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Assessment Procedures

Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity

, ORCID Icon, , , , , , , , , , ORCID Icon & show all
Pages 2989-2999 | Received 14 Dec 2021, Accepted 14 Aug 2022, Published online: 27 Aug 2022
 

Abstract

Purpose

To assess the intra- and inter-rater reliability motor and sensory functioning, balance, joint range of motion and joint pain subscales of the Italian Fugl-Meyer Assessment (FMA) Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) at the item- subtotal- and total-level in patients with sub-acute stroke.

Materials and methods

The FMA was administered to 60 patients with sub-acute stroke (mean age ± SD = 75.4 ± 10.7 years; 58.3% men) and independently rated by two physiotherapists on two consecutive days. Intra- and inter-reliability was studied by a rank-based statistical method for paired ordinal data to detect any systematic or random disagreement.

Results

The item-level intra- and inter-rater reliability was satisfactory (>70%). Reliability level >70% was achieved at subscale and total score level when one- or two-points difference was considered. Systematic disagreements were reported for five items of the FMA-UE, but not for FMA-LE.

Conclusions

The Italian version of the FMA showed to be a reliable instrument that can therefore be recommended for clinical and research purposes.

    Implications for rehabilitation

  • The FMA is the gold standard for assessing stroke patients’ sensorimotor impairment worldwide.

  • The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke.

  • The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the Italian Ministry of Health, current Research funds.

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