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Rasch analysis staging methodology to classify upper extremity movement impairment after stroke.
Arch Phys Med Rehabil 2013; 94(8):1527-33AP

Abstract

OBJECTIVES

To define Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) cutoff scores that demarcate 1 level of upper extremity (UE) impairment from another, and describe motor behaviors for each category in terms of expected FMA-UE item performance.

DESIGN

Analysis of existing FMA-UE data.

SETTING

University research laboratory.

PARTICIPANTS

Persons (N=512) 0 to 145 days poststroke, 42 to 90 years of age.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

An item response Rasch analysis staging method was used to calculate cutoff scores, which were defined as the Rasch-Andrich threshold values of 2 criterion FMA-UE items derived from an analysis of this sample. The analysis enabled conversion of cutoff scores, in logit units, to FMA-UE points assessed on 30 FMA-UE voluntary movement items (60 possible points).

RESULTS

The boundary between severe and moderate impairment was defined as -1.59 ± .27 logits or 19 ± 2 points; and between moderate and mild impairment was defined as 2.44 ± .27 logits or 47 ± 2 points. A description of expected performance in each impairment level shows that patients with severe impairment exhibited some distal movements, and patients with mild impairment had difficulties with some proximal movements.

CONCLUSIONS

The cutoff scores, which link to a description of specific movements a patient can, can partially, and cannot perform, may enable formation of heterogeneous patient groups, advance efforts to identify specific movement therapy targets, and define treatment response in terms of specific movement that changed or did not change with therapy.

Authors+Show Affiliations

Ralph H. Johnson VA Medical Center, Charleston, SC, USA. WoodbuML@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23529144

Citation

Woodbury, Michelle L., et al. "Rasch Analysis Staging Methodology to Classify Upper Extremity Movement Impairment After Stroke." Archives of Physical Medicine and Rehabilitation, vol. 94, no. 8, 2013, pp. 1527-33.
Woodbury ML, Velozo CA, Richards LG, et al. Rasch analysis staging methodology to classify upper extremity movement impairment after stroke. Arch Phys Med Rehabil. 2013;94(8):1527-33.
Woodbury, M. L., Velozo, C. A., Richards, L. G., & Duncan, P. W. (2013). Rasch analysis staging methodology to classify upper extremity movement impairment after stroke. Archives of Physical Medicine and Rehabilitation, 94(8), pp. 1527-33. doi:10.1016/j.apmr.2013.03.007.
Woodbury ML, et al. Rasch Analysis Staging Methodology to Classify Upper Extremity Movement Impairment After Stroke. Arch Phys Med Rehabil. 2013;94(8):1527-33. PubMed PMID: 23529144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rasch analysis staging methodology to classify upper extremity movement impairment after stroke. AU - Woodbury,Michelle L, AU - Velozo,Craig A, AU - Richards,Lorie G, AU - Duncan,Pamela W, Y1 - 2013/03/22/ PY - 2012/12/08/received PY - 2013/03/08/revised PY - 2013/03/12/accepted PY - 2013/3/27/entrez PY - 2013/3/27/pubmed PY - 2013/11/1/medline KW - FMA-UE KW - Fugl-Meyer Assessment of the Upper Extremity KW - IRT KW - Rehabilitation KW - Stroke KW - UE KW - Upper extremity KW - item response theory KW - upper extremity SP - 1527 EP - 33 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 94 IS - 8 N2 - OBJECTIVES: To define Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) cutoff scores that demarcate 1 level of upper extremity (UE) impairment from another, and describe motor behaviors for each category in terms of expected FMA-UE item performance. DESIGN: Analysis of existing FMA-UE data. SETTING: University research laboratory. PARTICIPANTS: Persons (N=512) 0 to 145 days poststroke, 42 to 90 years of age. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: An item response Rasch analysis staging method was used to calculate cutoff scores, which were defined as the Rasch-Andrich threshold values of 2 criterion FMA-UE items derived from an analysis of this sample. The analysis enabled conversion of cutoff scores, in logit units, to FMA-UE points assessed on 30 FMA-UE voluntary movement items (60 possible points). RESULTS: The boundary between severe and moderate impairment was defined as -1.59 ± .27 logits or 19 ± 2 points; and between moderate and mild impairment was defined as 2.44 ± .27 logits or 47 ± 2 points. A description of expected performance in each impairment level shows that patients with severe impairment exhibited some distal movements, and patients with mild impairment had difficulties with some proximal movements. CONCLUSIONS: The cutoff scores, which link to a description of specific movements a patient can, can partially, and cannot perform, may enable formation of heterogeneous patient groups, advance efforts to identify specific movement therapy targets, and define treatment response in terms of specific movement that changed or did not change with therapy. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/23529144/Rasch_analysis_staging_methodology_to_classify_upper_extremity_movement_impairment_after_stroke_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(13)00239-6 DB - PRIME DP - Unbound Medicine ER -