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

Arch Phys Med Rehabil. 2017 Mar;98(3):456-462. doi: 10.1016/j.apmr.2016.06.023. Epub 2016 Aug 9.

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: Cluster analysis; Rehabilitation; Stroke; Upper extremity.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities / standards*
  • Reference Values
  • Severity of Illness Index
  • Stroke / physiopathology*
  • Stroke Rehabilitation
  • Upper Extremity / physiopathology*