Fugl-Meyer Assessment of Motor Recovery after Stroke: Difference between revisions
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=== Validity === | === Validity === | ||
<u>Criterion Validity:</u> | |||
<u></u>Stroke: | |||
(Malouin et al, 1994; n = 32; mean age = 60; mean time since stroke = 64.5 days, Acute Stroke) <ref name="Malouin et al">Malouin, F., Pichard, L., et al. "Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale." Arch Phys Med Rehabil 1994 75: 1206-1212</ref> | |||
*Excellent FMA & Motor Assessment Scale (MAS) total score correlations (r = 0.96) | |||
*Poor FMA & MAS sitting balance item correlations (r = -0.10) | |||
*Motor and sensory FMA scores 5 days post-stroke were the strongest predictor of motor recovery 6 months post-stroke (Duncan et al, 1992) <ref name="Duncan et al">Duncan, P. W., Goldstein, L. B., et al. "Measurement of motor recovery after stroke. Outcome assessment and sample size requirements." Stroke 1992 23(8): 1084-1089</ref> | |||
<u>Construct Validity:</u> | |||
<u></u>Stroke:<br>Acute Stroke: | |||
*Excellent correlation: modified Balance Subscale on FMA and the Barthel Index; r = 0.86 - 0.89 (Mao et al, 2002) <ref name="Mao et al">Mao, H.-F., Hsueh, I. P., et al. "Analysis and comparison of the psychometric properties of three balance measures for stroke patients." Stroke 2002 33: 1022-1027</ref> | |||
*Excellent correlation: FMA and Functional Independence Measures (FIM) administered to 172 inpatients who had recently had a stoke; r = 0.63 (Shelton et al, 2000) <ref name="Shelton et al">Shelton, F. D., Volpe, B. T., et al. "Motor impairment as a predictor of functional recovery and guide to rehabilitation treatment after stroke." Neurorehabil Neural Repair 2001 15(3): 229-237</ref> | |||
*FMA effectively distinguished between three levels of self care (Independent, Partly Dependant, and Dependant) in a sample of 109 recent (< 90 days) stroke survivors (Bernspang et al, 1987). <ref name="Bernspang et al">Bernspang, B., Asplund, K., et al. (1987). "Motor and perceptual impairments in acute stroke patients: effects on self-care ability." Stroke 1987 18: 1081-1086</ref> | |||
*FMA was a better measure of higher-level recovery than the MAS (Malouin, et al, 1994) <ref name="Malouin et al">Malouin, F., Pichard, L., et al. "Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale." Arch Phys Med Rehabil 1994 75: 1206-1212</ref> | |||
Chronic Stroke<br> (Dettmann et al, 1987; n = 15; mean age = 64 years; mean time since stroke, 2 years, Chronic Stroke) <ref name="Dettmann et al">Dettmann, M. A., Linder, M. T., et al. "Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient." Am J Phys Med 1987 66: 77-90</ref> | |||
*The FMA and the Barthel Index were used to assess a group of 15 participants at an average of 2 years post stroke. Correlations between the measures were excellent (r = 0.67). The strongest correlations were observed in the Balance subscore (r = 0.76) the Upper Extremity subscore of the motor domain (r = 0.75) and FMA Motor total score (r = 0.74) | |||
=== Responsiveness === | === Responsiveness === |
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Objective
[edit | edit source]
The Fugl-Meyer Assessment of Motor Recovery after Stroke is used to evaluate and measure recovery in post-stroke hemiplegic patients.
