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

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 s...

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Main Authors: Veronica Rowe, PhD, OTR/L, Sarah Blanton, PT, DPT, Dawn Aycock, PhD, RN, ANP-BC, Matthew J. Hayat, PhD, Syeda Zahra Ali, MPH
Format: Article
Language:English
Published: Elsevier 2023-06-01
Series:Archives of Rehabilitation Research and Clinical Translation
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2590109523000083
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author Veronica Rowe, PhD, OTR/L
Sarah Blanton, PT, DPT
Dawn Aycock, PhD, RN, ANP-BC
Matthew J. Hayat, PhD
Syeda Zahra Ali, MPH
author_facet Veronica Rowe, PhD, OTR/L
Sarah Blanton, PT, DPT
Dawn Aycock, PhD, RN, ANP-BC
Matthew J. Hayat, PhD
Syeda Zahra Ali, MPH
author_sort Veronica Rowe, PhD, OTR/L
collection DOAJ
description 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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spelling doaj.art-b2394b71d44545f38589f6c8b635fcc22023-06-03T04:22:38ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952023-06-0152100261Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and ValidityVeronica Rowe, PhD, OTR/L0Sarah Blanton, PT, DPT1Dawn Aycock, PhD, RN, ANP-BC2Matthew J. Hayat, PhD3Syeda Zahra Ali, MPH4Georgia State University, Atlanta, GA; Corresponding author Veronica Rowe, PhD, OTR/L, Georgia State University, Occupational Therapy Department, 140 Decatur Street, Atlanta, GA 30303, USA.Emory University, Atlanta, GAGeorgia State University, Atlanta, GAGeorgia State University, Atlanta, GAGeorgia State University, Atlanta, GAObjective: 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.http://www.sciencedirect.com/science/article/pii/S2590109523000083Outcome assessmentPsychometricsRehabilitationStrokeTelehealth or TelemedicineUpper Extremity
spellingShingle Veronica Rowe, PhD, OTR/L
Sarah Blanton, PT, DPT
Dawn Aycock, PhD, RN, ANP-BC
Matthew J. Hayat, PhD
Syeda Zahra Ali, MPH
Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity
Archives of Rehabilitation Research and Clinical Translation
Outcome assessment
Psychometrics
Rehabilitation
Stroke
Telehealth or Telemedicine
Upper Extremity
title Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity
title_full Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity
title_fullStr Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity
title_full_unstemmed Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity
title_short Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity
title_sort remote delivery of the fugl meyer assessment for the upper extremity a pilot study to assess feasibility reliability and validity
topic Outcome assessment
Psychometrics
Rehabilitation
Stroke
Telehealth or Telemedicine
Upper Extremity
url http://www.sciencedirect.com/science/article/pii/S2590109523000083
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