Validity, Reliability, and Measurement Error of the Remote Fugl-Meyer Assessment by Videoconferencing: Tele-FMA

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Technology

Background:

• The Fugl-Meyer Assessment (FMA) is a standard clinical tool for evaluating motor function after stroke.
• The measurement properties of a remote version of the FMA administered via videoconferencing (Tele-FMA) were previously unknown.
• Telerehabilitation offers a promising avenue for remote patient care, necessitating validated assessment tools.

Purpose of the Study:

• To investigate the validity, reliability, and measurement error of the Fugl-Meyer Assessment (FMA) when administered remotely via videoconferencing (Tele-FMA).
• To identify potential barriers to the remote administration of the FMA.
• To assess the suitability of Tele-FMA for clinical use in telerehabilitation.

Main Methods:

• Forty-five stroke survivors with internet-connected devices participated.
• An in-person FMA was compared with a Tele-FMA in 11 participants.
• Intrarater and interrater reliability were assessed using intraclass correlation coefficients (ICC) and weighted kappa for individual items. Validity was analyzed using Bland-Altman limits of agreement and Spearman correlation.

Main Results:

• Adequate agreement was observed between in-person FMA and Tele-FMA.
• Tele-FMA demonstrated excellent intrarater (ICC ≥ 0.96) and interrater (ICC ≥ 0.99) reliability for both upper extremity (UE) and lower extremity (LE) assessments.
• Moderate to strong correlations were found between Tele-FMA scores and other functional measures, such as step tests and hand function domains.

Conclusions:

• The Tele-FMA exhibits excellent reliability and adequate validity for assessing post-stroke motor impairment.
• The Tele-FMA is a viable measurement tool that can be integrated into telerehabilitation programs.
• Remote administration of the FMA via videoconferencing is a practical approach for remote patient monitoring and care.