Translating measurement findings into rehabilitation practice: An example using Fugl-Meyer Assessment-Upper Extremity with patients following stroke

摘要

Standardized assessments are critical for advancing clinical rehabilitation, yet assessment scores often provide little information for rehabilitation treatment planning. A keyform recovery map is an innovative way for a therapist to record patient responses to standardized assessment items. The form enables a therapist to view the specific items that a patient can or cannot perform. This information can assist a therapist in tailoring treatments to a patient’s individual ability level. We demonstrate how a keyform recovery map can be used to inform clinical treatment planning for individuals with strokerelated upperlimb motor impairment. A keyform map of poststroke upperlimb recovery defined by items of the FuglMeyer AssessmentUpper Extremity (FMAUE) was generated by a previously published Rasch analysis. Three individuals with stroke enrolled in a separate research study were randomly selected from each of the three impairment strata of the FMAUE. Their performance on each item was displayed on the FMAUE keyform. The forms directly connected qualitative descriptions of patients’ motor ability to assessment measures, thereby suggesting appropriate shorter and longer term rehabilitation goals. This study demonstrates how measurement theory can be used to translate a standardized assessment into a useful, evidencebased tool for making clinical practice decisions.