PMID- 37483132
OWN - NLM
STAT- MEDLINE
DCOM- 20230828
LR  - 20240502
IS  - 1552-6844 (Electronic)
IS  - 1545-9683 (Linking)
VI  - 37
IP  - 8
DP  - 2023 Aug
TI  - Sensitivity to Change and Responsiveness of the Upper Extremity Fugl-Meyer 
      Assessment in Individuals With Moderate to Severe Acute Stroke.
PG  - 545-553
LID - 10.1177/15459683231186985 [doi]
AB  - BACKGROUND: The Fugl-Meyer Assessment-Upper Extremity (FMA-UE) is a widely used 
      outcome measure for quantifying motor impairment in stroke recovery. Meaningful 
      change (responsiveness) in the acute to subacute phase of stroke recovery has not 
      been determined. OBJECTIVE: Determine responsiveness and sensitivity to change of 
      the FMA-UE from 1-week to 6-weeks (subacute) after stroke in individuals with 
      moderate to severe arm impairment who received standard clinical care. METHODS: A 
      total of 51 participants with resulting moderate and severe UE hemiparesis after 
      stroke had FMA-UE assessment at baseline (within 2 weeks of stroke) and 6-weeks 
      later. Sensitivity to change was assessed using Glass's delta, standardized 
      response means (SRM), standard error of measure (SEM), and minimal detectable 
      change (MDC). Responsiveness was assessed with the minimal clinically important 
      difference (MCID), estimated using receiver operating characteristic curve 
      analysis with patient-reported global rating of change scales (GROC) and a 
      provider-reported modified Rankin Scale (mRS) as anchors. RESULTS: The MCID 
      estimates were 13, 12, and 9 anchored to the GROC Arm Weakness, GROC Recovery, 
      and mRS. Glass's delta and the SRM revealed large effect sizes, indicating high 
      sensitivity to change, (∆ = 1.24, 95% CI [0.64, 1.82], SRM = 1.10). Results for 
      the SEM and MDC were 2.46 and 6.82, respectively. CONCLUSION: The estimated MCID 
      for the FMA-UE for individuals with moderate to severe motor impairment from 1 to 
      6-weeks after stroke is 13. These estimates will provide clinical context for 
      FMA-UE change scores by helping to identify the change in upper-extremity motor 
      impairment that is both beyond measurement error and clinically meaningful.
FAU - Huynh, Baothy P
AU  - Huynh BP
AUID- ORCID: 0000-0002-3266-3402
AD  - Department of Rehabilitation Sciences, MGH Institute of Health Professions, 
      Boston, MA, USA.
FAU - DiCarlo, Julie A
AU  - DiCarlo JA
AD  - Center for Neurotechnology and Neurorecovery, Department of Neurology, 
      Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
AD  - VA RR&D Center for Neurorestoration and Neurotechnology, Rehabilitation R&D 
      Service, Department of VA Medical Center, Providence, RI, USA.
FAU - Vora, Isha
AU  - Vora I
AD  - Department of Rehabilitation Sciences, MGH Institute of Health Professions, 
      Boston, MA, USA.
FAU - Ranford, Jessica
AU  - Ranford J
AD  - Center for Neurotechnology and Neurorecovery, Department of Neurology, 
      Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
AD  - Division of Neurocritical Care, Department of Neurology, Massachusetts General 
      Hospital, Boston, MA, USA.
FAU - Gochyyev, Perman
AU  - Gochyyev P
AD  - Department of Rehabilitation Sciences, MGH Institute of Health Professions, 
      Boston, MA, USA.
FAU - Lin, David J
AU  - Lin DJ
AD  - Department of Rehabilitation Sciences, MGH Institute of Health Professions, 
      Boston, MA, USA.
AD  - Center for Neurotechnology and Neurorecovery, Department of Neurology, 
      Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
AD  - VA RR&D Center for Neurorestoration and Neurotechnology, Rehabilitation R&D 
      Service, Department of VA Medical Center, Providence, RI, USA.
AD  - Division of Neurocritical Care, Department of Neurology, Massachusetts General 
      Hospital, Boston, MA, USA.
AD  - Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston, 
      MA, USA.
FAU - Kimberley, Teresa J
AU  - Kimberley TJ
AUID- ORCID: 0000-0001-6397-4054
AD  - Department of Rehabilitation Sciences, MGH Institute of Health Professions, 
      Boston, MA, USA.
AD  - Center for Neurotechnology and Neurorecovery, Department of Neurology, 
      Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
AD  - Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, 
      USA.
LA  - eng
GR  - K24 DC018603/DC/NIDCD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20230724
PL  - United States
TA  - Neurorehabil Neural Repair
JT  - Neurorehabilitation and neural repair
JID - 100892086
SB  - IM
MH  - Humans
MH  - *Stroke Rehabilitation
MH  - Recovery of Function/physiology
MH  - Disability Evaluation
MH  - *Stroke/complications
MH  - Upper Extremity
MH  - Paresis/diagnosis/etiology
OTO - NOTNLM
OT  - ROC curve
OT  - minimal clinically important difference
OT  - stroke rehabilitation
OT  - upper extremity
EDAT- 2023/07/24 06:42
MHDA- 2023/08/28 06:42
CRDT- 2023/07/24 04:23
PHST- 2023/08/28 06:42 [medline]
PHST- 2023/07/24 06:42 [pubmed]
PHST- 2023/07/24 04:23 [entrez]
AID - 10.1177/15459683231186985 [doi]
PST - ppublish
SO  - Neurorehabil Neural Repair. 2023 Aug;37(8):545-553. doi: 
      10.1177/15459683231186985. Epub 2023 Jul 24.