FMA-UE - FUGL-MEYER ASSESSMENT: UPPER EXTREMITY

1. BY: HOZEFA MOHAMMED HUSA
FUGL-MEYER ASSESSMENT:
UPPER EXTREMITY
(FMA-UE)
ASSESSMENT OF SENSORIMOTOR FUNCTION

2. BY: HOZEFA MOHAMMED HUSA
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. BY: HOZEFA MOHAMMED HUSA

4. BY: HOZEFA MOHAMMED HUSA

5. BY: HOZEFA MOHAMMED HUSA

6. BY: HOZEFA MOHAMMED HUSA

7. BY: HOZEFA MOHAMMED HUSA

8. BY: HOZEFA MOHAMMED HUSA

9. BY: HOZEFA MOHAMMED HUSA

10. BY: HOZEFA MOHAMMED HUSA

11. BY: HOZEFA MOHAMMED HUSA
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
1. MOTOR FUNCTION(UE=66, LE=34)
2. SENSORY FUNCTION(24)
3. BALANCE(14)
4. JROM(44)
5. JOINT PAIN(44)

12. BY: HOZEFA MOHAMMED HUSA
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

13. BY: HOZEFA MOHAMMED HUSA
• ICF DOMAIN: BODY FUNCTION
• MEASUREMENT DOMAIN: MOTOR AND
SENSORY

14. BY: HOZEFA MOHAMMED HUSA
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

15. BY: HOZEFA MOHAMMED HUSA
• 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

16. BY: HOZEFA MOHAMMED HUSA
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

17. BY: HOZEFA MOHAMMED HUSA
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