Fugl-Meyer Assessment of Motor Recovery after Stroke

Last Updated

August 02, 2016

Purpose

The Fugl-Meyer Assessment of Motor Recovery after Stroke:

Evaluates and measures recovery in post-stroke hemiplegic patients
Used in both clinical and research settings
One of the most widely used quantitative measures of motor impairment (Gladstone et al, 2002)
Total of 5 domains

Link to Instrument

Instrument Details

Acronym FMA

Area of Assessment

Activities of Daily Living
Functional Mobility
Pain

Assessment Type

Observer

Administration Mode

Paper & Pencil

Cost

Free

Cost Description

Cost of equipment only

Diagnosis/Conditions

Stroke Recovery

Stroke

Non-Specific Patient Population

Items are scored on a 3-point ordinal scale
0 = cannot perform
1 = performs partially
2 = performs fully
Maximum Score?= 226 points?
The Five domains assessed include:
1) Motor function (UE maximum score = 66; LE maximum score = 34)
2) Sensory function (maximum score = 24)
3) Balance (maximum score = 14)
4) Joint range of motion (maximum score = 44)
5) Joint pain (maximum score = 44)
Subscales can be administered without the?using the full?test.
Modified (abbreviated) versions have been developed (Hsueh et al, 2008).
The "Instrument Details" link above goes to the Fugl-Meyer Assessment for upper extremity. The link to the Fugl-Meyer Assessment for lower extremity is: https://www.gu.se/sites/default/files/2024-01/FM-LE%20eng%20190303%20PROTOCOL.pdf.

Number of Items

226

Tennis ball
A small spherical shaped container
A tool to administer reflex tests
Enough space is needed for a patient to move around freely
If possible, space should be a quiet, private room with few distractions

30 minutes

Shortened versions require less than 10 minutes.

Required Training

Reading an Article/Manual

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially Uploaded to the Rehabilitation Measures Database in 2010. Updated by Carmen Capo-Lugo, PT, PhD and Dorian Rose PT, PhD and the Stroke Edge task force in 2016.

ICF Domain

Body Function

Measurement Domain

Motor
Sensory

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association��s Multiple Sclerosis Taskforce (MSEDGE), Parkinson��s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:

Abbreviations:
HR	Highly Recommend
R	Recommend
LS / UR	Reasonable to use, but limited study in target group / Unable to Recommend
NR	Not Recommended

Recommendations for use based on acuity level of the patient:

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

Recommendations based on level of care in which the assessment is taken:

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

Recommendations for entry-level physical therapy education and use in research:

	Students should learn to administer this tool? (Y/N)	Students should be exposed to tool? (Y/N)	Appropriate for use in intervention research studies? (Y/N)	Is additional research warranted for this tool (Y/N)
StrokEDGE	Yes	Yes	Yes	Not reported

Considerations

Limitations: (Gladstone et al, 2002)

The Sensation, Balance, Joint Range of Motion and Joint Pain domains have been criticized as less well suited for this instrument given its intended purpose
Joint Range of Motion may be a confounding variable, so the inclusion of the Joint Pain domain may be unnecessary
Distal fine motor functions may be underrepresented
Finger movement not assessed (but gross hand function is included)
Arm scores are more heavily weighted than the leg scores
Better measure of balance are now available
Inclusion of subjective items on the Sensation and Joint Pain domains may reduce the measures reliability
The Sensory Scale��s psychometric properties suggest that is should NOT be used to assess stroke patients (Lin et al, 2004)

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Standard Error of Measurement (SEM)

Stroke:

(Sanford et al, 1993; n = 12; mean age = 66 years; stroke onset < 6 months, Acute Stroke)

FMA total scores: 9.4

Minimal Detectable Change (MDC)

Stroke:

(Wagner et al, 2008, n = 14, mean age = 59.9 (14.6) years, assessed on average 14 (6.5) months post stroke, Chronic Stroke)

FMA = 5.2 points for the Upper Extremity portion of the assessment

Minimally Clinically Important Difference (MCID)

Stroke:

(Shelton et al, 2001; n = 171; mean age 70 (11) years; assessed within 17 (12) days of stroke, Acute Stroke)

