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Functional Mobility Assessment

Functional Mobility Assessment

Last Updated

Purpose

The Functional Mobility Assessment (FMA) is a measure that evaluates an individual’s ability and satisfaction with a mobility device.

Link to Instrument

Acronym FMA

Area of Assessment

Functional Mobility
Occupational Performance

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

Cost Description

Paper version (PDF) available for free. See website to access.

Use contact on the website for more information on computerized versions.

CDE Status

Not a CDE (date searched: 06/08/2023)

Key Descriptions

  • The FMA is a self-report instrument that measures patient satisfaction and ability to perform mobility-related Activities of Daily Living.
  • The FMA has 10 questions scored on a Likert scale, with a response of 1 meaning “completely disagree” and a response of 6 meaning “completely agree”.
  • The FMA can be administered as a questionnaire or interview.
  • Scores range from 10 to 60, with a score of 10 indicating low levels of satisfaction with functional mobility using their current assistive equipment and a score of 60 indicating high levels of satisfaction with functional mobility using their current assistive equipment.
  • The FMA can be integrated seamlessly with initial client intake.

Number of Items

10

Equipment Required

  • Writing tool

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Shawn Luke, Casey Wilson, Melissa Hayes, and Vanessa Rosas, Master of Occupational Therapy Students.

Faculty mentor: Danbi Lee, PhD, OTD, OTR/L

Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle

Body Part

Lower Extremity

ICF Domain

Body Function
Activity
Participation

Measurement Domain

Activities of Daily Living
Emotion
General Health
Motor
Sensory

Considerations

The FMA is available in an FMA-Family Centered (FMA-FC) version, validated for use with children and adolescents aged 3-21 (Beavers et al., 2018).

The FMA has been translated into Portuguese and validated for use in Brazilian populations (Paulisso et al., 2020).

Mixed Populations

back to Populations

Cut-Off Scores

Wheelchair users & non-wheelchair users: (Faieta et al., 2020; n = 871; mean age = 53 (16.7); (spinal cord injury n = 123, cerebral palsy n = 102, stroke n = 62, osteoarthritis n = 59), (power wheelchair n = 255, scooter n = 25, manual wheelchair n = 378, cane/crutch/walker n = 171, no device n = 41)

  • Score thresholds for satisfaction with functional mobility (score ranges out of a range from 10 to 60 with all items scored):
    • 10 – 35 = low satisfaction
    • 36 – 41 = moderate satisfaction
    • 42 – 60 = high satisfaction

Test/Retest Reliability

Wheelchair users: (Paulisso et al., 2019; N = 47; 44 manual wheelchair users, 3 power wheelchair users; 87.2% male; mean (SD) age = 40.1 (14.3) years; Brazilian population)

  • Adequate test-retest reliability (Spearman r = 0.88)

 

Wheelchair users & non-wheelchair users: (Kumar et al., 2013; N = 41; 21 wheelchair users, 20 non-wheelchair users; mean (SD) age = 54 (16) years; mean (SD) time of mobility device use = 7.4 (9.1) years)

  • Adequate test-retest reliability for all participants (ICC = 0.87)
  • Adequate test-retest reliability for wheelchair users (ICC = 0.85)
  • Adequate test-retest reliability for non-wheelchair users (ICC = 0.87)

 

Interrater/Intrarater Reliability

Wheelchair users: (Paulisso et al., 2019)

  • Excellent interrater reliability, as rated by two occupational therapists previously trained for use of the FMA (Spearman r = 0.97)

 

Wheelchair users & non-wheelchair users: (Faieta et al., 2020; N = 871; mean age = 53 (16.7); 14.1% spinal cord injury, 11.7% cerebral palsy, 7.1% stroke, 6.8% osteoarthritis; 43.4% manual wheelchair users, 29.3% power wheelchair users, 2.9% scooter users, 19.6% cane/crutch/walker users, 4.7% no device)

  • Excellent interrater reliability (ICC = 0.85)

 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Wheelchair users: (Paulisso et al., 2019)

  • Adequate concurrent validity with the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST), which evaluates satisfaction of assistive technology (r = 0.411)

Construct Validity

Convergent validity:

Wheelchair users: (Paulisso et al., 2019)

  • Adequate convergent validity with the Functional Independence Measure (FIM), which evaluates independence in the ability to perform activities of daily living (r = 0.323)
  • Poor convergent validity with the Wheelchair Skills Test Questionnaire (WST-Q), which evaluates performance of wheelchair users in carrying out tasks (r = 0.295)

Content Validity

Kumar et al. (2013) state that the FMA is a revised instrument created by modifying the items from the Functioning Everyday with a Wheelchair (FEW) assessment to include items applicable to assessing the needs of both existing wheelchair users and users of other mobility devices, such as canes, crutches, walkers, prosthetics, orthotics, or no device at all. The FEW is a self-report tool developed from consumer-generated information and has established good content validity (captured 98.5% of mobility-related goals; p. 214).

Face Validity

Paulisso et al. (2020) evaluated face validity with 12 mobility device users (some used multiple devices: wheelchair n = 10, crutch n = 4, cane n = 1, walker n = 1) and 12 occupational therapy students and determined that “[the FMA] is semantically, idiomatically, culturally, and conceptually adapted to the Brazilian context, while its format and content are in accordance with the FMA instrument in its original version. We identified that FMA has good face validation and allows therapists to gather relevant data related to satisfaction and priorities regarding mobility devices (p. 6).”

Faieta et al. (2020) performed a Rasch analysis and determined that “the person-item maps provide face validity in the ordering of items (p. 714).” Faieta et al. (2020) also state that “psychometric evaluation suggests the FMA provides valid and reliable measures of perceived satisfaction with functional mobility. The difficulty of the items demonstrates face validity of the FMA (p. 714).”

Floor/Ceiling Effects

Wheelchair users & non-wheelchair users: (Faieta et al., 2020)

  • Adequate ceiling effect of 4.71%
  • Adequate floor effect of 3.79%

Bibliography

Beavers, D. B., Holm, M. B., Rogers, J. C., Plummer, T., & Schmeler, M. (2018). Adaptation of the adult Functional Mobility Assessment (FMA) into a FMA-Family Centred (FMA-FC) paediatric version. Child Care Health Development, 44, 630–635. .

Faieta, J. M., Hand, B. N., Berner, T. R., Schmeler, M. U., & Digiovine, C. U. (2020). Evaluation of the Functional Mobility Assessment through Rasch analysis. Archives of Physical Medicine and Rehabilitation,101(4), 712-716. .

Kumar, A., Schmeler, M. R., Karmarkar, A. M., Collins, D. M., Cooper, R., Cooper, R. A., Shin, H., & Holm, M. B. (2013). Test-retest reliability of the Functional Mobility Assessment (FMA): A pilot study. Disability and Rehabilitation: Assistive Technology, 8(3), 213–219.

Paulisso, D.C., Cruz, D. M. C., Allegretti, A. L. C., Schein, R. M., Costa, J. D., Campos, L. C. B., Schmeler, M. R. (2020). Cross cultural adaptation and face validity of the Functional Mobility Assessment into Brazilian Portuguese. Occupational Therapy International, 1-7.

??Paulisso, D. C., Schmeler, M. R., Schein, R. M., Caltabiano Allegretti, A. L., Batista Campos, L. C., Costa, J. D., Fachin-Martins, E., & Cezar da Cruz, D. M. (2019). Functional Mobility Assessment is reliable and correlated with satisfaction, independence and skills. Assistive Technology, 1–7.