Translation, cross-cultural adaptation, and validation of the simplified Chinese Fugl-Meyer assessment: a cross-sectional study in stroke patients.

Abstract

The Fugl-Meyer assessment (FMA) is the gold standard for evaluating sensorimotor-impairment after stroke, yet no validated Chinese translation exists despite China's large stroke burden. This study aimed to develop and validate a Chinese version of the FMA for use in Chinese-speaking stroke populations. We followed internationally accepted guidelines for translation and cross-cultural adaptation to ensure conceptual, semantic, and cultural equivalence. The process involved forward and backward translation, expert team review, and cognitive pretesting. The finalized Simplified Chinese FMA was administered to 60 adult stroke survivors (subacute and chronic) from rehabilitation centers in Chongqing, China. Psychometric evaluation was cross-sectional and included internal consistency (Cronbach's α), inter-rater reliability (ICC), item-level agreement, concurrent validity (NIHSS, mRS, FIM), and construct validity using factor analysis. The Chinese FMA showed excellent internal consistency (α = 0.770-0.970) and outstanding inter-rater reliability (ICC = 0.99 for both extremities), with item-level agreement of 95% (upper limb) and 93.33% (lower limb). Concurrent validity was confirmed <i>via</i> strong correlations with the mRS (<i>r</i>=-0.534), NIHSS (<i>r</i>=-0.856), and FIM (<i>r</i> = 0.867). Factor analysis supported its theoretical structure, with no ceiling or floor effects observed. The Chinese FMA demonstrates robust psychometric properties comparable to the original English version and other validated translations.