Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity

IF 1.9 Q2 REHABILITATION Archives of rehabilitation research and clinical translation Pub Date : 2023-06-01 DOI:10.1016/j.arrct.2023.100261

Veronica Rowe PhD, OTR/L , Sarah Blanton PT, DPT , Dawn Aycock PhD, RN, ANP-BC , Matthew J. Hayat PhD , Syeda Zahra Ali MPH

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Abstract

Objective

To develop a remote protocol for the upper extremity Fugl-Meyer Assessment (reFMA) and assess the reliability and validity with in-person delivery.

Design

Feasibility testing.

Setting

Remote/virtual and in-person in participants’ homes.

Participants

Three triads of therapists, stroke survivors, and carepartners (N=9) participated in Phases 1 and 2. Twelve different stroke survivors participated in Phase 3.

Intervention

The FMA was administered and received remotely using the instructional protocol (Phases 1 and 2). Pilot testing with the delivery of the reFMA remotely and the FMA in-person occurred in Phase 3.

Main Outcome Measures

Feedback for refinement and feasibility of obtaining the reFMA (including the System Usability Scale) and the FMA scores remotely and in-person to assess reliability and validity of the reFMA.

Results

The reFMA was refined to incorporate feedback and suggestions from users. Interrater reliability between 2 therapists evaluating the FMA remotely was found to be poor with little agreement. For criterion validity, only 1 out of 12 (8.3%) total scores were in agreement between the in-person and remote assessments.

Conclusion

Reliable and valid remote administration of the FMA is an important aspect of telerehabilitation for the upper extremity after stroke, but further research is needed to address current protocol limitations. This study provides preliminary support for the need for alternative strategies to improve appropriate implementation of the FMA remotely. Possible explanations for the poor reliability are explored and suggestions for improvement of the remote delivery of the FMA are provided.

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Fugl-Meyer上肢评估的远程传递:评估可行性、可靠性和有效性的试点研究

目的制定上肢Fugl-Meyer评估（reFMA）的远程方案，并评估亲自分娩的可靠性和有效性。设计可行性测试。在参与者家中设置远程/虚拟和面对面。参与者由治疗师、中风幸存者和护理伙伴组成的三个小组（N=9）参与了第1阶段和第2阶段。12名不同的中风幸存者参与了第3阶段的干预。使用指导方案（第1和第2阶段）远程管理和接受FMA。在第3阶段进行了远程交付reFMA和亲自交付FMA的试点测试。主要结果测量对远程和亲自获得reFMA（包括系统可用性量表）和FMA分数的改进和可行性的反馈，以评估reFMA的可靠性和有效性。结果对reFMA进行了改进，以纳入用户的反馈和建议。2名远程评估FMA的治疗师之间的询问可靠性较差，几乎没有达成一致。在标准有效性方面，只有1/12（8.3%）的总分在面对面评估和远程评估之间一致。结论可靠有效的FMA远程给药是卒中后上肢远程康复的一个重要方面，但还需要进一步研究来解决目前方案的局限性。这项研究为改进远程FMA的适当实施的替代策略的必要性提供了初步支持。探讨了可靠性差的可能原因，并提出了改进FMA远程交付的建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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