FMA Motor Scores from Admission to Discharge

10 point increase in FMA Upper Extremity = 1.5 change in discharge FIM
10 point increase in FMA Lower Extremity = 1.9 change in discharge FIM

(Page SJ et al, 2012; n = 146; mean age 57 (11) years; chronic ischemic stroke, minimum-to-moderate UE hemiparesis)

Therapist Anchors	MCID: UE-FM
Grasping ability	4.25
Releasing ability	5.25
Ability to move arm	7.25
Ability to perform COPM	4.25
Overall UE function	5.25

Cut-Off Scores

Stroke:

(Duncan et al, 2000; n = 459; mean age = 70 (11.4) years; stroke onset within 14 days, Acute Stroke)

Percent of cohort that achieved recovery
	NIH<1	Fugl-Meyer>90	Barthel>90	SF36 Female PFI>66	SF36 Male PFI>75	Rankin<1	Rankin<2
Baseline	10.46	13.07	8.06	0.00	0.00	1.74	12.20
1 Month	16.78	12.85	26.14	9.44	12.08	5.45	21.57
3 Month	11.11	7.84	13.94	10.73	11.59	9.80	12.85
6 Month	6.54	3.05	9.15	3.86	4.83	7.41	7.19
Never	55.10	63.20	42.70	76.00	71.50	75.60	46.20

Normative Data

Stroke:

(Duncan et al, 2000, Acute Stroke)

Percent of cohort that achieved recovery
	NIH<1	Fugl-Meyer>90	Barthel>90	SF36 Female PFI>66	SF36 Male PFI>75	Rankin<1	Rankin<2
Baseline	10.46	13.07	8.06	0.00	0.00	1.74	12.20
1 Month	16.78	12.85	26.14	9.44	12.08	5.45	21.57
3 Month	11.11	7.84	13.94	10.73	11.59	9.80	12.85
6 Month	6.54	3.05	9.15	3.86	4.83	7.41	7.19
Never	55.10	63.20	42.70	76.00	71.50	75.60	46.20

Interrater/Intrarater Reliability

Stroke:

(Duncan et al, 1983; n = 19; mean age = 56 (13) years; same PT rating on 3 occasions each 3 weeks apart; VA sample, Chronic Stroke)

Interrater Reliability
Rating	Domain	Pearson's r
Excellent	FMA total score	r = 0.98-0.99
Excellent	Upper Extremity	r = 0.995 - 0.996
Excellent	Lower Extremity	r = 0.96
Excellent	Sensation	r = 0.95 - 0.96
Excellent	Joint Range / Pain	r = 0.86 - 0.996
Excellent	Balance	r = 0.89 - 0.98

Sullivan et al, 2011; n=15 patients (10-71 days post-stroke; mean age 62.8 yrs. One expert PT rater compared to 17 trained PT's using standardized procedures developed for LEAPS trial.

	Intra-rater Reliability	Inter-rater Reliability
FM Domain	ICC (3,1)	95% CI	ICC (2,1)	95% CI
Motor: Total	0.99	0.83-1.0	0.98	0.93-0.99
Motor: UE	0.95	0.66-1.0	0.99	0.97-1.0
Motor: LE	0.99	0.91-1.0	0.91	0.69-0.97
Sensory: Total	0.96	0.70-1.0	0.93	0.83-0.98
Sensory: Light Touch	1.0	1.0-1.0	0.87	0.69-0.95
Sensory: Proprioception	0.95	0.63-1.0	0.96	0.90-0.99

See et al, 2013; n=31 patients (54��47 mo post-stroke; mean age 61.1yrs. Three therapist raters. Testing was conducted on the UE FMA only. Performance for the total UE FMA, proximal arm subsection, and distal arm (wrist/hand) were examined separately. Reliability was assessed utilizing standardized procedures developed for a Phase II RCT.

