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How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke?
Arch Phys Med Rehabil 2015; 96(10):1845-9AP

Abstract

OBJECTIVE

To determine the optimal cutoff scores for the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) with regard to predicting no, poor, limited, notable, or full upper-limb capacity according to frequently used cutoff points for the Action Research Arm Test (ARAT) at 6 months poststroke.

DESIGN

Prospective.

SETTING

Rehabilitation center.

PARTICIPANTS

Patients (N=460) with a first-ever ischemic stroke at 6 months poststroke.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Based on the ARAT classification of poor to full upper-limb capacity, receiver operating characteristic curves were used to calculate the area under the curve, optimal cutoff points for the FMA-UE were determined, and a weighted kappa was used to assess the agreement.

RESULTS

FMA-UE scores of 0 through 22 represent no upper-limb capacity (ARAT 0-10); scores of 23 through 31 represent poor capacity (ARAT 11-21); scores of 32 through 47 represent limited capacity (ARAT 22-42); scores of 48 through 52 represent notable capacity (ARAT 43-54); and scores of 53 through 66 represent full upper-limb capacity (ARAT 55-57). Overall, areas under the curve ranged from .916 (95% confidence interval [CI], .890-.943) to .988 (95% CI, .978-.998; P<.001).

CONCLUSIONS

There is considerable overlap in the area under the curve between the ARAT and FMA-UE. FMA-UE scores >31 points correspond to no to poor arm-hand capacity (ie, ≤21 points) on the ARAT, whereas FMA-UE scores >31 correspond to limited to full arm-hand capacity (ie, ≥22 points) on the ARAT.

Authors+Show Affiliations

Vogellanden Center for Rehabilitation, Zwolle, The Netherlands. Electronic address: m.h.w.j.hoonhorst@vogellanden.nl.Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.Department of Neurology, Isala Clinics, Zwolle, The Netherlands.Department of Rehabilitation Medicine, Isala Klinieken, Zwolle, The Netherlands.Department of General Practice, University of Groningen, Groningen, The Netherlands.Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, Research Institute MOVE, VU Medical Center, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26143054

Citation

Hoonhorst, Maurits H., et al. "How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke?" Archives of Physical Medicine and Rehabilitation, vol. 96, no. 10, 2015, pp. 1845-9.
Hoonhorst MH, Nijland RH, van den Berg JS, et al. How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke? Arch Phys Med Rehabil. 2015;96(10):1845-9.
Hoonhorst, M. H., Nijland, R. H., van den Berg, J. S., Emmelot, C. H., Kollen, B. J., & Kwakkel, G. (2015). How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke? Archives of Physical Medicine and Rehabilitation, 96(10), pp. 1845-9. doi:10.1016/j.apmr.2015.06.009.
Hoonhorst MH, et al. How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke. Arch Phys Med Rehabil. 2015;96(10):1845-9. PubMed PMID: 26143054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke? AU - Hoonhorst,Maurits H, AU - Nijland,Rinske H, AU - van den Berg,Jan S, AU - Emmelot,Cornelis H, AU - Kollen,Boudewijn J, AU - Kwakkel,Gert, Y1 - 2015/07/02/ PY - 2015/03/27/received PY - 2015/06/12/revised PY - 2015/06/15/accepted PY - 2015/7/6/entrez PY - 2015/7/6/pubmed PY - 2016/1/12/medline KW - Rehabilitation KW - Stroke KW - Upper extremity SP - 1845 EP - 9 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 96 IS - 10 N2 - OBJECTIVE: To determine the optimal cutoff scores for the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) with regard to predicting no, poor, limited, notable, or full upper-limb capacity according to frequently used cutoff points for the Action Research Arm Test (ARAT) at 6 months poststroke. DESIGN: Prospective. SETTING: Rehabilitation center. PARTICIPANTS: Patients (N=460) with a first-ever ischemic stroke at 6 months poststroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Based on the ARAT classification of poor to full upper-limb capacity, receiver operating characteristic curves were used to calculate the area under the curve, optimal cutoff points for the FMA-UE were determined, and a weighted kappa was used to assess the agreement. RESULTS: FMA-UE scores of 0 through 22 represent no upper-limb capacity (ARAT 0-10); scores of 23 through 31 represent poor capacity (ARAT 11-21); scores of 32 through 47 represent limited capacity (ARAT 22-42); scores of 48 through 52 represent notable capacity (ARAT 43-54); and scores of 53 through 66 represent full upper-limb capacity (ARAT 55-57). Overall, areas under the curve ranged from .916 (95% confidence interval [CI], .890-.943) to .988 (95% CI, .978-.998; P<.001). CONCLUSIONS: There is considerable overlap in the area under the curve between the ARAT and FMA-UE. FMA-UE scores >31 points correspond to no to poor arm-hand capacity (ie, ≤21 points) on the ARAT, whereas FMA-UE scores >31 correspond to limited to full arm-hand capacity (ie, ≥22 points) on the ARAT. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/26143054/How_Do_Fugl_Meyer_Arm_Motor_Scores_Relate_to_Dexterity_According_to_the_Action_Research_Arm_Test_at_6_Months_Poststroke L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(15)00489-X DB - PRIME DP - Unbound Medicine ER -