Item Difficulty of Fugl-Meyer Assessment for Upper Extremity in Persons With Chronic Stroke With Moderate-to-Severe Upper Limb Impairment.
Item Difficulty of Fugl-Meyer Assessment for Upper Extremity in Persons With Chronic Stroke With Moderate-to-Severe Upper Limb Impairment.
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DOI：
10.3389/fneur.2020.577855
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发表时间：
2020
影响因子：
3.4
通讯作者：
Liu M
中科院分区：
文献类型：
--
作者：
Hijikata N;Kawakami M;Ishii R;Tsuzuki K;Nakamura T;Okuyama K;Liu M
背景和目的：有限的研究已经进行的目的是了解上肢运动是困难的严重慢性中风的人。本研究的目的是使用Rasch分析法对患有中度至重度缺陷的慢性卒中患者进行Fugl-Meyer上肢功能评估（FMA-UE）的结构测试，并确定项目难度等级。方法：这是对先前随机对照试验或临床试验数据的二次分析。研究对象为101名慢性脑卒中伴中度至重度轻偏瘫患者（脑卒中发作后时间，1375.3 ± 1157.9天; 33项FMA-UE，31.1 ± 12.8）。主成分分析和不拟合统计用于评估维度。使用等级量表模型进行Rasch分析，并确定项目难度。结果：剔除了6个不匹配项。结果表明，27项FMA-UE是一维的。Rasch分析表明，在协同作用下进行的运动是最简单的项目之一。肩部和肘部运动是最简单的项目，而前臂和手腕运动则是中等难度到最困难的项目。手部物品跨越不同的难度级别。讨论和结论：FMA-UE是评估慢性卒中伴中度至重度功能障碍患者上肢运动功能的有效工具。结果表明，项目难度与Fugl-Meyer提出的逐步恢复过程相一致。确定了中度至重度慢性轻瘫患者难以进行的运动，这将使在未来的研究中能够使用运动难度的测量来比较每种运动。
Background and Purpose: Limited research has been conducted with the aim of understanding which upper extremity movements are difficult for persons with severe chronic stroke. The purpose of this study was to test the structure of the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) using Rasch analysis in persons with chronic stroke with moderate to severe deficits and to determine the item difficulty hierarchy. Methods: This was a secondary analysis of data from previous randomized, controlled trials, or clinical trials. The participants were 101 persons with chronic stroke with moderate to severe hemiparesis (time after onset of stroke, 1375.3 ± 1157.9 days; the 33-item FMA-UE, 31.1 ± 12.8). Principal component analysis and infit statistics were used to evaluate dimensionality. Rasch analysis using a rating scale model was performed, and item difficulty was determined. Results: Six misfit items were removed. The results showed that the 27-item FMA-UE was unidimensional. Rasch analysis showed that the movements performed within synergies were among the easiest items. Shoulder and elbow movements were among the easiest items, whereas forearm and wrist movements were among the moderately to most difficult items. Hand items spanned various difficulty levels. Discussion and Conclusions: The FMA-UE is a valid assessment tool of upper extremity motor function in persons with chronic stroke with moderate to severe deficits. The results showed that item difficulty was consistent with the stepwise recovery course proposed by Fugl-Meyer. The movements that are difficult for patients with moderate to severe chronic paresis were determined, which would enable comparison of each movement using a measure of motion difficulty in future studies.
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影响因子：
4.2
作者：
Lang, Catherine E.;Wagner, Joanne M.;Dromerick, Alexander W.
通讯作者：
Dromerick, Alexander W.
影响因子：
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作者：
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通讯作者：
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影响因子：
1.7
作者：
Mizuno, Katsuhiro;Abe, Takayuki;Liu, Meigen
通讯作者：
Liu, Meigen
影响因子：
2.2
作者：
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通讯作者：
Domen, Kazuhisa
DOI：
10.1016/j.apmr.2014.10.022
发表时间：
2015-06-01
影响因子：
4.3
作者：
McCabe, Jessica;Monkiewicz, Michelle;Daly, Janis J.
通讯作者：
Daly, Janis J.