Test	UE FMA Total Score	UE FMA Proximal Subscore	UE FMA Hand/Wrist Subscore
Intrarater reliability
Spearman's r²	0.99	0.99	0.94
ICC	0.99	0.99	0.99
MDC₉₀	3.2 pts	1.7 pts	1.7 pts
Interrater reliability
Spearman's r²	0.97	0.95	0.85
ICC	0.99	0.98	0.98
MDC₉₀	3.2 pts	1.6 pts	2.5 pts

Internal Consistency

Stroke:

(Lin et al, 2004; n = 176; mean age = 67.9 (10.9) years; assessed 14, 30, 90 and 180 days after stroke, Acute Stroke)

Excellent internal consistency: alpha = 0.94 to 0.98 across 4 administrations

Criterion Validity (Predictive/Concurrent)

Stroke:

(Malouin et al, 1994; n = 32; mean age = 60; mean time since stroke = 64.5 days, Acute Stroke)

Excellent FMA & Motor Assessment Scale (MAS) total score correlations (r = 0.96)
Poor FMA & MAS sitting balance item correlations (r = -0.10)
Motor and sensory FMA scores 5 days post-stroke were the strongest predictor of motor recovery 6 months post-stroke (Duncan et al, 1992)

Gait Speed (Nadeau et al, 1999; n = 16; mean age = 47.9 (15.6) years; mean number of months post-stroke = 43.9, Chronic Stroke)

Poor correlations between FMA Sensation and Gait speed (r = 0.05) and comfort (r = 0.14)
Excellent correlations between FMA total motor scores and gait speed (m = 1.09 meter per second; r = 0.61); and comfort (m = 0.76 meters per second; r = 0.61)

(Page SJ et al, 2015; n=32, mean age=57(10) years, chronic stroke patients with moderately impaired UE function)

Excellent correlations between Wrist and Hand Upper Extremity Fugl-Meyer (w/h UE FM) and the Action Research Arm Test across two trials: (r = 0.74) and (r = 0.67)

See et al, 2013; n=12 .These exams were performed on 12 patients (of the cohort of 31 described under Reliability testing above), 4 separate visits across a treatment period, for a total of 48 exams. Testing was conducted on the UE FMA only. Performance for the total UE FMA, proximal arm subsection, and distal arm (wrist/hand) were examined separately.

Test	Baseline Value	Correlation with UE FMA Total Score	Correlation with UE FMA Proximal Score	Correlation with UE FMA Hand/Wrist Subscore
Max. Grip force, affected/nonaffected	0.29��0.22	0.74	0.73	0.73
Max. Pinch force, affected/nonaffected	0.40��0.30	0.88	0.87	0.85
Box & Blocks (no. Of blocks)	0 (0-29)	0.86	0.79	0.88
ARAT score	27.2��22.5	0.93	0.88	0.89
9-hole peg (no. Of pegs placed)	0 (0-7)	0.75	0.64	0.80
SIS hand subscore	2.3��1.3	0.86	0.79	0.88

ARAT = Action Research Arm Test; SIS = Stroke Impact Scale. Baseline values are mean �� SD except for Box & Blocks and 9-hole peg scores, which are median. Correlation values are Spearman r values which in all cases were significant with p < 0.0001.

(Wei et al, 2011; n=27 with chronic stroke (4.92��0.45 yrs post-stroke)

Excellent correlations were observed both pre-training and post-training among the Upper Extremity Fugl-Meyer Assessment , the Motor Status Scale and the Action Research Arm Test (��=0.91-0.93). Modified Ashworth Scale and the UE FMA were fairly to moderately correlated (��=0.40-0.62)

Construct Validity

Acute Stroke:

Excellent correlation: modified Balance Subscale on FMA and the Barthel Index; r = 0.86 - 0.89 (Mao et al, 2002)
Excellent correlation: FMA and Functional Independence Measures (FIM) administered to 172 inpatients who had recently had a stoke; r = 0.63 (Shelton et al, 2000)
FMA effectively distinguished between three levels of self care (Independent, Partly Dependant, and Dependant) in a sample of 109 recent (< 90 days) stroke survivors (Bernspang et al, 1987).
FMA was a better measure of higher-level recovery than the MAS (Malouin, et al, 1994)

Chronic Stroke

(Dettmann et al, 1987; n = 15; mean age = 64 years; mean time since stroke, 2 years, Chronic Stroke)

