SynthesisArchives of physical medicine and rehabilitation2016
Dimensionality and Item-Difficulty Hierarchy of the Lower Extremity Fugl-Meyer Assessment in Individuals With Subacute and Chronic Stroke.
Synthesis in Archives of physical medicine and rehabilitation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative efficacy of different repetitive transcranial magnetic stimulation protocols for lower extremity motor function in stroke patients: a network meta-analysis.Frontiers in neuroscience · 2024Pooled it
- Online versus offline Fugl-Meyer lower extremity training for physical therapy students: a randomized study.BMC medical education · 2026Trial
- Trial
- Effects of 10-Hz rTMS over the leg motor cortex using a double-cone coil on lower limb motor recovery in subacute stroke: a randomised, double-blind, sham-controlled study.Journal of neuroengineering and rehabilitation · 2025Trial
- Effect of the Kickstart exoskeleton lower extremity walking system on improving lower extremity walking ability in subacute stroke patients: a randomized controlled trial.Journal of neuroengineering and rehabilitation · 2025Trial
- Classification of postural control characteristics during quiet standing in patients with subacute stroke and their association with lesion networks.Research square · 2026Article
- Acute basal ganglia ischemic stroke: a study on structure-function coupling.Brain imaging and behavior · 2026Article
- A novel biomechanical indicator for impaired ankle dorsiflexion function during walking in individuals with chronic stroke.Gait & posture · 2024Article
- Item-Level Analysis of a Newly Developed Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) Using the Rasch Measurement Model.Healthcare (Basel, Switzerland) · 2022Article
- Effectiveness of a Novel Contralaterally Controlled Neuromuscular Electrical Stimulation for Restoring Lower Limb Motor Performance and Activities of Daily Living in Stroke Survivors: A Randomized Controlled Trial.Neural plasticity · 2022Article
- Effects of the Intermittent Theta Burst Stimulation of the Cerebellar Vermis on Balance Recovery After Stroke: A Study Protocol for a Randomized Controlled Trial.Frontiers in aging neuroscience · 2022Article
- Effect of Customized Insoles on Gait in Post-Stroke Hemiparetic Individuals: A Randomized Controlled Trial.Biology · 2021Article
- Exploring the Impact of Missing Data on Residual-Based Dimensionality Analysis for Measurement Models.Educational and psychological measurement · 2021Article
- Comparing the effects of different electromagnetic stimulation on lower limb motor impairment after stroke: a protocol for systematic review and network meta-analysis.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo investigate the dimensionality and item-difficulty hierarchy of the Fugl-Meyer Assessment of the lower extremity (FMA-LE).
designSecondary analyses of data pooled from 4 existing datasets: a phase III randomized controlled trial investigating the effectiveness of body weight support and a treadmill for rehabilitation of walking poststroke, and 3 cross-sectional studies investigating the link between impaired motor performance poststroke and walking.
settingUniversity research centers and rehabilitation centers.
participantsA pooled sample of individuals with a stroke (N=535, men=313; mean age ± SD, 61.91±12.42y).
interventionsNot applicable.
main outcome measuresConfirmatory factor analyses (CFA) and Rasch residual principal component analysis (PCA) investigated the dimensionality of the FMA-LE. The Rasch analysis rating scale model investigated item-difficulty hierarchy of the FMA-LE.
resultsThe CFA showed adequate fit of a 3-factor model, with 2 out of 3 indices (CFA=.95; Tucker-Lewis Index=.94; root mean square error of approximation=.124) showing good model fit. Rasch PCA showed that removal of the reflex and coordination items explained 90.8% of variance in the data, suggesting that the abnormal synergy items contributed to the measurement of a unidimensional construct. However, rating scale model results revealed deviations in the item-difficulty hierarchy of the unidimensional abnormal synergy items from the originally proposed stepwise sequence of motor recovery.
conclusionsOur findings suggest that the FMA-LE might represent a multidimensional construct, challenging the use of a total score of the FMA-LE to predict lower extremity motor recovery. Removal of the misfit items resulted in creation of a unidimensional scale composed of the abnormal synergy items. However, this unidimensional scale deviates from the originally proposed hierarchical ordering.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.