Dimensionality and construct validity of the Fugl-Meyer Assessment of the upper extremity.


Journal Article

To investigate the dimensionality and construct validity of the Fugl-Meyer Assessment of the upper extremity by using Rasch analysis.Secondary analysis of pooled data from 2 existing datasets: a randomized therapeutic exercise clinical trial and a cohort longitudinal study of stroke recovery.University research center.A total of 512 subjects, ages 69.8+/-11.1 years, who were 0 to 145 days poststroke.Not applicable.Dimensionality was examined with principal components analysis and Rasch item-fit statistics. The Rasch-derived item hierarchy was examined for consistency with the expected course of poststroke upper-extremity recovery suggested by the reflex-hierarchical conceptual model underlying the assessment.Factor loadings and item infit statistics suggested that the 3 reflex items were empirically disconnected from other assessment items. The reflex items were removed. The modified 30-item assessment showed a unidimensional structure. The Rasch-item-difficulty order was not consistent with the expected item order.The items testing resting-state reflexes may threaten the assessment's dimensionality. With reflex items removed, the assessment is a unidimensional measure of volitional movement. The Rasch-generated item-difficulty order challenges the hierarchical structure implied by the instrument's underlying conceptual framework.

Full Text

Cited Authors

  • Woodbury, ML; Velozo, CA; Richards, LG; Duncan, PW; Studenski, S; Lai, S-M

Published Date

  • June 2007

Published In

Volume / Issue

  • 88 / 6

Start / End Page

  • 715 - 723

PubMed ID

  • 17532892

Pubmed Central ID

  • 17532892

Electronic International Standard Serial Number (EISSN)

  • 1532-821X

International Standard Serial Number (ISSN)

  • 0003-9993

Digital Object Identifier (DOI)

  • 10.1016/j.apmr.2007.02.036


  • eng