Assessments of Motor Function Post Stroke

Abstract

Objective: The purpose of this article is to review assessments of motor function after stroke.

Method: Eleven assessments were reviewed for what aspects of motor function are measured; tools needed; evidence for reliability and validity of the assessment and advantages and disadvantages of the assessment. The assessments were the Fugl-Meyer Assessment Scale for Stroke Patients (FMA), the Motor Assessment Scale (MAS), the Rivermead Motor Assessment (RMA), the Chedoke-McMaster Stroke Assessment (CMSA), the Motor Club Assessment (MCA), the Motricity Index (MI), the Stroke Rehabilitation Assessment of Movement (STREAM), the Frenchay Arm Test (FAT), the Action Research Arm Test (ARAT), the Functional Test for the Hemiparetic Upper Extremity (FT), and the Arm Motor Ability Test (AMAT).

Results: The FMA, MAS, RMA, CMSA, MCA, MI, and STREAM measure motor function in both the upper and lower extremities while the FAT, ARAT, FT, and AMAT are specific to the upper limb only. The majority of the assessments test at the impairment level rather than at the activity level. The FMA, CMSA, MCA, MI, and STREAM require the least equipment (for example, a mat/bed, chair, marble/block) while the RMA, the MAS, the FAT, ARAT, FT, and AMAT require the use of numerous small objects, some of which are very specific in dimensions. The instruments differ in their reliability and validity with the FMA and CMSA having more sound psychometric evidence than the other tests reviewed.

Conclusion: Familiarity with assessments of motor function can be helpful in selecting the one most appropriate to one's setting and need. These assessments, in addition to assessing activities of daily living, can separate specific lost neurological function from compensatory responses to document the outcomes and the effectiveness of therapeutic techniques.

Key Words:

• Hemiplegia
• rehabilitation
• motor performance

Additional information

Notes on contributors

Susan L. Whitney

Jennifer R. Johnson was a graduate student in the School of Occupational Therapy, Texas Woman's University, Houston, TX at the time of this study. She is currently employed as an Occupational Therapist at Touro Infirmary in New Orleans, LA

Debra Stewart is Lecturer, School of Rehabilitation Science, McMaster University and staff therapist at Erinoak Centre, Missis-sauga, Ontario. She is currently completing a MSc (Design, Measurement and Evaluation) at McMaster University.

Ronald L. Mace (deceased, June 29, 1998) was also affiliated with The Center for Universal Design, School of Design, North Carolina University.

Lois Rosage and Geraldine Shaw are Occupational Therapist Consultants who provide evaluations for the housing programs at the Philadelphia Corporation for Aging.

Debbie Rand is Occupational Therapist, Beit Rivka Geriatric Rehabilitation Hospital, Petach Tikva, Israel. She completed this study in partial fulfillment of the requirements for the Master of Science degree in Occupational Therapy, School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem. Her mailing address is 50 Heh B'Eyar Street, Apartment 5, Rosh Ha'Ayin, Israel, 48056.

Maureen McKenna is a Licensed Physical Therapist and Licensed Marriage and Family Therapist in California. Her Current position is: Assistant Professor of Physical Therapy, Wheeling Jesuit University, 316 Washington Avenue, Wheeling, WV 26003.