Standardized International Manual of the Fugl-Meyer Assessment of Motor Function After Stroke.
Julie Hervé-Colas, Sarah P Newton, Stefan T Engelter and 12 others
PMID 41773341WHAT IT FOUND
Experts agreed on a standardized manual for the Fugl-Meyer Assessment, with 89% consensus for the upper limb and 93% for the lower limb.
This resolves ambiguous instructions and sets clear training standards for consistent motor scoring in stroke care.
Key findings
01The expert group reached a median agreement of 89% for the upper extremity manual and 93% for the lower extremity manual.
02Key ambiguities were resolved, including allowing a 30-degree elbow extension deficit and using 160 degrees as the reference for full shoulder flexion in elderly patients.
03Novice assessors require structured training and must complete at least three independent supervised assessments before scoring patients independently.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The expert panel was dominated by physiotherapists (11 of 14), with only one occupational therapist, which may bias the manual towards PT-specific perspectives. The systematic review was limited to PubMed and did not include non-English studies or grey literature. There is no consensus on FMA-LE severity categories, and MCID values vary widely depending on the anchor used and the patient population. The manual is currently available only in English, limiting its immediate global applicability without translation.
Declared interests
The authors declared no conflicts of interest. Dr. Kathryn S. Hayward received seed funding from the University of Melbourne to produce photographs for the manual.
The easy way to misread this
Do not treat the severity cut-offs for the FMA-UE as a single universal standard. The paper shows that different studies use different definitions for severe, moderate, and mild impairment (e.g., severe is defined as 0-22 in one study and 0-31 in another), so you must specify which criteria you are using when reporting results.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →