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Interpreting Variations in Fugl-Meyer Assessment Protocols: Results and Recommendations From a Nominal Group
Susan E Fasoli1, Julia Mazariegos2, Kelly Rishe3
1Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA; Department of Veterans Affairs, Rehabilitation Research and Development Service, Center for Neurorestoration and Neurotechnology, Providence, RI.
Archives of Physical Medicine and Rehabilitation
|October 26, 2024
Summary
Variations in Fugl-Meyer Assessment for the Upper Extremity (FMA-UE) protocols can impact stroke rehabilitation research. This study established consensus on best practices for FMA-UE administration to improve consistency.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Assessment
Background:
- The Fugl-Meyer Assessment for the Upper Extremity (FMA-UE) is a widely used clinical tool for evaluating motor function after stroke.
- Variations in administration and scoring protocols for the FMA-UE exist across studies, potentially affecting reliability and comparability of results.
- Standardization of assessment procedures is crucial for robust clinical research and evidence-based practice in stroke rehabilitation.
Purpose of the Study:
- To identify and document variations in administration and scoring instructions among existing FMA-UE protocols.
- To achieve expert consensus on optimal FMA-UE administration procedures for stroke rehabilitation research and clinical practice.
- To develop recommendations for standardized FMA-UE assessment to enhance consistency and data interpretation.
Main Methods:
- A nominal group consensus technique was employed, involving iterative reviews of FMA-UE protocols.
- Ten experts in stroke rehabilitation and FMA-UE administration participated in virtual consensus meetings.
- Qualitative reviews and anonymous voting were used to analyze variations in general administration instructions, with an 80% agreement threshold for consensus.
Main Results:
- Consensus was reached on 7 out of 10 general administration instructions for the FMA-UE.
- The study identified significant score discrepancies (up to 21 points) due to protocol variations, highlighting the impact on results.
- Recommendations for "best practice" general instructions were developed for clinicians and researchers.
Conclusions:
- Discrepancies in FMA-UE administration protocols can lead to inconsistent interpretation of stroke rehabilitation research findings.
- Standardized FMA-UE protocols are essential to increase the perceived value and adoption of evidence-based practices.
- This consensus process represents a foundational step towards creating unified FMA-UE recommendations for broader implementation.
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