title: Are the hierarchical properties of the Fugl-Meyer assessment scale the same in acute stroke and chronic stroke?
abstract: BACKGROUND
  The motor function section of the Fugl-Meyer assessment scale (FM motor scale) is a robust scale of motor ability in people after stroke, with high predictive validity for outcome. However, the FM motor scale is time-consuming. The hierarchical properties of the upper extremity (UE) and lower extremity (LE) sections of the FM motor scale have been established in people with chronic stroke. These data support the use of a more concise method of administration and confirm scores can be legitimately summed.
  
  
  OBJECTIVE
  The aim of this study was to establish that a similar hierarchy exists in people within 72 hours after stroke onset.
  
  
  METHODS
  A prospective, cross-sectional design was used.
  
  
  METHODS
  Data were obtained from 75 eligible people in a nationwide prospective study (the Early Prediction of Functional Outcome After Stroke). The full version of both sections of the FM motor scale was administered within 72 hours after stroke onset. The hierarchy of item difficulty was investigated by applying Guttman scaling procedures within each stage and each subsection of the UE and LE sections of the scale. The scaling procedures then were applied to item difficulty between stages and subsections and finally across all scale items (stage divisions ignored) of the FM motor scale.
  
  
  RESULTS
  For all analyses, the results exceeded acceptable levels for the coefficient of reproducibility and the coefficient of scalability.
  
  
  CONCLUSIONS
  The sample was a population of people with stroke of moderate severity.
  
  
  CONCLUSIONS
  The unidimensional hierarchy of the UE and LE sections of the FM motor scale (already established for chronic stroke) within 72 hours after stroke onset was confirmed. A legitimate total summed score can indicate a person's level of motor ability.
authors.affiliation: J.L. Crow, MSc, MCSP, DipTP, Unit Physical Therapy, Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC University Medical Center Rotterdam, Room Nc-318, PO Box 2040, 3000 CA Rotterdam, the Netherlands. j.crow@erasmusmc.nl.
authors.forename: J Lesley
authors.initials: JL
authors.lastname: Crow
authors.affiliation: G. Kwakkel, PT, PhD, Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, the Netherlands, and Department of Neurorehabilitation, Reade Center for Rehabilitation and Rheumatology, Amsterdam, the Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
authors.affiliation: J.B.J. Bussmann, PT, PhD, Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC University Medical Center Rotterdam.
authors.forename: Johannes B J
authors.initials: JB
authors.lastname: Bussmann
authors.affiliation: J.A.G. Goos, PT, MNR, Department of Physical Therapy, Franciscus Hospital, Roosendaal, the Netherlands.
authors.forename: Jos A G
authors.initials: JA
authors.lastname: Goos
authors.affiliation: B.C. Harmeling-van der Wel, PT, Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC University Medical Center Rotterdam.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Harmeling-van der Wel
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009068:Movement / Q000502:physiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology*; D013997:Time Factors; D034941:Upper Extremity / Q000503:physiopathology*