Intra- and inter-rater reliability of Fugl-Meyer Assessment of Upper Extremity in stroke

• Published in: Journal of rehabilitation medicine Vol. 51; no. 9; pp. 652 - 659
• Main Authors: Hernández, Edgar D, Galeano, Claudia P, Barbosa, Nubia E, Forero, Sandra M, Nordin, Åsa, Sunnerhagen, Katharina S, Alt Murphy, Margit
• Format: Journal Article
• Language: English
• Published: Sweden Journal of Rehabilitation Medicine 2019; Medical Journals Sweden
• Subjects: agreement; Agreements; Comparative studies; Military hospitals; motor activity; Neurosciences; Neurovetenskaper; non-parametric statistics; Ordinal measurement; Physical therapists; physical therapy specialty; psychometrics; Quality of care; recovery; Rehabilitation; Reliability; reproducibility of results; scale; Sport Sciences; Stroke; stroke rehabilitation; upper extremity; Upper limbs; Edgar D. Hernández, Claudia P. Galeano, Nubia E. Barbosa, Sandra M. Forero, Åsa Nordin, Katharina S. Sunnerhagen, Margit Alt Murphy
• ISSN: 1650-1977; 1651-2081
• DOI: 10.2340/16501977-2590

The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) is recommended for evaluation of sensorimotor impairment post stroke, but the item-level reliability of the scale is unknown. The study aims to determine intra- and inter-rater reliability of the FMA-UE at item-, subscale- and total score level in patients with early subacute stroke.
Intra/inter-rater reliability.
Sixty consecutively included patients with stroke (mean age 65.9 years) admitted to Central Military Hospital of Colombia, Bogota.
Two physiotherapists scored FMA-UE independently on 2 consecutive days within 10 days post stroke. A rank-based statistical method for paired ordinal data was used to assess the level of agreement, systematic and random disagreements.
Systematic disagreements either in position or concentration were detected in 4 items of the shoulder section. The item level intra- and inter-rater agreement was high (79-100%). The 70% agreement was also reached for the subscales and the total score when 1-3-point difference was accepted.
The FMA-UE is reliable both within and between raters in patients with stroke in the early subacute phase. A wider international use of FMA-UE will allow comparison of stroke recovery between regions and countries and thereby potentially improve the quality of care and rehabilitation in persons with stroke worldwide.