Reliability, Concurrent Validity, and Responsiveness of the Fugl-Meyer Assessment (FMA) for Hemiplegic Patients

Abstract

[Purpose] The purpose of this study was to determine the reliability, validity, and responsiveness of the Fugl-Meyer Assessment (FMA) for hemiplegic patients. [Subjects] For the reliability and validity study, 50 patients with stroke (26 males, 24 females) were recruited. For the responsiveness study, 16 hemiplegic patients (8 males, 8 females) participated. [Methods] Two physical therapists and one occupational therapist rated 50 video recordings of hemiplegic patients using the FMA to test the inter-rater reliability, and one physical therapist (rater A) rated each of the 50 video clips on two occasions, two weeks apart, to evaluate the test-retest reliability. Responsiveness was calculated three months after the baseline assessment. Reliability was calculated using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD). Concurrent validity was examined using Pearson’s correlation coefficient and responsiveness was calculated using the effect size (ES) and standardized response mean (SRM). [Results] Assessment using the FMA showed high relative reliability, and the absolute reliability was satisfactory for the inter-rater and test-retest reliabilities. The correlations between motor function of the FMA and the Jebsen-Taylor hand function, grip power, motor assessment scale (MAS), and the Berg balance scale (BBS) were moderate to good, and were highly significant (p<0.05), while responsiveness was moderate to large. [Conclusion] The results indicate that the FMA is a reasonable assessment of the function of the upper and lower extremities of patient with stroke.