Fasoli Susan E, Mazariegos Julia, Rishe Kelly, Blanton Sarah, DiCarlo Julie A, Lin David, Rowe Veronica T
Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA; Department of Veterans Affairs, Rehabilitation Research and Development Service, Center for Neurorestoration and Neurotechnology, Providence, RI.
Department of Physical Medicine and Rehabilitation, Sheikh Khalifa Stroke Institute, Johns Hopkins Hospital, Baltimore, MD.
Arch Phys Med Rehabil. 2025 Apr;106(4):573-579. doi: 10.1016/j.apmr.2024.10.004. Epub 2024 Oct 24.
To identify variations among administration and scoring instructions of 6 upper extremity Fugl-Meyer Assessment (FMA-UE) protocols and to achieve consensus regarding optimal administration procedures.
Nominal group consensus technique comprised of iterative independent reviews of protocol content, anonymous voting, and group consensus meetings.
Clinicians working in clinical practice and research settings participated in virtual meetings via Zoom.
Ten experts in stroke rehabilitation and administration of the FMA-UE contributed to the interprofessional consensus group.
Not applicable.
Qualitative reviews of each FMA-UE protocol and rater responses (agree/disagree) regarding variations in general administration instructions (ie, instructions that could affect the scoring of many individual test items) were discussed and analyzed during a 3-phase consensus process. An a priori target of 80% or greater agreement was used to determine group consensus.
Consensus was attained for 7 of 10 general administration instructions. Recommendations from our consensus group summarize "best practice" general instructions for researchers and clinicians. A case example, in which we found up to a 21-point difference between the highest and lowest FMA-UE scores, highlights the potential effect of these protocol variations.
Variations among FMA-UE administration protocols during stroke rehabilitation studies can lead to discrepancies in the interpretation and translation of research findings across institutions and limit the perceived value and uptake of standardized assessments for evidence-based practice. The results of this nominal group consensus provide a first step toward developing cohesive FMA-UE recommendations for wider dissemination and review.
识别6种上肢Fugl-Meyer评估（FMA-UE）方案在实施和评分说明方面的差异，并就最佳实施程序达成共识。
名义小组共识技术，包括对方案内容进行反复独立审查、匿名投票和小组共识会议。
在临床实践和研究环境中工作的临床医生通过Zoom参加虚拟会议。
10名中风康复和FMA-UE实施方面的专家参与了跨专业共识小组。
不适用。
在一个分三个阶段的共识过程中，对每个FMA-UE方案进行定性审查，并讨论和分析评分者对一般实施说明（即可能影响许多单个测试项目评分的说明）差异的回答（同意/不同意）。使用80%或更高同意率的先验目标来确定小组共识。
10条一般实施说明中有7条达成了共识。我们的共识小组提出的建议总结了针对研究人员和临床医生的“最佳实践”一般说明。一个案例显示，FMA-UE最高得分与最低得分之间相差高达21分，突出了这些方案差异的潜在影响。
中风康复研究中FMA-UE实施方案的差异可能导致不同机构对研究结果的解释和转化出现差异，并限制标准化评估在循证实践中的感知价值和应用。这种名义小组共识的结果为制定更具凝聚力的FMA-UE建议以进行更广泛传播和审查迈出了第一步。
