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Determining Levels of Upper Extremity Movement Impairment by Applying a Cluster Analysis to the Fugl-Meyer Assessment of the Upper Extremity in Chronic Stroke

Published:August 09, 2016DOI:https://doi.org/10.1016/j.apmr.2016.06.023

      Abstract

      Objective

      To quantitatively determine levels of upper extremity movement impairment by using a cluster analysis of the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) with and without reflex items.

      Design

      Secondary analysis.

      Setting

      University and research centers.

      Participants

      Individuals (N=247) with chronic stroke (>6mo poststroke).

      Interventions

      Not applicable.

      Main Outcome Measures

      Cutoff scores defined by FMA-UE total scores of clusters identified by 2 hierarchical cluster analyses performed on the full sample of FMA-UE individual item scores (with and without reflexes). Patterns of motor function defined by aggregate item scores of clusters.

      Results

      FMA-UE scores ranged from 2 to 63 (mean, 26.9±15.7) with reflex items and from 0 to 57 (mean, 22.1±15.3) without reflex items. Three clusters were identified. The distributions of the FMA-UE scores revealed considerable overlap between the clusters; therefore, 4 distinct stroke impairment levels were derived.

      Conclusions

      For chronic stroke, the cluster analysis of the FMA-UE supports either a 3- or a 4-impairment level classification scheme.

      Keywords

      List of abbreviations:

      FMA-UE (Fugl-Meyer Assessment of the Upper Extremity), IRT (item response theory), UE (upper extremity)
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