Sullivan, Katherine J., Tilson, Julie K., Cen, Steven Y., Rose, Dorian K., Hershberg, Julie, Correa, Anita, Gallichio, Joann, McLeod, Molly, Moore, Craig, Wu, Samuel S., Duncan, Pamela W.
funding text
This work supported by funding from the National Institute of Neurological Disorders and Stroke and the National Center for Medical Rehabilitation Research (R01 NS050506). All authors received research salary support from this grant.
abstract
Background and Purpose-Outcome measurement fidelity within and between sites of multi-site, randomized, clinical trials is an essential element to meaningful trial outcomes. As important are the methods developed for randomized, clinical trials that can have practical utility for clinical practice. A standardized measurement method and rater training program were developed for the total Fugl-Meyer motor and sensory assessments; inter-rater reliability was used to test program effectiveness. Methods-Fifteen individuals with hemiparetic stroke, 17 trained physical therapists across 5 regional clinical sites, and an expert rater participated in an inter-rater reliability study of the Fugl-Meyer motor (total, upper extremity, and lower extremity subscores) and sensory (total, light touch, and proprioception subscores) assessments. Results-Intra-rater reliability for the expert rater was high for the motor and sensory scores (range, 0.95-1.0). Inter-rater agreement (intraclass correlation coefficient, 2, 1) between expert and therapist raters was high for the motor scores (total, 0.98; upper extremity, 0.99; lower extremity, 0.91) and sensory scores (total, 0.93; light touch, 0.87; proprioception, 0.96). Conclusions-Standardized measurement methods and training of therapist assessors for a multi-site, rehabilitation, randomized, clinical trial resulted in high inter-rater reliability for the Fugl-Meyer motor and sensory assessments. Poststroke sensorimotor impairment severity can be reliably assessed for clinical practice or rehabilitation research with these methods. (Stroke. 2011; 42: 427-432.)