Translation and cultural validation of clinical observational scales – the Fugl-Meyer assessment for post stroke sensorimotor function in Colombian Spanish

Purpose: Fugl-Meyer Assessment (FMA) is the most widely used and recommended clinical scale for evaluation of sensorimotor impairment post stroke, but an official Spanish version is not available today. This study aimed to establish methodological structure for translation and cultural adaptation process and perform a transcultural validation of the upper and lower extremity FMA to Colombian Spanish. Methods: Procedures included forward and backward translation, step-wise reviewing by bilingual and professional experts to ensure conceptual and semantic equivalence. Validation included a pilot evaluation of item-level agreement on 10 individuals with stroke at the Central Military Hospital of Colombia. Results: Comprehensive step-wise procedure for transcultural validation was established. Low agreement (less than 70%) was detected for items assessing arm movements within synergies and for coordination/speed subscale. All points of disagreement were systematically reviewed and agreed upon when drafting the final version of the Spanish FMA. Conclusions: 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 RehabilitationThe 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. 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.

研究目的：Fugl-Meyer评估量表（Fugl-Meyer Assessment, FMA）是目前临床应用最广泛、推荐度最高的脑卒中后感觉运动功能损伤评估量表，但目前尚无官方西班牙语版本。本研究旨在建立翻译与文化调适流程的方法论框架，并针对哥伦比亚西班牙语语境完成上下肢FMA的跨文化效度验证。
研究方法：流程涵盖正向翻译与回译环节，由具备双语背景与专业资质的专家逐阶段审阅，以确保概念与语义的等效性。效度验证阶段于哥伦比亚中央军事医院开展，纳入10名脑卒中患者进行条目层面一致性的预试验评估。
研究结果：本研究建立了完整的跨文化效度验证逐阶段流程。检测发现，针对协同运动模式内上肢动作以及协调/速度亚量表的条目，一致性较低（低于70%）。针对所有存在分歧的条目，研究团队均进行了系统性复盘，并在定稿西班牙语版FMA时达成共识。
研究结论：该西班牙语版FMA的应用可实现西班牙语国家脑卒中严重程度与运动功能恢复情况的统一描述，进而为全球范围内不同国家与地区的脑卒中及康复治疗结局对比提供可能。本研究提出的完整方法论流程，可为其他语种下成熟临床量表的引入提供借鉴。
康复应用启示：上下肢Fugl-Meyer评估量表是当前临床应用最广泛、推荐度最高的脑卒中后感觉运动功能损伤评估工具。本研究验证的西班牙语版FMA，首次可应用于西班牙语地区的科研与临床实践。该量表的应用可实现西班牙语国家脑卒中严重程度与运动功能恢复情况的统一描述，进而为全球范围内不同国家与地区的脑卒中及康复治疗结局对比提供可能。上下肢Fugl-Meyer评估量表是当前临床应用最广泛、推荐度最高的脑卒中后感觉运动功能损伤评估工具。本研究验证的西班牙语版FMA，首次可应用于西班牙语地区的科研与临床实践。该量表的应用可实现西班牙语国家脑卒中严重程度与运动功能恢复情况的统一描述，进而为全球范围内不同国家与地区的脑卒中及康复治疗结局对比提供可能。