Details

Autor(en) / Beteiligte

• Woodbury, Michelle L., PhD, OTR/L
• Velozo, Craig A., PhD, OTR/L
• Richards, Lorie G., PhD, OTR/L
• Duncan, Pamela W., PhD, PT

Titel

Rasch Analysis Staging Methodology to Classify Upper Extremity Movement Impairment After Stroke

Ist Teil von

• Archives of physical medicine and rehabilitation, 2013-08, Vol.94 (8), p.1527-1533

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Objectives To define Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) cutoff scores that demarcate 1 level of upper extremity (UE) impairment from another, and describe motor behaviors for each category in terms of expected FMA-UE item performance. Design Analysis of existing FMA-UE data. Setting University research laboratory. Participants Persons (N=512) 0 to 145 days poststroke, 42 to 90 years of age. Intervention Not applicable. Main Outcome Measures An item response Rasch analysis staging method was used to calculate cutoff scores, which were defined as the Rasch-Andrich threshold values of 2 criterion FMA-UE items derived from an analysis of this sample. The analysis enabled conversion of cutoff scores, in logit units, to FMA-UE points assessed on 30 FMA-UE voluntary movement items (60 possible points). Results The boundary between severe and moderate impairment was defined as −1.59±.27 logits or 19±2 points; and between moderate and mild impairment was defined as 2.44±.27 logits or 47±2 points. A description of expected performance in each impairment level shows that patients with severe impairment exhibited some distal movements, and patients with mild impairment had difficulties with some proximal movements. Conclusions The cutoff scores, which link to a description of specific movements a patient can, can partially, and cannot perform, may enable formation of heterogeneous patient groups, advance efforts to identify specific movement therapy targets, and define treatment response in terms of specific movement that changed or did not change with therapy.