Fugl-Meyer Assessment for upper extremity in stroke: A pyschometric systematic review

Abstract

Background Stroke is a very common pathology, with a high prevalence of impairment of the sensorimotor function of the upper limb. There are many scales that assess this variable. Fugl-Meyer Assessment is one of the most widely used, but there are many versions of this scale to assess this construct. Purpose To identify, critically appraise, and summarize the different Fugl-Meyer Assessment (FMA) versions to recognize which is better to measure upper-extremity sensorimotor function in stroke patients. Study Design A psychometric systematic review was carried out in this research. Methods An exhaustive search was conducted during June and July 2023 in the following databases: Pubmed, Web of Science (WoS), Open Grey, Scielo, Cochrane, Dialnet, and LILACS. By the most updated consensus-based standards fot the selection of health status Measurement INstruments methodology (COSMIN) and preferred reporting items for systematic reviews and meta-analyses (PRISMA) statements for a systematic review of the measurement properties of existing patient-reported outcome measures to select the most appropriate outcome measurement instrument. The protocol of this systematic review was registered in Open Science Framework (https://osf.io/dy54p/ ). Results About 22 versions of the FMA were identified in 36 studies. The Upper Extremity subscale of the Fugl-Meyer Assessment (FMA-UE) was the version most frequently analyzed (n = 13) among the included articles. Conclusions Fugl-Meyer Assessment (Full version, 50 items, FMA) was the questionnaire version with the most evaluated psychometric characteristics and most translations, with the better score regarding the quality of evidence, which indicates that is the recommended FMA version to assess upper-extremity sensorimotor function in stroke patients.