About the Fugl-Meyer Motor Assessment
The Fugl-Meyer Assessment is the most widely used stroke-specific measure of motor impairment. The motor subscales grade volitional movement along the Brunnstrom stages of recovery: isolated reflex activity, mass flexor synergy, mass extensor synergy, movement that combines synergies, and finally movement performed out of synergy with near-normal coordination and speed. Each item is graded 0, 1, or 2. The upper-extremity motor subscale totals 66 points across 33 items; the lower-extremity motor subscale totals 34 points across 17 items.
Interpreting the total
For the upper-extremity motor subscale, Woodbury and colleagues (2013) proposed severity bands derived from Rasch analysis when the score is expressed as a percentage of the maximum. We report the raw score, the percentage, and the Woodbury band. The lower-extremity subscale has no equivalently granular published severity binning at this threshold set; we recommend interpreting change relative to the patient's baseline and clinical phase.
Minimal clinically important difference (MCID)
For the upper-extremity subscale, the most commonly cited MCIDs are roughly 5.25 points in chronic stroke (Page et al. 2012) and 9 to 10 points in acute stroke (van der Lee et al. 2001). Interpret change against the MCID that matches your patient's recovery phase.
Primary source: Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13–31. Administration reference: Sullivan KJ et al. Stroke. 2011;42(2):427–432. Severity banding: Woodbury et al. Arch Phys Med Rehabil. 2013;94(8):1527–1533. MCID references: Page SJ et al. Phys Ther. 2012;92(6):791–798; van der Lee JH et al. Stroke. 2001;32(6):1363–1370.