Cross-cultural translation and adaptation of the Danish version of the Fugl-Meyer assessment for post stroke sensorimotor function

The Fugl-Meyer assessment (FMA) is the most widely used and recommended clinical assessment scale for evaluating sensorimotor impairments in stroke patients, but an official Danish version has not been available. This study aimed to perform a standardized translation and cross-cultural adaptation (TCCA) of the FMA into Danish. First, a comprehensive eight-step TCCA procedure including forward and backward translation and step-wise reviewing by proof-reader and bilingual physiotherapists, to ensure conceptual and semantic equivalence was applied to develop a Danish version of the FMA. Second, inter-rater reliability of the Danish FMA was assessed in 10 subacute stroke patients. Svensson’s statistical method designed for rank-based paired ordinal data to identify items showing non-systematic or systematic disagreements in relative position or concentration was used to make further improvements on translation. A Danish FMA version was successfully made by the step-wise TCCA procedure. The clinical validation revealed satisfactory to excellent inter-tester reliability across all items (70–100%). Significant systematic disagreement either in position or concentration or both were observed in about 20% of the items. The Danish version of the FMA was translated and adapted allowing for a wider standardized use of the FMA in stroke rehabilitation in Denmark.Implications for rehabilitationThe Fugl–Meyer assessment (FMA) is the most used and recommended clinical assessment scale for evaluating sensorimotor impairments in stroke patients.The translated and adapted Danish version of the FMA is now available for use in research and clinical practice in Denmark.This allows for a standardized and unified description of stroke motor recovery and severity in neurorehabilitation nationwide as well as the possibility to compare and conduct trials using FMA internationally. The Fugl–Meyer assessment (FMA) is the most used and recommended clinical assessment scale for evaluating sensorimotor impairments in stroke patients. The translated and adapted Danish version of the FMA is now available for use in research and clinical practice in Denmark. This allows for a standardized and unified description of stroke motor recovery and severity in neurorehabilitation nationwide as well as the possibility to compare and conduct trials using FMA internationally.

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患者感觉运动功能损害评估量表，但此前尚无官方丹麦语版本。本研究旨在对FMA进行标准化翻译与跨文化调适（standardized translation and cross-cultural adaptation, TCCA），将其转化为丹麦语版本。首先，本研究采用涵盖正向翻译、反向翻译以及由校对人员与双语物理治疗师逐步审阅的完整八步TCCA流程，以确保概念与语义的等效性，从而开发FMA的丹麦语版本。其次，本研究纳入10例亚急性脑卒中患者，对丹麦语版FMA的评定者间信度进行评估。本研究采用针对等级配对有序数据设计的Svensson统计方法，识别在相对位置或集中度上存在非系统性或系统性分歧的条目，进而对翻译内容进行进一步优化。通过逐步推进的TCCA流程，本研究成功开发出丹麦语版FMA。临床验证结果显示，所有条目均具有令人满意至极佳的评定者间信度（70%~100%）。约20%的条目在位置、集中度或两者兼具上存在显著系统性分歧。本次翻译与调适后的丹麦语版FMA，可在丹麦脑卒中康复领域实现更广泛的标准化应用。

康复实践启示
Fugl-Meyer评估量表（FMA）是目前临床应用最广泛、推荐度最高的脑卒中患者感觉运动功能损害评估量表。本次翻译并调适完成的丹麦语版FMA，现已可在丹麦的科研与临床实践中投入使用。这将使丹麦全国范围内的神经康复领域能够对脑卒中患者的运动功能恢复情况与损害严重程度进行标准化、统一化的描述，同时也为国际间开展FMA相关对照研究与临床试验提供了可能。

Fugl-Meyer评估量表（FMA）是目前临床应用最广泛、推荐度最高的脑卒中患者感觉运动功能损害评估量表。本次翻译并调适完成的丹麦语版FMA，现已可在丹麦的科研与临床实践中投入使用。这将使丹麦全国范围内的神经康复领域能够对脑卒中患者的运动功能恢复情况与损害严重程度进行标准化、统一化的描述，同时也为国际间开展FMA相关对照研究与临床试验提供了可能。