The FMA and the Barthel Index were used to assess a group of 15 participants at an average of 2 years post stroke. Correlations between the measures were excellent (r = 0.67). The strongest correlations were observed in the Balance subscore (r = 0.76) the Upper Extremitysubscore of the motor domain (r = 0.75) and FMA Motor total score (r = 0.74)

(Hsieh et al, 2009; onset > 6 months, Chronic Stroke)

FMA Construct Validity (Spearman's rho followed by 95% CI)

Excellent pre-treatment correlation between FMA and Action Research Arm Test: 0.73** (0.58, 0.83)
Excellent pre-treatment correlation between FMA and Wolf Motor Function Test-TIME: 0.76** (0.63, 0.86)
Excellent pre-treatment correlation between FMA and Wolf Motor Function Test-Functional Ability Scale: 0.71** (0.56, 0.82)
Adequate pre-treatment correlation between the FMA and FIM-motor: 0.49** (0.27, 0.66)

*P < 0.05
**P < 0.01

Excellent post-treatment correlation between FMA and Action Research Arm Test: 0.74** (0.60, 0.84)
Excellent post -treatment correlation between FMA and Wolf Motor Function Test-TIME: 0.71** (0.56, 0.82)
Excellent post -treatment correlation between FMA and Wolf Motor Function Test-Functional Ability Scale: 0.51** (0.29, 0.68)
Adequate post -treatment correlation between the FMA and FIM-motor: 0.42** (0.18, 0.62)

*P < 0.05
**P < 0.01

Content Validity

Stroke:

(Woodbury et al, 2008; n = 377; men age = 69.2 (11.2) years, Acute Stroke) Upper extremity (modified version, 3 reflex items removed)

Administered at admission and 6-months post stroke
Rasch Analysis demonstrated adequate fit for each of the 30 items except the hook grasp item
Results suggest items contained in modified FMA, (except the hook grasp item) were assessing the same underlying construct

(Crow et al, 2008; n = 62; retrospective analysis, Chronic Stroke) Upper and lower-extremity (excluding balance) portions of FMA:

Items within a scale are valid, unidimensional and cumulative
Results suggest that if a patient is able to successfully complete an item of a certain difficulty, that same patient should be able to complete less difficult items, implying that a shortened administration of the FMA may produce valid results

Floor/Ceiling Effects

Stroke:

(Lin et al, 2004, Acute Stroke)

Ceiling effects have been observed with the Sensation subscore. The following percentages of acute stroke patients reaching the highest possible score:

Days Post Stroke	% Highest Possible Score
14-30 days	44.4%
14-180 days	72.1%
30-90 days	48.9%
90-180 days	48.9%
90-180 days	62.7%

Floor effects have been reported for the modified Balance domain. The strongest effects were observed 14 days post stroke with 29.3% of participants not able to achieve the lowest possible score on the measure (Mao et al, 2002)Possible ceiling effects on hand and lower extremity items (Gladstone, et al, 2002).

Responsiveness

Stroke:

(Mao et al, 2002, Acute Stroke)

Excellent on the modified version of the FMA Balance score
- Between assessments at 14, 30, 90 and 180 days post-stroke
- Responsiveness decreased as the time between stroke and assessments increased

Moderate to Low: (Lin et al, 2004) responsiveness was found for the Sensation subscale of the FMA as assessed by Standardized Response Means (SRM).

Means were low at:
- 14-30 days: SRM = 0.42
- 30-90 days: SRM = 0.43
- 90-180 days: SRM = 0.27
Moderate responsiveness when assessed from 14 to 180 days (SRM = 0.67)

(Hsueh et al, 2009, Chronic Stroke)

Small to moderate effect sizes were observed on the FMA, the Stroke Rehabilitation Assessment of Movement instrument (STREAM) and each of the measures shortened versions.
Moderate effect sizes on the shortened version of both measures (0.53 and 0.51)
Small effect sizes on the long version of the measure (0.045 and 0.38)

(Wei et al, 2011; n=27 with chronic stroke (4.92��0.45 yrs post-stroke

Pre- and post-training which consisted of 20 sessions of UE robotic training that could be completed in 4-7 weeks.

