title: Clinically important differences for the upper-extremity Fugl-Meyer Scale in people with minimal to moderate impairment due to chronic stroke.
abstract: BACKGROUND
  The upper-extremity portion of the Fugl-Meyer Scale (UE-FM) is one of the most established and commonly used outcome measures in stroke rehabilitative trials. Empirical work is needed to determine the amount of change in UE-FM scores that can be regarded as important and clinically meaningful for health professionals, patients, and other stakeholders.
  
  
  OBJECTIVE
  This study used anchor-based methods to estimate the clinically important difference (CID) for the UE-FM in people with minimal to moderate impairment due to chronic stroke.
  
  
  METHODS
  One hundred forty-six individuals with stable, mild to moderate upper-extremity (UE) hemiparesis were administered the UE-FM before and after an intervention targeting their affected UEs. The treating therapists rated each participant's perceived amount of UE motor recovery on a global rating of change (GROC) scale evaluating several facets of UE movement (grasp, release, move the affected UE, perform 5 important functional tasks with the affected UE, overall UE function). Estimated CID of the UE-FM scores was calculated using receiver operating characteristic (ROC) curve with the GROC scores as the anchor.
  
  
  RESULTS
  The ROC curve analysis revealed that change in UE-FM scores during the intervention period distinguished participants who experienced clinically important improvement from those that did not based on the therapists' GROC scores. The area under the curve ranged from 0.61 to 0.70 for the different facets of UE movement.
  
  
  CONCLUSIONS
  The estimated CID of the UE-FM scores ranged from 4.25 to 7.25 points, depending on the different facets of UE movement.
authors.affiliation: The Ohio State University, 453 W 10th Ave, Suite 406, Columbus, OH 43210, USA. stephen.page@osumc.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
authors.forename: George D
authors.initials: GD
authors.lastname: Fulk
authors.forename: Pierce
authors.initials: P
authors.lastname: Boyne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D012372:ROC Curve; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*