Development of a Computerized Adaptive Testing System of the Fugl-Meyer Motor Scale in Stroke Patients

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• 作者：Wen-Hsuan Hou ; MD^a ; Ching-Lin Shih ; PhD^b ; Yeh-Tai Chou ; MS^c ; Ching-Fan Sheu ; PhD^d ; Jau-Hong Lin ; PhD^e ; Hung-Chia Wu ; MSc^a ; I-Ping Hsueh ; MA^f ; Ching-Lin Hsieh ; PhD^f ; ^{clhsieh@ntu.edu.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cerebrovascular accident ; Rehabilitation
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2012
• 出版时间：June 2012
• 年：2012
• 卷：93
• 期：6
• 页码：1014-1020
• 全文大小：328 K

文摘

Hou W-H, Shih C-L, Chou Y-T, Sheu C-F, Lin J-H, Wu H-C, Hsueh I-P, Hsieh C-L. Development of a computerized adaptive testing system of the Fugl-Meyer motor scale in stroke patients.

Objective

To develop a computerized adaptive testing system of the Fugl-Meyer motor scale (CAT-FM) to efficiently and reliably assess motor function in patients with stroke.

Design

First, a simulation study was used to develop and examine the psychometric properties of the CAT-FM. Second, a field study was employed to determine the administration efficiency of the CAT-FM.

Setting

One medical center and 1 teaching hospital.

Participants

Patients' responses (n=301) were used for the simulation study; 49 patients participated in the field study.

Interventions

Not applicable.

Main Outcome Measures

The 2 CAT-FM item banks (upper extremity and lower extremity) include 37 items from the original Fugl-Meyer scale. The reliability, validity, and responsiveness of the CAT-FM were determined by the simulation study.

Results

Two stopping rules (reliability ≥0.9 or an increase of reliability <.01 after testing an item) were used. The simulation study showed that the CAT-FM had high reliability (≥.93 for upper-extremity and lower-extremity subscales) and concurrent validity (Pearson r≥.91 for the upper-extremity and lower-extremity subscales and motor scale). The responsiveness was moderate (standardized response mean for the upper extremity=.67, lower extremity=.79, and motor=.77) for the 226 patients who completed both assessments at 14 and 90 days after stroke. The field study found that, on average, the time needed to administer the CAT-FM was 242 seconds with 4.7 items.

Conclusions

The CAT-FM is an efficient, reliable, valid, and responsive clinical tool for assessing motor function in patients with stroke.