Fugl Meyer and STREAM (CVA)

Question 1

Brunnstrom - fugl Meyer

Answer 1

Motor return in individuals w/ hemiplegia post stroke

• patterned movement in terms of synergies
• staging individuals by ability to isolate movement w/in and out of these synergies
• only assessment scale that provides an objective measure to motor recovery over time

Question 2

Fugl Meyer motor assessment

Answer 2

Movement in synergy
Movement combining synergy
Movement out of synergy

Question 3

FM prognosis UE

Answer 3

At 1 mo post stroke, >19/66 regain 94% of hand dexterity by 6 mo

Question 4

FM prognosis LE

Answer 4

Severe 0-14
Moderate 15-19
Mild 20+

3 pt change correlates to a meaningful change on a disability scale

Question 5

FM testing and scoring

Answer 5

Uninvolved, involved ROM, involved 3 trials (take best)

0-cannot be performed
1- performed a partially (slow)
2- performed faultlessly

Question 6

FM LE

Answer 6

1. In synergy (flexor, ext)
2. Combining synergy (knee flex >90 seated, DF seated)
3. Out of synergy (knee flex standing, DF standing)

Question 7

FM UE

Answer 7

1. In synergy (flex, ext)
2. Combining (no movement at elbow)
3. Out of synergy
4. Wrist (move wrist w/ shoulder and elbow in diff positions)
5. Hand

Question 8

STREAM components

Answer 8

30 items
UE movement
LE movement
Basic mobility

Question 9

STREAM minimal detectable change

Answer 9

Chronic 4.2

Acute UE 2.8 LE 2.5

Question 10

STREAM minimal clinically important difference

Answer 10

UE 2.2
LE 1.9
Mobility 4.8

Question 11

STREAM scoring, limb movement

Answer 11

0: unable to move through ANY range
1a: only part w/ marked deviation
1b: only part but correctly
1c: complete but only w/ marked deviation
2: complete movement in a manner comparable to unaffected side

Question 12

STREAM score, basic mobility

Answer 12

0: unable through ANY range

1a: needs partial assistance/stabilization and marked deviation
1b: needs assistance/stabilization and normal movement pattern
1c: indep with marked deviations

2. Independent w/ normal movement, requires aid
3. Complete indep w/ normal movement w/out aid

X: not tested

Question 13

STREAM pt 1 supine

Answer 13

1. Protract scap
2. Ext elbow
3. Flex hip and knee
4. Roll on side
5. Raise hips of bed (bridge)
6. Moves for lying supine to siting)

Question 14

STREAM pt 2 sitting

Answer 14

7. Shrug shoulders
8. Raises hand to touch top of head
9. Places hand on sacrum
10. Raises arm overhead to fullest elevation
11. Sup/pro forearm
12. Closes hand from open
13. Opens hands form closed
14. Oppose thumb to index finger

Question 15

STREAM pt 2 sitting cont

Answer 15

15. Flex hip
16. Extend knee
17. Flex knee
18. DF ankle
19. PF ankle
20. Ext knee and DF ankle
21. Raises to stand

Question 16

STREAM pt 3 standing

Answer 16

22. Standing for 20 count
23. Ab hip w/ knee ext
24. Flex knee w/ hip ext
25. DF ankle w/ knee ext

Question 17

STREAM pt 4 walking

Answer 17

26. Step up
27. 3 steps backward
28. 3 steps sideways to affected side
29. 10 m walk indoor (>20 sec - 1c)
30. Down stairs, alternating feet

Question 18

STREAM pros

Answer 18

All encompassing
Reliable
No specialized equipment
Considers movt quality
Repeatable

Question 19

STREAM cons

Answer 19

Time to administer

Small strength to capture changes

Question 20

STREAM tests for basic mobility ( /3)

Answer 20

Roll onto side (supine)
Bridge (supine)
Supine to sit (supine)
Sit to stand (sitting)
20 second standing
*all standing to walking
Step up
3 steps back, sideways to affected side 
Walk 10m indoor
Walk down 3 stairs alternating feet