Is the long form of the Fugl-Meyer motor scale more responsive than the short form in patients with stroke?
OBJECTIVE
To compare the responsiveness of the Rasch-calibrated 37-item Fugl-Meyer motor Scale with that of the 12-item Fugl-Meyer motor scale at both an individual and a group level.


METHODS
Repeated-measurements design.


METHODS
Medical center.


METHODS
Patients (N=301) 14 days after stroke.


METHODS
Not applicable.


METHODS
50-item Fugl-Meyer motor scale, 37-item Fugl-Meyer motor scale, and 12-item Fugl-Meyer motor scale.


RESULTS
The patients were assessed with the original 50-item Fugl-Meyer motor scale 4 times, at 14, 30, 90, and 180 days after stroke onset. The patients' responses were used for estimating the Rasch scores of the 37-item Fugl-Meyer motor scale and 12-item Fugl-Meyer motor scale. The effect size, standardized response mean, and paired t test were used to compare the group-based responsiveness of the 3 forms (50-item Fugl-Meyer motor scale, 37-item Fugl-Meyer motor scale, 12-item Fugl-Meyer motor scale). Individual-level responsiveness was compared based on the significance of change between the 37-item Fugl-Meyer motor scale and 12-item Fugl-Meyer motor scale. Because up to 13 items of the 50-item Fugl-Meyer motor scale did not meet the Rasch model's assumptions, the significance of change of the 50-item Fugl-Meyer motor scale was not calculated. At the group level, the FM-37 and FM-12 Fugl-Meyer motor scale had sufficient and similar responsiveness. At the individual level, the FM-37 Fugl-Meyer motor scale detected more patients with significant improvement than the FM-12 Fugl-Meyer motor scale. The SC values and category distribution of the FM-37 Fugl-Meyer motor scale were significantly better than those of the FM-12 Fugl-Meyer motor scale (P<.001).


CONCLUSIONS
Although the group-level responsiveness of the 12-item Fugl-Meyer motor scale was sufficient and very similar to that of the 37-item Fugl-Meyer motor scale, the 37-item Fugl-Meyer motor scale had better individual-level responsiveness. The 37-item Fugl-Meyer motor scale is suggested as an outcome measure for both clinicians and researchers.
School of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, Tainan, Taiwan.
Kuan-Lin
KL
Chen
Center for Teacher Education, National Tsing Hua University, Hsinchu, Taiwan.
Cheng-Te
CT
Chen
Department of Psychology, National Chung Cheng University, Chiayi, Taiwan; Research Center for Psychological and Educational Testing, National Taiwan Normal University, Taipei, Taiwan.
Yei-Tai
YT
Chou
Center for Teacher Education, National Sun Yat-Sen University, Kaohsiung, Taiwan.
Ching-Lin
CL
Shih
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chia-Lin
CL
Koh
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: clhsieh@ntu.edu.tw.
Ching-Lin
CL
Hsieh
D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000368:Aged; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D011594:Psychometrics / Q000379:methods*; D020127:Recovery of Function; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*
Outcome assessment; Psychometrics; Rehabilitation; Stroke