Background and Purpose
Clinical administration of the wrist stability, wrist mobility, and hand items of the upper extremity Fugl-Meyer (W/H UE FM) may prove a rigorous, easily administered, bedside measure of motor impairment in mildly impaired stroke survivors. The purpose of this study was to evaluate the item-structure of the W/H UE FM using Rasch analysis.
Methods
Secondary analysis of W/H UE FM data arising from clinical trials of mildly impaired stroke survivors using latent parallel analysis, ordinal factor analysis, and partial credit model Rasch analyses.
Results
Latent parallel analysis and ordinal factor analysis indicated that all W/H UE FM items represent a single unidimensional construct, wrist and hand motor ability. Rasch analysis of data from 150 mildly impaired stroke survivors (94 men; mean age, 57.1 ± 11.4y; mean time since stroke, 19.5 months) revealed that the W/H UE FM operated as a reliable, valid, and effective measure of wrist and hand motor ability. These data were compatible with Rasch model assumptions and are consistent with previous W/H UE FM research. Mass flexion and extension movements were the least difficult W/H UE FM items.
Discussion and Conclusion
The W/H UE FM is well suited to mildly impaired stroke survivors who exhibit the ability perform mass flexion and mass extension movements. The full scale UE FM may be preferable for stroke survivors with lower levels of ability.