Urdu translation and cross-cultural validation of the Fugl-Meyer assessment in people with stroke

Abstract

Purpose

The purpose of this study was to translate the FMA for Upper and Lower Extremity into Urdu and determine the validity and reliability of the translated Urdu FMA in people with chronic stroke.

Materials and methods

A Standardized step-wise forward-backward translation of FMA into Urdu was conducted with the help of bilingual translators, experts from Riphah International University, and experts familiar with the original FMA scale to ensure conceptual equivalency. The final version was constructed after pilot testing of the Urdu FMA on 10 stroke patients. Inter- and intra-rater reliability, content, concurrent and construct validity were determined in 50 individuals with chronic stroke (mean age 53.2 years).

Results

Intra- and inter-rater reliability, determined by Weighted kappa was satisfactory (k = 0.75–0.99). Internal consistency determined by Cronbach alpha was above 0.80. The content validity Index was acceptable (0.92). Moderate correlations were found with Functional Independence Measure, Modified Rankin Scale, and National Institute of Health Stroke Severity (r = 0.69–0.79). The factor analysis showed that two factors (upper and lower extremity) explained 67.8% of the variance.

Conclusion

The Urdu FMA is reliable and valid for the assessment of sensorimotor function in people with chronic stroke and can therefore be recommended for use in clinical and research applications.

IMPLICATIONS FOR REHABILITATION

• The Urdu FMA is now available for use in Pakistan.

• The Urdu FMA is reliable and valid for the assessment of sensorimotor function in people with chronic stroke.

• The use of Urdu FMA is recommended to clinicians to estimate stroke severity and motor recovery.

Keywords:

• FMA
• validity
• reliability
• stroke
• motor assessment
• upper extremity
• lower extremity

Acknowledgements

The initial guidance of Prof. Dr. Arshad Nawaz Malik during the startup of this work is acknowledged. The first author is very grateful to the volunteer services of the physiotherapists at the Rehabilitation Clinic of Riphah International University, Lahore.

Disclosure statement

The study does not have any conflict of interest regarding financial and research benefits.