Each item is scored on a 3point ordinal scale 0, 1, or 2, with 0 generally corresponding to no function, 1 to partial function, and 2 to perfect function. Methods fifteen individuals with hemiparetic stroke, 17 trained physical therapists across 5 regional clinical sites, and an expert rater participated in an interrater reliability study of the fugl meyer motor total, upper extremity, and lower extremity subscores and sensory total, light touch, and proprioception subscores assessments. To measure ue hemiparesis, researchers have frequently administered the ue section of the fugl meyer assessment ue fm. The fma was designed by fugl meyer et al6 to provide a numeric score of motor status after stroke based on the sequential stages of motor recovery described by twitchell, 7 reynolds et al, 8 and brunnstrom 9 using measures such as limb synergy and range of motion.
Establishing criterion validity for the functional upper. Pdf on oct 1, 2016, barbara singer and others published the fuglmeyer. The maximum possible score in fugl meyer scale is 226, which corresponds to full sensorymotor recovery. Researcharticle upperextremityfunctionalevaluationby fugl. The fugl meyer assessment fma of upper and lower extremity is the most used and recommended clinical scale for evaluation of sensorimotor impairment after stroke. The fuglmeyer assessment fma is widely used to measure the extent of motor control of the upper and lower extremities post stroke. The reliability, validity, and responsiveness of the catfm were determined by. Fugl meyer assessment of the upper extremity fmaue was used to measure upper limb motor function excluding the 3 reflex items, yielding a maximum of 60. Fuglmeyer assessment of sensorimotor function after stroke.
A manual was produced with a standardised content, procedure and scoring for the fugl meyer assessment upper limb section part 2. The spanish version of fma, validated in this study, is now first time available for use in research and clinical practice. A keyform map of poststroke upper limb recovery defined by items of the fugl meyer assessmentupper extremity fmaue was generated by a previously published rasch analysis. Excellent correlations between wrist and hand upper extremity fugl meyer wh ue fm and the action research arm test across two trials.
Septa pass from the deep surface of the facial sheath to the bone within, confining the functional muscle groups within osteofascial compartments tough fascia gives additional areas of attachment to the muscles and ensures that they work to. Subjects the participants were 140 communitydwelling hemiplegic stroke patients. Paper open access the effects of comprehensive core. Researcharticle upperextremityfunctionalevaluationby. Three individuals with stroke enrolled in a separate research study were randomly selected from each of the three impairment strata of the fmaue.
Sensation, upper extremity dysesteyes closed, compared with the unaffected side anesthesia hypoesthesia or hesia normal light touch upper arm, forearm palmary surface of the hand 0 0 1 1 2 2 less than 34 correct or absence 34 correct or considerable difference correct 100%. Implementation fugl meyer assessment of lower extremity method. The ue portion assesses voluntary movement, reflex activity, grasp and coordination. Test 6mwt, and fugl meyer assessment of lower extremity fmale. Fifteen individuals with hemiparetic stroke, 17 trained physical therapists across 5 regional clinical sites, and an expert rater participated in an interrater reliability study of the fugl meyer motor total, upper extremity, and lower extremity subscores and sensory total, light touch, and proprioception subscores assessments.
The fugl meyer lower extremity fmale consisted of 4 domains that comprised of lower extremity motor function lemf, sensation s, passive joint motion pjm, and joint pain jp retrieved from rehabilitation medicine, university of gothenburg, 2010 was used to evaluate lower extremity. Jul 01, 2014 spread of raw scores across all stages and subsections of the upper extremity and lower extremity sections of the fugl meyer assessment scale. After four weeks of robotassisted therapy, experimental results showed that the patients score and their activities of daily living improved a lot. Fuglmeyer ar, jaasko l, leyman i, olsson s, steglind s. Pdf the fuglmeyer upper extremity scale researchgate. How is the fugl meyer assessment of sensorimotor recovery completed. Quantifying motor impairment through the use of the fugl meyer assessment can assist therapists in. It is applied clinically and in research to determine disease severity, describe motor recovery, and to plan and assess treatment. A chair, bedside table, reflex hammer, cotton ball, pencil, small piece of cardboard or paper, small can, tennis ball, stop watch, and blindfold. Translating measurement findings into rehabilitation. This assessment is a measure of upper extremity ue and lower extremity le motor and sensory impairment. Fuglmeyer assessment upper and lower extremity components. Bernspang, asplund, eriksson, and fugl meyer 1987 administered the fma to. Reflex activity 1a and 1b subject is supine or sitting.
