Abstract
Background and objectives: The Upper Extremity Fugl-Meyer Assessment (UEFMA) is one of the most recommended and used methods of clinical evaluation not only for post-stroke motor function disability conditions but also for physiotherapy goal-setting. Up to the present, an official Romanian version has not been officially available. This study aims to carry out a translation, adaptation, and validation of UEFMA in Romanian, thus giving both patients and medical practitioners the equal opportunity of benefiting from its proficiency. Material and methods: The English version of the motor component of UEFMA was back and forth translated in the assent of best practice translation guidelines. The research was performed on a group of 64 post-stroke in-patients regarding psychometric properties for content validation and an exploratory and confirmatory factorial analysis was performed using the Bayesian model. To assess internal consistency and test–retest reliability, we used the Cronbach Alpha index and Intraclass Correlation Coefficient (ICC). We used Pearson correlation with the Functional Independence Measure (FIM) and Modified Rankin Scale (MRS) to determine concurrent validation. Standardized response mean (SRM) was applied to determine the responsiveness of the instrument used. Results: After performing the exploratory factor analysis, a single factor was extracted, with an Eigenvalue of 19.363, which explained 64.543% of the variation. The model was confirmed by Bayesian exploration, with Root Mean Square Residual (RMR) 0.051, Goodness-of-fit Index (GFI) 0.980, Normed-Fit Index (NFI) 0.978 and Relative Fit Index (RFI) 0.977. The Cronbach Alpha value was 0.981, the Intraclass Correlation Coefficient (ICC) index for average measures was 0.992, the Pearson correlation with FIM 0.789, and MRS −0.787, while the SRM was 1.117. Conclusions: The Romanian version of the UEFMA scale is a reliable, responsive and valid tool which can be used as a standardized assessment in post-stroke patients across Romania.
Highlights
Stroke is the third leading cause of disability worldwide
The Romanian version of the Upper Extremity Fugl-Meyer Assessment (UEFMA) scale is a reliable, responsive and valid tool which can be used as a standardized assessment in post-stroke patients across Romania
The KMO value of 0.913 indicates that the data used were fit for the exploratory factor analysis (EFA), with χ2 of Bartlett’s sphericity test of 2648.235 and p < 0.001
Summary
Stroke is the third leading cause of disability worldwide. Over the past decades, low- and middle-income countries have doubled their stroke-caused incidence of morbidity and disability, whereas high-income countries registered a decrease of 42% [1]. Concerning physical rehabilitation of patients with stroke sequelae, they need adequate clinical and functional assessment. A large number of assessment evaluation scales have been developed to determine: the level of disability or functional independence (Barthel scale, Functional Independence Measure (FIM) or Activities of Daily Living (ADL) scale, Modified Rankin Scale (MRS)), upper and lower extremities motor function, balance, cognitive function and speech, stroke severity, the somatosensory function (Nottingham scale), spasticity (Ashworth scale) or depression (Post Stroke Depression Rating Scale, PSDRS scale) [4,5,6,7,8,9]. The Upper Extremity Fugl-Meyer Assessment (UEFMA) is one of the most recommended and used methods of clinical evaluation for post-stroke motor function disability conditions and for physiotherapy goal-setting. Results: After performing the exploratory factor analysis, a single factor was extracted, with an Eigenvalue of 19.363, which explained 64.543% of the variation
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