman-Mak E, Conrad KJ, Mazza J, Stuck RM. A review of the foot function index and the foot function index – revised. J Foot Ankle Res. 2013;6:5.
Permissions. Public domain. Mapi Research Trust’s ePROVIDE listing gives the FFI’s copyright as “Public Domain” (“This questionnaire is in the public domain”), and the developers state that “both the FFI and FFI-R are in the public domain and permission to use them is free of charge” (Budiman-Mak et al., 2013).
Clinically reviewed by Dr. Richard Holsman, PT, DPT, NCS. Last reviewed: November 12, 2026. Holsman Physical Therapy is not affiliated with these authors, organizations or journals, and they do not endorse this website.
Next step: Bring this printout to your next visit and review it with your therapist. Holsman physical therapists see patients at clinics across North Jersey, the Bronx and Brooklyn, plus in-home visits. Refer a patient or call 1-855-465-7626.
The Foot Function Index (FFI) is a 23-question self-report form for foot problems: 9 questions about foot pain, 9 about difficulty with activities such as walking and stairs, and 5 about how often foot problems limit your activities. It was developed by Elly Budiman-Mak, Kendon Conrad and Kathryn Roach in 1991 and is in the public domain.
Each answer is from 0 to 10. For each of the three parts, the answers are added, divided by the most possible for the items answered, and multiplied by 100. The total FFI is the average of the three part scores, from 0 to 100. Higher scores mean more pain, difficulty and activity limitation.
Choose N/A if you did not do that activity in the past week, for example if you never wear orthotics. N/A items are left out of the score, so they do not count against you.
The FFI has no official severity cut-offs. It is most useful for tracking your own scores over time. In the original study of adults with rheumatoid arthritis, the average total score was about 28.
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Physical therapists at clinics across North Jersey, the Bronx and Brooklyn, plus in-home visits.
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