Development and Preliminary Validity Study of a Modified Version of the Upper Extremity Fugl-Meyer Assessment for Use in Telerehabilitation.
Development and Preliminary Validity Study of a Modified Version of the Upper Extremity Fugl-Meyer Assessment for Use in Telerehabilitation.
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上肢FUGL-MEYER评估的修改版本的开发和初步有效性研究用于远离居民。
DOI：
10.1097/npt.0000000000000447
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发表时间：
2023-10-01
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上肢Fugl-Meyer评估（UEFMA, maximum 66）广泛应用于临床和研究中，用于检查中风后上肢（UE）损伤。本研究旨在开发并提供试点数据，以支持远程版本的UEFMA通过远程康复检查中风后UE损伤的有效性。团队成员开发了用于远程康复的UEFMA的远程版本（tUEFMA，最大值44），使用UEFMA的II至IV和VII子量表。使用UEFMA（面对面）和tUEFMA（远程）对22名中至重度手臂损伤（UEFMA，中位数= 19）和慢性中风（1年后）的参与者进行评估。在tUEFMA的基础上，利用预测方程对函数进行了识别，实现了对UEFMA的预测。采用类内相关性（Intraclass correlation， ICC）检验UEFMA和tUEFMA所包含的子量表之间以及它们的2个归一化总分之间的绝对一致性。在UEFMA的总分和基于tUEFMA的预测值之间发现了强烈且显著的一致性（ICC = 0.79, P < 0.05）。ICC测试还报告了在使用实时视频链接的UEFMA和tUEFMA之间的子尺度II到IV的良好一致性和子尺度VII的较差一致性。研究结果表明，tUEFMA是一种很有前途的工具，可以远程检查慢性中风和中度至重度手臂损伤患者的UE损伤。未来的研究应该评估更多的心理测量特性和tUEFMA在卒中参与者中广泛的手臂损伤的临床应用。视频摘要可获得作者的更多见解（参见视频，补充数字内容1，可在：http://links.lww.com/JNPT/A441）。
The Upper Extremity Fugl-Meyer Assessment (UEFMA, maximum 66) is widely used in clinics and research studies to examine poststroke upper extremity (UE) impairment. This study aimed to develop and provide pilot data to support the validity of a remote version of the UEFMA to examine UE impairment after stroke through telerehabilitation. Team members developed a remote version of the UEFMA for telerehabilitation (tUEFMA, maximum 44) using subscales II to IV and VII of the UEFMA. Twenty-two participants with moderate to severe arm impairment (UEFMA, median = 19) and chronic stroke (>1 year post) were evaluated using the UEFMA (face-to-face) and the tUEFMA (remotely). A prediction equation was used to identify the function to predict the UEFMA based on the tUEFMA. Intraclass correlation (ICC) was used to test the absolute agreement between the subscales included in the UEFMA and the tUEFMA, and between their 2 normalized total scores. A strong and significant agreement was found between the total scores of the UEFMA and the projected value based on the tUEFMA (ICC = 0.79, P < 0.05). The ICC test also reported a good agreement in subscales II to IV and a poor agreement in subscale VII between the UEFMA and the tUEFMA using a real-time video link. The study findings suggest that the tUEFMA is a promising tool to remotely examine UE impairment in individuals with chronic stroke and moderate to severe arm impairment. Future research should evaluate additional psychometric properties and clinical utility of the tUEFMA across stroke participants with a broad range of arm impairments. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A441).