• Neurorehabil Neural Repair · Nov 2008

    Comparative Study

    Psychometric comparisons of 2 versions of the Fugl-Meyer Motor Scale and 2 versions of the Stroke Rehabilitation Assessment of Movement.

    • I-Ping Hsueh, Miao-Ju Hsu, Ching-Fan Sheu, Su Lee, Ching-Lin Hsieh, and Jau-Hong Lin.
    • School of Occupational Therapy, College of Medicine, National Taiwan University, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan.
    • Neurorehabil Neural Repair. 2008 Nov 1; 22 (6): 737-44.

    ObjectiveTo provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM).MethodsFor the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions.ResultsOnly the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho >or= .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d >or= 0.34; standardized response mean >or= 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients >or= .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results.ConclusionsThe 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

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