Falchini Francesca, Germanotta Marco, Fasano Alessio, Cortellini Laura, Insalaco Sabina, Cipollini Valeria, Papadopoulou Dionysia, Aprile Irene Giovanna
IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy.
J Clin Med. 2024 Dec 19;13(24):7750. doi: 10.3390/jcm13247750.
Despite the increase in home-based rehabilitation, outcome measures for telerehabilitation are still underdeveloped. The Fugl-Meyer Assessment (FMA) is one of the most widely used tools for evaluating post-stroke motor deficits, with the upper extremity component (FMA-UE) recommended for assessing motor deficits of the arm. This study aims to examine the intrarater and interrater reliability of the Italian version of the FMA-UE, administered remotely via video conferencing during a robotic telerehabilitation program. Twenty stroke patients participated and underwent 20 sessions of remote upper limb rehabilitation with a robotic device. In-person evaluations were conducted before (T0) and after (T1) treatment, with additional remote assessments throughout. The study evaluated both intrarater and interrater reliability using Intraclass Correlation Coefficients (ICC) and Bland-Altman plots, classifying reliability as excellent for scores above 0.90. Bland-Altman analysis showed no systematic variance for both intrarater and interrater reliability of the FMA-UE scale. Excellent reliability was found with intrarater ICC = 0.972 and interrater ICC = 0.981. Sections A and C of the FMA-UE showed excellent intrarater reliability, while sections B and D had satisfactory results. Both intrarater and interrater reliability analysis of the total score of the FMA-UE scale also showed strong agreement with Cohen's Kappa values above 0.70. The findings suggest that the remote administration of the FMA-UE scale is a reliable tool for assessing upper limb motor function in stroke patients, supporting its use in telerehabilitation settings.
尽管居家康复有所增加，但远程康复的结果测量仍不完善。Fugl-Meyer评估（FMA）是评估中风后运动功能障碍最广泛使用的工具之一，其中上肢部分（FMA-UE）被推荐用于评估手臂的运动功能障碍。本研究旨在检验通过视频会议在机器人远程康复计划中远程实施的意大利语版FMA-UE的评估者内和评估者间信度。20名中风患者参与了研究，并使用机器人设备进行了20次远程上肢康复治疗。在治疗前（T0）和治疗后（T1）进行了面对面评估，同时在整个过程中还进行了额外的远程评估。该研究使用组内相关系数（ICC）和Bland-Altman图评估了评估者内和评估者间信度，将信度分类为得分高于0.90为优秀。Bland-Altman分析显示，FMA-UE量表的评估者内和评估者间信度均无系统差异。评估者内ICC = 0.972，评估者间ICC = 0.981，信度极佳。FMA-UE的A部分和C部分评估者内信度极佳，而B部分和D部分结果令人满意。FMA-UE量表总分的评估者内和评估者间信度分析也显示，Cohen's Kappa值高于0.70，一致性较强。研究结果表明，远程实施FMA-UE量表是评估中风患者上肢运动功能的可靠工具，支持其在远程康复环境中的应用。
