TY - JOUR
T1 - Development of a computerized adaptive testing system of the Fugl-Meyer motor scale in stroke patients
AU - Hou, Wen Hsuan
AU - Shih, Ching Lin
AU - Chou, Yeh Tai
AU - Sheu, Ching-Fan
AU - Lin, Jau Hong
AU - Wu, Hung Chia
AU - Hsueh, I. Ping
AU - Hsieh, Ching Lin
N1 - Funding Information:
Supported by the National Science Council (grant no. NSC 96-2314-B-037-028 ), the National Health Research Institutes (grant no. NHRI-EX99-9512PI ), and the E-Da Hospital (grant no. EDAHP100002 ).
PY - 2012/6
Y1 - 2012/6
N2 - Objective: To develop a computerized adaptive testing system of the Fugl-Meyer motor scale (CAT-FM) to efficiently and reliably assess motor function in patients with stroke. Design: First, a simulation study was used to develop and examine the psychometric properties of the CAT-FM. Second, a field study was employed to determine the administration efficiency of the CAT-FM. Setting: One medical center and 1 teaching hospital. Participants: Patients' responses (n=301) were used for the simulation study; 49 patients participated in the field study. Interventions: Not applicable. Main Outcome Measures: The 2 CAT-FM item banks (upper extremity and lower extremity) include 37 items from the original Fugl-Meyer scale. The reliability, validity, and responsiveness of the CAT-FM were determined by the simulation study. Results: Two stopping rules (reliability <0.9 or an increase of reliability <.01 after testing an item) were used. The simulation study showed that the CAT-FM had high reliability (<.93 for upper-extremity and lower-extremity subscales) and concurrent validity (Pearson r<.91 for the upper-extremity and lower-extremity subscales and motor scale). The responsiveness was moderate (standardized response mean for the upper extremity=.67, lower extremity=.79, and motor=.77) for the 226 patients who completed both assessments at 14 and 90 days after stroke. The field study found that, on average, the time needed to administer the CAT-FM was 242 seconds with 4.7 items. Conclusions: The CAT-FM is an efficient, reliable, valid, and responsive clinical tool for assessing motor function in patients with stroke.
AB - Objective: To develop a computerized adaptive testing system of the Fugl-Meyer motor scale (CAT-FM) to efficiently and reliably assess motor function in patients with stroke. Design: First, a simulation study was used to develop and examine the psychometric properties of the CAT-FM. Second, a field study was employed to determine the administration efficiency of the CAT-FM. Setting: One medical center and 1 teaching hospital. Participants: Patients' responses (n=301) were used for the simulation study; 49 patients participated in the field study. Interventions: Not applicable. Main Outcome Measures: The 2 CAT-FM item banks (upper extremity and lower extremity) include 37 items from the original Fugl-Meyer scale. The reliability, validity, and responsiveness of the CAT-FM were determined by the simulation study. Results: Two stopping rules (reliability <0.9 or an increase of reliability <.01 after testing an item) were used. The simulation study showed that the CAT-FM had high reliability (<.93 for upper-extremity and lower-extremity subscales) and concurrent validity (Pearson r<.91 for the upper-extremity and lower-extremity subscales and motor scale). The responsiveness was moderate (standardized response mean for the upper extremity=.67, lower extremity=.79, and motor=.77) for the 226 patients who completed both assessments at 14 and 90 days after stroke. The field study found that, on average, the time needed to administer the CAT-FM was 242 seconds with 4.7 items. Conclusions: The CAT-FM is an efficient, reliable, valid, and responsive clinical tool for assessing motor function in patients with stroke.
UR - http://www.scopus.com/inward/record.url?scp=84862784580&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84862784580&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2011.12.005
DO - 10.1016/j.apmr.2011.12.005
M3 - Article
C2 - 22440481
AN - SCOPUS:84862784580
VL - 93
SP - 1014
EP - 1020
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 6
ER -