Development and Preliminary Validity Study of a Modified Version of the Upper Extremity Fugl-Meyer Assessment for Use in Telerehabilitation.
Carolina Carmona, Jane E Sullivan, Riegele Arceo and 6 others
PMID 37314323WHAT IT FOUND
In chronic stroke, a video-based modified Fugl-Meyer arm test tracked total arm impairment well, but hand items matched poorly.
Use it for total arm scores, not detailed hand function.
Key findings
01The video-based modified Fugl-Meyer showed significant moderate to good agreement with the face-to-face Fugl-Meyer for included arm subscales, except the Hand subscale, which showed poor agreement.
02A linear conversion projected the remote score to an estimated full in-person Fugl-Meyer score (pUEFMA = 1.41 × tUEFMA + 2) with significant and good agreement.
03The remote test performed better for participants with more severe impairment (UEFMA 10-20, mean absolute error = 2.75) and worse for participants with more moderate impairment (UEFMA 21-40, mean absolute error = 4.9).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 22 adults with chronic stroke, so the results are preliminary. Only participants with moderate to severe arm impairment were included, so the tool has not been checked in people with mild impairment. The remote and in-person tests were sometimes far apart, from 1 to 46 weeks, although the median was 4 weeks and most were within 8 weeks. The remote test was always done before the in-person test, and one examiner did all remote tests, which may have affected the comparison. The modified version removed reflex, wrist, and coordination/speed items, and changed some hand and movement items, so it is not the same as the full in-person Fugl-Meyer. Hand items agreed poorly with the in-person hand score, so remote hand ratings should not be treated as equivalent. Camera placement, internet speed, device access, and participant difficulty with setup may have affected video quality and scoring. The projection equation has not yet been tested in a larger independent sample.
Declared interests
The authors declared no conflict of interest. The article metadata lists N.I.H. extramural and non-U.S. government research support.
The easy way to misread this
Do not treat the video-based test as a full replacement for in-person Fugl-Meyer scoring. It showed good overall agreement but poor agreement for hand items, and it was tested only in 22 people with chronic stroke and moderate to severe arm impairment.