Determining Levels of Upper Extremity Movement Impairment by Applying a Cluster Analysis to the Fugl-Meyer Assessment of the Upper Extremity in Chronic Stroke.
Elizabeth J Woytowicz, Jeremy C Rietschel, Ronald N Goodman and 4 others
PMID 27519928WHAT IT FOUND
In 247 people with chronic stroke, Fugl-Meyer upper limb scores grouped into severe, severe-moderate, moderate-mild, and mild impairment patterns.
Reflex items did not change the grouping, so they may be left out when classifying movement impairment.
Key findings
01The three-cluster analysis produced severe, moderate, and mild groups, but 56 participants had scores shared between the severe and moderate clusters.
02A four-cluster method removed overlap and produced severe, severe-moderate, moderate-mild, and mild groups with different motor patterns.
03Including or excluding the three reflex items changed the total score cut-points very little.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The analysis uses baseline data from five earlier intervention studies and reports no treatment outcomes. The sample includes only chronic stroke, and the authors say sub-acute patients may produce different cut-points. The sample was biased toward moderate to severe impairment, and the authors say more people with higher scores are needed to refine the upper end. The three-group system had large overlap, and the four-group system was an additional exercise created after that overlap was seen. The Fugl-Meyer Upper Extremity score describes motor impairment, not actual ability to perform tasks, and the authors say total scores do not always predict functional recovery. The cluster analysis did not include functional measures such as the Wolf Motor Function Test.
Declared interests
The supplied text does not include a conflict-of-interest declaration. The article is tagged as supported by NIH extramural and U.S. government non-PHS research, and it uses baseline data from five funded intervention studies.
The easy way to misread this
Do not use these cut-points as a functional ability score or as proof that a treatment will work. The study classified motor impairment patterns in chronic stroke, and the authors state that total Fugl-Meyer scores do not always predict functional recovery.