Development of a computerized adaptive testing system of the Fugl-Meyer motor scale in stroke patients

Wen Hsuan Hou, Ching Lin Shih, Yeh Tai Chou, Ching Fan Sheu, Jau Hong Lin, Hung Chia Wu, I. Ping Hsueh, Ching Lin Hsieh

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Objective: To develop a computerized adaptive testing system of the Fugl-Meyer motor scale (CAT-FM) to efficiently and reliably assess motor function in patients with stroke. Design: First, a simulation study was used to develop and examine the psychometric properties of the CAT-FM. Second, a field study was employed to determine the administration efficiency of the CAT-FM. Setting: One medical center and 1 teaching hospital. Participants: Patients' responses (n=301) were used for the simulation study; 49 patients participated in the field study. Interventions: Not applicable. Main Outcome Measures: The 2 CAT-FM item banks (upper extremity and lower extremity) include 37 items from the original Fugl-Meyer scale. The reliability, validity, and responsiveness of the CAT-FM were determined by the simulation study. Results: Two stopping rules (reliability <0.9 or an increase of reliability <.01 after testing an item) were used. The simulation study showed that the CAT-FM had high reliability (<.93 for upper-extremity and lower-extremity subscales) and concurrent validity (Pearson r<.91 for the upper-extremity and lower-extremity subscales and motor scale). The responsiveness was moderate (standardized response mean for the upper extremity=.67, lower extremity=.79, and motor=.77) for the 226 patients who completed both assessments at 14 and 90 days after stroke. The field study found that, on average, the time needed to administer the CAT-FM was 242 seconds with 4.7 items. Conclusions: The CAT-FM is an efficient, reliable, valid, and responsive clinical tool for assessing motor function in patients with stroke.

Original languageEnglish
Pages (from-to)1014-1020
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Issue number6
Publication statusPublished - Jun 2012
Externally publishedYes


  • Cerebrovascular accident
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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