title: Development of a computerized adaptive testing system of the Fugl-Meyer motor scale in stroke patients.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  One medical center and 1 teaching hospital.
  
  
  METHODS
  Patients' responses (n=301) were used for the simulation study; 49 patients participated in the field study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, E-Da Hospital, Kaohsiung, Taiwan.
authors.forename: Wen-Hsuan
authors.initials: WH
authors.lastname: Hou
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Shih
authors.forename: Yeh-Tai
authors.initials: YT
authors.lastname: Chou
authors.forename: Ching-Fan
authors.initials: CF
authors.lastname: Sheu
authors.forename: Jau-Hong
authors.initials: JH
authors.lastname: Lin
authors.forename: Hung-Chia
authors.initials: HC
authors.lastname: Wu
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Hsueh
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Hsieh
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D011594:Psychometrics; D015203:Reproducibility of Results; D012494:Sampling Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D013624:Taiwan; D013647:Task Performance and Analysis; D034941:Upper Extremity / Q000503:physiopathology