Intended Population
[edit | edit source]
The FMA was designed to be used for patients with post-stroke hemiplegic patients of all ages
Method of Use[edit | edit source]
Equipment Required:
Tennis ball
- A small spherical container
- Reflex hammer
- Quiet, private space with little distraction
Description:
Items are scored on a 3-point ordinal scale
0 = cannot perform
1 = performs partially
2 = performs fully
- Maximum Score = 226 points
- The Five domains assessed include:
Motor function (UE maximum score = 66; LE maximum score = 34)
Sensory function (maximum score = 24)
Balance (maximum score = 14)
Joint range of motion (maximum score = 44)
Joint pain (maximum score = 44)
- Subscales can be administered without the using the full test
Links to scoring sheet found below
Reference
[edit | edit source]
Evidence[edit | edit source]
Reliability[edit | edit source]
Test-retest Reliability:
General Rehab Sample:
(Platz et al, 2005; n = 37 stroke, 14 MS, and 5 TBI patients; assessed twice within a 7 day interval, General Rehab Sample) [1]
- Excellent Total Motor Score (ICC = 0.97)
- Excellent Sensation (ICC = 0.81)
- Excellent Passive Joint motion (ICC = 0.95)
Interrater/Intrarater Reliability:
Stroke:
(Duncan et al, 1983; n = 19; mean age = 56 (13) years; same PT rating on 3 occasions each 3 weeks apart; VA sample, Chronic Stroke) [2]
Interrater Reliability
Rating | Domain | Pearson's r |
Excellent | FMA total score | r = 0.98-0.99 |
Excellent | Upper Extremity | r = 0.995 - 0.996 |
Excellent | Lower Extremity | r = 0.96 |
Excellent | Sensation | r = 0.95 - 0.96 |
Excellent | Joint Range / Pain | r = 0.86 - 0.996 |
Excellent | Balance | r = 0.89 - 0.98 |
Validity[edit | edit source]
Criterion Validity:
Stroke:
(Malouin et al, 1994; n = 32; mean age = 60; mean time since stroke = 64.5 days, Acute Stroke) [3]
- Excellent FMA & Motor Assessment Scale (MAS) total score correlations (r = 0.96)
- Poor FMA & MAS sitting balance item correlations (r = -0.10)
- Motor and sensory FMA scores 5 days post-stroke were the strongest predictor of motor recovery 6 months post-stroke (Duncan et al, 1992) [2]
Construct Validity:
Stroke:
Acute Stroke:
- Excellent correlation: modified Balance Subscale on FMA and the Barthel Index; r = 0.86 - 0.89 (Mao et al, 2002) [4]
- Excellent correlation: FMA and Functional Independence Measures (FIM) administered to 172 inpatients who had recently had a stoke; r = 0.63 (Shelton et al, 2000) [5]
- FMA effectively distinguished between three levels of self care (Independent, Partly Dependant, and Dependant) in a sample of 109 recent (< 90 days) stroke survivors (Bernspang et al, 1987). [6]
- FMA was a better measure of higher-level recovery than the MAS (Malouin, et al, 1994) [3]
Chronic Stroke
(Dettmann et al, 1987; n = 15; mean age = 64 years; mean time since stroke, 2 years, Chronic Stroke) [7]
- The FMA and the Barthel Index were used to assess a group of 15 participants at an average of 2 years post stroke. Correlations between the measures were excellent (r = 0.67). The strongest correlations were observed in the Balance subscore (r = 0.76) the Upper Extremity subscore of the motor domain (r = 0.75) and FMA Motor total score (r = 0.74)
Responsiveness[edit | edit source]
Miscellaneous
[edit | edit source]
Links[edit | edit source]
Fugl-Meyer Assessment of Motor Recovery After Stroke
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Platz, T., Pinkowski, C., et al. "Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study." Clin Rehabil 2005 19: 404-411
- ↑ 2.0 2.1 Duncan, P. W., Propst, M., et al. "Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident." Phys Ther 1983 63: 1606-1610 Cite error: Invalid
<ref>
tag; name "Duncan et al" defined multiple times with different content - ↑ 3.0 3.1 Malouin, F., Pichard, L., et al. "Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale." Arch Phys Med Rehabil 1994 75: 1206-1212
- ↑ Mao, H.-F., Hsueh, I. P., et al. "Analysis and comparison of the psychometric properties of three balance measures for stroke patients." Stroke 2002 33: 1022-1027
- ↑ Shelton, F. D., Volpe, B. T., et al. "Motor impairment as a predictor of functional recovery and guide to rehabilitation treatment after stroke." Neurorehabil Neural Repair 2001 15(3): 229-237
- ↑ Bernspang, B., Asplund, K., et al. (1987). "Motor and perceptual impairments in acute stroke patients: effects on self-care ability." Stroke 1987 18: 1081-1086
- ↑ Dettmann, M. A., Linder, M. T., et al. "Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient." Am J Phys Med 1987 66: 77-90