Cutoff score of the lowerextremity motor subscale of fuglmeyer. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with poststroke hemiplegia12. Approved by fugl meyer ar 2010 1 fugl meyer assessment id. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with poststroke hemiplegia. Sep 30, 2017 this video shows how to complete the fugl meyer assessment for both the upper and lower extremities. Apta combined sections meeting 2008 incorporating valid. These exams were performed on 12 patients of the cohort of 31 described under reliability testing above, 4 separate visits across a treatment period, for a.
The fugl meyer assessment fma is a quantitative measure that is widely used to assess motor recovery poststroke in hemiplegic patients. It involves the measurement of both upper and lower extremities ue, le however, the scores for ue are weighted more. As the implementation of procedure, five respondents of stroke patients who had. The fma lower extremity subscore was able to distinguish between patients who needed assistance in walking better than gait speed at speeds less than 0. The fugl meyer assessment of motor recovery after stroke. The fuglmeyer assessment of upper extremity fmaue is one of the most used and recommended assessment scales of sensorimotor function in stroke. Fugl meyer assessment for upper extremity scores were significantly correlated with movement time, spectral arc length, and peak velocity. Apta combined sections meeting 2008 incorporating valid and. Application of the fuglmeyer assessment fma and the. Upper vs lower extremity functional loss in neuromuscular disease. Reliability, concurrent validity, and responsiveness of. Fuglmeyer assessment of motor recovery after stroke. Table 1 from fuglmeyer assessment of sensorimotor function.
Fuglmeyer assessment evaluation of upper extremity. Quality of reflexes, coordination, and voluntary movements of the paretic leg were assessed using a 34point scale. Reflex activity no reflex activity can be elicited. The fma was designed by fugl meyer et al 6 to provide a numeric score of motor status after stroke based on the sequential stages of motor recovery described by twitchell, 7 reynolds et al, 8 and brunnstrom 9 using measures such as limb synergy and range of motion. There is no consensus concerning which standardized upper extremity motor scale is best suited for routinely assessing recovery of motor function in the upper extremity poststroke. Experimentaldesign subjects wereseatedcomfortablyin achair totestuefma. Key method methods fifteen individuals with hemiparetic stroke, 17 trained physical therapists across 5 regional clinical sites, and an expert rater participated in an interrater reliability study of the fugl meyer motor total, upper extremity, and lower extremity subscores. Comparison of the action research arm test and the fugl. Compensation in recovery of upper extremity function after stroke. Results kmean clustering analysis classified 42 stroke survivors in the high mobility function group. Fuglmeyer assessment clinical neuroscience, university of. The minimal clinically important difference of fugl meyer assessment scale is 6 for lower limb in chronic stroke and 910 for upper limb in subacute stroke. Translation and cultural validation of clinical observational. The fugl meyer assessment fma scale is a welldesigned, comprehensive, and efficient clinical examination method that has been widely used by therapists to.
Rehabilitation medicine, university of gothenburg approved by fugl meyer ar 2010 1 fugl meyer assessment id. Approved by fugl meyer ar 2010 1 updated 20150311 fugl meyer assessment id. Fuglmeyer assessment scale item scoring 0 1 2 lower extremity i. Fuglmeyer assessment of sensorimotor function after. Amongthe33items forueevaluation, wereselectedforkinect motion datarecording. Upper extremity ue hemiparesis constitutes a common strokeinduced impairment. This study investigated the reliability of the scale when different therapists assessed the patients performance at the same test session and when the assessment was performed by the same. The fuglmeyer assessment for the upper extremity fmaue and the.
Lowerlimb robotassisted therapy in rehabilitation of. It is designed to assess five domains in patients with poststroke hemiplegia consisting of. Intra and interrater reliability of fuglmeyer assessment. Reliability, concurrent validity, and responsiveness of the fugl meyer assessment fma for hemiplegic patients heesoo kim, phd student. Psychometric properties of the lower extremity subscale of the fugl. Volitional movement within synergies, supine position none partial full flexor synergy. Key method methods fifteen individuals with hemiparetic stroke, 17 trained physical therapists across 5 regional clinical sites, and an expert rater participated in an interrater reliability study of the fuglmeyer motor total, upper extremity, and lower extremity subscores and sensory total, light touch, and proprioception. Reflex activity, supine position none can be elicited flexors. Intertester reliability was found to be high for the total scores of upper and lower extremity motor performance. The fugl meyer assessment of upper extremity fmaue is recommended for evaluation of sensorimotor impairment post stroke, but the itemlevel reliability of the scale is unknown. This study aims to determine intra and interrater reliability of the fmaue at item, subscale and total score level in patients with early subacute stroke. These optimal cutoff scores may be able to identify upper limb feeding performance. Deep fascia of the lower limb is well defined and forms a tough circumferential stocking like structure that contains the musculature.
