Psychometric comparisons of 2 versions of the Fugl-Meyer motor scale and 2 versions of the strok rehabilitation assessment of movement

I. Ping Hsueh, Miao Ju Hsu, Ching-Fan Sheu, Su Lee, Ching Lin Hsieh, Jau Hong Lin

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Abstract

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho <.91) and satisfactory predictive validity (rho =.72-.77). The scales showed responsiveness (effect size d < 0.34; standardized response mean < 0.95; P <.0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients <.96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

Original languageEnglish
Pages (from-to)737-744
Number of pages8
JournalNeurorehabilitation and Neural Repair
Volume22
Issue number6
DOIs
Publication statusPublished - 2008 Nov 1

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All Science Journal Classification (ASJC) codes

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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