	SRM	GRI*
UE FMA	0.85	3.62
Shoulder & elbow	0.84 (large responsiveness)	2.70
Wrist & Hand	0.67 (moderate responsiveness)	3.45

*GRI has no recommended value. Bigger GRI values mean larger effect size and more responsiveness. SRM = Standardized Response Mean; GRI= Guyatt��s Responsiveness Index[

Test/Retest Reliability

General Rehab Sample:

(Platz et al, 2005; n = 37 stroke, 14 MS, and 5 TBI patients; assessed twice within a 7 day interval, General Rehab Sample)

Excellent Total Motor Score (ICC = 0.97)
Excellent Sensation (ICC = 0.81)
Excellent Passive Joint motion (ICC = 0.95)

Interrater/Intrarater Reliability

Excellent Interrater Reliability:

(Duncan et al, 1983; 4 PT's using the above sample)

FMA Domain	Pearson's r
Upper Extremity	r = 0.98 - 0.995
Lower Extremity	r = 0.89 - 0.95

Excellent interrater reliability, FMA Total Score: (ICC = 0.96)(Sanford et al, 1993; n = 12; mean age = 66 (11.5) years; 0 to 6 months post stroke, Acute Stroke)

Rating	FMA Domain	ICC
Excellent	Upper Extremity	0.97
Excellent	Lower Extremity	0.92
Adequate	Sensation	0.85
Adequate	Joint Range of Motion	0.85
Poor	Pain	0.61

Wrist and Hand Upper Extremity Fugl-Meyer (w/h UE FM):

Study of the wrist stability and mobility hand scales (the 12 most distal items of the UE FM).

(Page SJ et al, 2015; n=32, mean age=57(10) years, chronic stroke patients with moderately impaired UE function)

Excellent intrarater reliability (ICC = 0.95)

Internal Consistency

Subsection to FMA Total Score Correlations:

(Wood-Dauphinee et al, 1990; n = 167; assessed at admission and 5 weeks)

Excellent correlation : Upper Extremity & FMA Total (r = 0.97)
Excellent correlation: Mower Extremity & FMA Total (r = 0.90)
Adequate correlation: Balance & FMA Total (r = 0.88)

(Page SJ et al, 2015; n=32, mean age=57(10) years, chronic stroke patients with moderately impaired UE function)

Excellent internal consistency for the Wrist and Hand Upper Extremity Fugl-Meyer (w/h UE FM) across two trials, Cronbach's alpha = 0.82 and 0.84)

Face Validity

Gladstone et al, 2002:

Face and content validity for the motor domain are "very good"
Scaling is heavily weighted for the upper extremity
Reflexes may be overrepresented in the scoring system

Bibliography

Bernspang, B., Asplund, K., et al. (1987). "Motor and perceptual impairments in acute stroke patients: effects on self-care ability." Stroke 18: 1081-1086.

Crow, J. L. and Harmeling-van der Wel, B. C. (2008). "Hierarchical properties of the motor function sections of the Fugl-Meyer assessment scale for people after stroke: a retrospective study." Phys Ther 88: 1554-1567.

Dettmann, M. A., Linder, M. T., et al. (1987). "Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient." Am J Phys Med 66: 77-90.

Duncan, P. W., Goldstein, L. B., et al. (1992). "Measurement of motor recovery after stroke. Outcome assessment and sample size requirements." Stroke 23(8): 1084-1089.

Duncan, P. W., Lai, S. M., et al. (2000). "Defining post-stroke recovery: implications for design and interpretation of drug trials." Neuropharmacology 39(5): 835-841.

Duncan, P. W., Propst, M., et al. (1983). "Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident." Phys Ther 63: 1606-1610.

Gladstone, D. J., Danells, C. J., et al. (2002). "The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties." Neurorehabil Neural Repair 16: 232-240.

Hsieh, Y. W., Wu, C. Y., et al. (2009). "Responsiveness and validity of three outcome measures of motor function after stroke rehabilitation." Stroke 40(4): 1386-1391.

