title: Rasch Analysis of the Wrist and Hand Fugl-Meyer: Dimensionality and Item-Level Characteristics.
abstract: OBJECTIVE
  Clinical administration of the wrist stability, wrist mobility, and hand items of the upper-extremity Fugl-Meyer (W/H UE FM) may provide a rigorous, easily administered, bedside measure of motor impairment in mildly impaired stroke survivors. The purpose of this study was to evaluate the item structure of the W/H UE FM to better understand its measurement properties using Rasch analysis.
  
  
  METHODS
  This was a secondary analysis of W/H UE FM data arising from clinical trials of mildly impaired stroke survivors using latent parallel analysis, ordinal factor analysis, and partial credit model Rasch analyses.
  
  
  RESULTS
  Latent parallel analysis and ordinal factor analysis indicated that all W/H UE FM items represent a single unidimensional construct, wrist and hand motor ability. Rasch analysis of data from 150 mildly impaired stroke survivors (94 men; mean age, 57.1 ± 11.4 years; mean time since stroke, 19.5 months) revealed that the W/H UE FM operated as a reliable, valid, and effective measure of wrist and hand motor ability. These data were compatible with Rasch model assumptions and are consistent with previous W/H UE FM research. Mass flexion and extension movements were the least difficult W/H UE FM items while the radial and hook grasp items were the most difficult.
  
  
  CONCLUSIONS
  The W/H UE FM is well suited to mildly impaired stroke survivors who exhibit the ability to perform mass flexion and mass extension movements. The full-scale UE FM may be preferable for stroke survivors with lower levels of ability.Video abstract available for additional insight from the authors (Supplemental Digital Content 1, http://links.lww.com/JNPT/A108).
authors.affiliation: Division of Occupational Therapy (A.C.P., S.J.P.), The Ohio State University, Columbus, Ohio; Quantitative Research, Evaluation, and Measurement (P.C.G.), College of Education and Human Ecology, The Ohio State University, Columbus, Ohio; Division of Occupational Therapy, Medical University of South Carolina (CAV), Charleston, South Carolina.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Persch
authors.forename: P Cristian
authors.initials: PC
authors.lastname: Gugiu
authors.forename: Craig A
authors.initials: CA
authors.lastname: Velozo
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D014953:Wrist / Q000503:physiopathology*