The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) is one of the most used and recommended assessment scales of sensorimotor function in stroke. This study investigated the reliability of the scale when different therapists assessed the patient's performance at the same test session and when the assessment was performed by the same therapist but on 2 different occasions. Sixty individuals with stroke at the Central Military Hospital of Colombia were included. The results showed that the agreement in each individual movement (FMA-UE includes 33 movements/items) was 79% or above. Disagreements in scorings between raters were noted for 4 single items. These disagreements were probably caused by the spontaneous recovery that occurred in the early subacute phase after stroke. The item, subscale and total score level reliabilities were high and the scale can be recommended for use in general, including in Spanish-speaking countries. It is important, however, that standardized testing procedures are followed. Objective: The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) is recommended for evaluation of sensorimotor impairment post stroke, but the itemlevel reliability of the scale is unknown. This study aims to determine intra-and inter-rater reliability of the FMA-UE at item-, subscale-and total score level in patients with early subacute stroke. Design: Intra/inter-rater reliability. Subjects: Sixty consecutively included patients with stroke (mean age 65.9 years) admitted to Central Military Hospital of Colombia, Bogota. Methods: Two physiotherapists scored FMA-UE independently on 2 consecutive days within 10 days post stroke. A rank-based statistical method for paired ordinal data was used to assess the level of agreement, systematic and random disagreements. Results: Systematic disagreements either in position or concentration were detected in 4 items of the shoulder section. The item level intra-and inter-rater agreement was high (79-100%). The 70% agreement was also reached for the subscales and the total score when 1-3-point difference was accepted. Conclusion: The FMA-UE is reliable both within and between raters in patients with stroke in the early subacute phase. A wider international use of FMA-UE will allow comparison of stroke recovery between regions and countries and thereby potentially improve the quality of care and rehabilitation in persons with stroke worldwide.

Use of FMA will allow unified description of stroke severity and motor recovery in Spanish speaking countries. This will open up possibility to compare stroke and rehabilitation outcomes with other countries and regions world-wide. Comprehensive methodological procedures provided can facilitate introduction of well-established clinical scales in other languages. Implications for Rehabilitation The Fugl-Meyer Assessment (FMA) of upper and lower extremity is the most used and recommended clinical scale for evaluation of sensorimotor impairment after stroke. The Spanish version of FMA, validated in this study, is now first time available for use in research and clinical practice. Use of FMA will allow unified description of stroke severity and motor recovery in Spanish speaking countries, which in turn opens up possibility to compare stroke and rehabilitation outcomes with other countries and regions world-wide.

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