The fugl meyer lower extremity fmale consisted of 4 domains that comprised of lower extremity motor function lemf, sensation s, passive joint motion pjm, and joint pain jp retrieved from rehabilitation medicine, university of gothenburg, 2010 was used to evaluate lower extremity motor functions. Attempt to elicit the achilles and patellar reflexes. The fma consists of five subscales that relate to various aspects of a patients upper and lower extremity, and the subscales are as follows. Reliability of the fuglmeyer assessment for testing motor.
Approved by fugl meyer ar 2010 3 updated 20150311 total ad max 66 h. Items to be scored are achilles and patellar reflexes. Establishing criterion validity for the functional upper extremity levels fuel in comparison to the fugl meyer to classify functional motor recovery in the acute stroke population american journal of occupational therapy, august 2019, vol. Lower extremity motor subscale of fugl meyer assessment fmale, berg balance scale, 5 times sittostand test, comfortable walking speed, 6minute walk test, and timed up and go test. Measures recovery in poststroke hemiplegic patients fuglmeyer. The fugl meyer assessment cutoff values to identify can use spoon and can use chopsticks were 5453 and 6261 points, with sensitivity and specificity of 86. Purpose the purpose of this study was to investigate the psychometric properties of the lower extremity subscale of the fugl meyer assessment lower extremity fmale for communitydwelling hemiplegic stroke patients. Quantifying motor impairment through the use of the fugl meyer assessment can assist therapists in live webinar. Psychometric properties of the lower extremity subscale of. A standardized approach to the fuglmeyer assessment and.
Maximal hip flexion abductionexternal rotation, maximal flexion in knee and ankle joint. Upper limb movement kinematics can be accurately measured. The fuglmeyer motor assessment fma, originally described by fugl meyer, jaasko, leyman, olson, and steglind 1975 as a system for the evaluation of motor function, balance, sensation qualities, and joint function, is now one of the most widely used clinical assessments of motor impairment and recovery such as that. At the end of rehabilitation training, the patients conditions were assessed by nursing and training staff using the fugl meyer assessment score. Motor functioning in the upper and lower extremities sensory functioning evaluates light touch on two surfaces of the arm and leg, and position sense for 8 joints balance contains 7 tests, 3 seated and 4 standing joint range of motion 8 joints joint pain. Bernspang, asplund, eriksson, and fugl meyer 1987 administered the fma to 109 patients within two weeks of having an acute stroke. Areas of interest where fma fuglmeyer assessment is mostly used. The sensation domain includes light touch and position, and the score range is 0 to 24 points. Fuglmeyer assessment scale scoring item 0 1 2 lower extremity i. Fugl meyer ar, jaasko l, leyman i, olsson s, steglind s.
This study establishes intratester reliability for all components of physical performance and intertester reliability for the total scores of upper and lower extremity motor performance in a cumulative numerical scoring system devised by fugl meyer et al. Fuglmeyer motor assessment for the lower extremities fmale. Green berets ultralight bug out bag with gear recommendations duration. Cutoff score of the lowerextremity motor subscale of fugl. Translating measurement findings into rehabilitation practice. In the adult rehabilitation setting, occupational therapists are often responsible for addressing upper extremity dysfunction in the poststroke population.
Pdf determining levels of upper extremity movement. Paper open access the effects of comprehensive core body. Neurotransplantation for patients with subcortical motor stroke. The fugl meyer assessment of physical performance fma is an example of one widely used scale. Evaluation of upperlimb feeding performance using the. The lower extremity motor subscale of the fugl meyer assessment fmale was used to measure the level of lower extremity motor recovery poststroke. F uglmeyer assessment lower extremity fmale scalelibrary. The fugl meyer assessment fma is a strokespecific, performancebased impairment index. Fugl meyer assessment upper and lower extremity components author. A standardized approach to the fuglmeyer assessment and its. Are the hierarchical properties of the fuglmeyer assessment. The items are summed to provide a final score, with maximum score no impairment of 66 points for the upper extremity and 34 points for the lower extremity. The fuglmeyer upper extremity assessment fma is a strokespecific and performancebased impairment index.
The wolf motor function test wmft and fugl meyer assessment fma scales are the instruments most commonly mentioned in the literature. Fuglmeyer upper extremity assessment bilateral arm. The hierarchy of item difficulty was then investigated with the same process as that used in a previous study of chronic stroke. Spread of raw scores across all stages and subsections of the upper extremity and lower extremity sections of the fugl meyer assessment scale. Fuglmeyer assessment of sensorimotor recovery after. Their performance on each item was displayed on the. Approved by fuglmeyer ar 2010 1 updated 20150311 fuglmeyer assessment id. Fuglmeyer assessment of sensorimotor function wikipedia. Reliability of the fuglmeyer assessment of sensorimotor.