FMA-UE - FUGL-MEYER ASSESSMENT: UPPER EXTREMITY

FMA-UE - FUGL-MEYER ASSESSMENT: UPPER EXTREMITY

1. FUGL-MEYER ASSESSMENT: UPPER EXTREMITY (FMA-UE) Assessment of sensorimotor function

2. PURPOSE Evaluates and measures recovery in post-stroke hemiplegic patients Used in both clinical and research settings One of the most widely used quantitative measures of motor impairment (Gladstone et al, 2002) Total of 5 domains Therapist rated scale

3. KEY DESCRIPTIONS Items are scored on a 3-point ordinal scale 0 = cannot perform 1 = performs partially 2 = performs fully Max score = 226 points The five domains assessed include Motor function(UE=66, LE=34) Sensory function(24) Balance(14) JROM(44) Joint pain(44)

4. Equipment required Tennis ball A small spherical shaped container A tool to administer reflex tests Enough space is needed for a patient to move around freely

5. Icf domain: body function Measurement domain: motor and sensory

6. Limitations (Gladstone et al, 2002) The sensation, balance, JROm and joint pain domains have been criticized as leess well suited for this instrument Jrom may be a confounding variable, so the inclusion of the joint pain domain may be unnecessary. Arm scores are more heavily weighted than the leg scores Better measures of balance are now available

7. Standard error of measurement ( sem ) (Stanford et al, 1993; n = 12, mean age = 66 years; onset < 6 months, acute stroke) fmA TOTAL SCORE: 9.4 MINIMAL DETECTABLE CHANGE (MDC) (WAGNER ET AL, 2008, N = 14, MEAN AGE = 59.9 YEARS, ASSESSED ON AVERAGE 14 MONTHS POST STROKE, CHRONIC STROKE) FMA = 5.2 POINTS FOR THE UPPER EXTREMITY PORTION OF THE ASSESSMENT MINIMALLY CLINICALLY IMPORTANT DIFFERENCE (MCID) (SHELTON ET AL, 2001; N = 171; MEAN AGE = 70 YEARS; ASSESSED WITHIN 17 DAYS OF STROKE, ACUTE STROKE) FMA MOTOR SCORES FROM ADMISSION TO DISCHARGE 10 POINTS INCREASE IN FMA-UE = 1.5 CHANGE IN DISCHARGE FIM 10 POINTS INCREASE IN FMA-LE = 1.9 CHANGE IN DISCHARGE FIM

8. INTERRATER/INTRARATER RELIABILITY INTERRATER RELIABILITY : EXCELLENT; PEARSON’S R = 0.98-0.99 (DUNCAN ET AL,1983; N=19, MEAN AGE=56 YEARS; SAME PT RATING ON 3 OCCASIONS EACH 3 WEEKS APART; VA SAMPLE, CHRONIC STROKE) INTRARATER RELIABILITY : EXCELLENT; ICC = 0.99 (SULLIVAN ET AL, 2011; N=15, MEAN AGE=62.8 YEARS; 18 PT’S RATER COMPARED) INTERNAL CONSISTENCY: EXCELLENT; ALPHA = 0.94-0.98 (LIN ET AL,2004; N=176; MEAN AGE=67.9YEARS; ACUTE STROKE) CRITERION VALIDITY: EXCELLENT; R = 0.96 (MALOUIN ET AL,1994; N=32; MEAN AGE=60; MEAN TIME SINCE STROKE= 64.5 DAYS, ACUTE STROKE) CONSTRUCT VALIDITY: EXCELLENT; R = 0.86-0.89 (MAO AT AL,2002)

9. REFERENCE 1. Sullivan KJ, Tilson JK, Cen SY, Rose DK, Hershberg J, Correa A, et al. Fugl -Meyer Assessment of Sensorimotor Function After Stroke. Stroke [Internet]. 2011 Feb [cited 2019 Mar 14];42(2):427–32. Available from: https://www.ahajournals.org/doi/10.1161/STROKEAHA.110.592766