Hsueh, I. P., Hsu, M. J., et al. (2008). "Psychometric comparisons of 2 versions of the Fugl-Meyer Motor Scale and 2 versions of the Stroke Rehabilitation Assessment of Movement." Neurorehabil Neural Repair 22(6): 737-744.

Lin, J. H., Hsueh, I. P., et al. (2004). "Psychometric properties of the sensory scale of the Fugl-Meyer Assessment in stroke patients." Clin Rehabil 18(4): 391-397.

Malouin, F., Pichard, L., et al. (1994). "Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale." Arch Phys Med Rehabil 75: 1206-1212.

Mao, H.-F., Hsueh, I. P., et al. (2002). "Analysis and comparison of the psychometric properties of three balance measures for stroke patients." Stroke 33: 1022-1027.

Nadeau, S., Arsenault, A. B., et al. (1999). "Analysis of the clinical factors determining natural and maximal gait speeds in adults with a stroke." Am J Phys Med Rehabil 78: 123-130.

Page, S. J., Fulk, G. D., & Boyne, P. (2012). "Clinically important differences for the upper-extremity fugl-meyer scale in people with minimal to moderate impairment due to chronic stroke." Physical Therapy 92(6): 791.

Page, S. J., Hade, E., & Persch, A. (2015). "Psychometrics of the wrist stability and hand mobility subscales of the Fugl-Meyer Assessment in moderately impaired stroke." Physical Therapy 95(1): 103-108.

Platz, T., Pinkowski, C., et al. (2005). "Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study." Clin Rehabil 19: 404-411.

Sanford, J., Moreland, J., et al. (1993). "Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke." Phys Ther 73: 447-454.

See J., Dodakian L., Chou C., Chan V., McKenzie A., Reinkensmeyer D.J., Cramer S.C. A standardized approach to the Fugl-Meyer assessment and its implications for clinical trials. Neurorehabil. Neural Repair. 2013;27:732�C741. []

Sullivan KJ, Tilson JK, Cen SY, Rose DK, Hershberg J, Correa A, et al. Fugl-Meyer assessment of sensorimotor function after stroke: standardized training procedure for clinical practice and clinical trials. Stroke. 2011;42(2):427�C32. doi: 10.1161/STROKEAHA.110.592766. []

Shelton, F. D., Volpe, B. T., et al. (2001). "Motor impairment as a predictor of functional recovery and guide to rehabilitation treatment after stroke." Neurorehabil Neural Repair 15(3): 229-237.

Wagner, J. M., Rhodes, J. A., et al. (2008). "Reproducibility and minimal detectable change of three-dimensional kinematic analysis of reaching tasks in people with hemiparesis after stroke." Phys Ther 88(5): 652-663.

Wei XJ, Tong KY, Hu XL. The responsiveness and correlation between Fugl-Meyer Assessment, Motor Status Scale, and the Action Research Arm Test in chronic stroke with upper-extremity rehabilitation robotic training. Int J Rehabil Res 2011;34:349�C56. []

Wood-Dauphinee, S. L., Williams, J. I., et al. (1990). "Examining outcome measures in a clinical study of stroke." Stroke 21: 731-739.

Woodbury, M. L., Velozo, C. A., et al. (2008). "Longitudinal stability of the Fugl-Meyer Assessment of the upper extremity." Arch Phys Med Rehabil 89: 1563-1569.

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Last Updated

Purpose

Link to Instrument

Area of Assessment

Assessment Type

Administration Mode

Cost

Cost Description

Diagnosis/Conditions

Number of Items

Required Training

Instrument Reviewers

ICF Domain

Measurement Domain

Professional Association Recommendation

Considerations

Standard Error of Measurement (SEM)

Minimal Detectable Change (MDC)

Minimally Clinically Important Difference (MCID)

Cut-Off Scores

Normative Data

Interrater/Intrarater Reliability

Internal Consistency

Criterion Validity (Predictive/Concurrent)

Construct Validity

Content Validity

Floor/Ceiling Effects

Responsiveness

Test/Retest Reliability

Interrater/Intrarater Reliability

Internal Consistency

Face Validity

Bibliography

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