FMA-LE PROTOCOL Rehabilitation Medicine, University of Gothenburg

FUGL-MEYER ASSESSMENT ID:

LOWER EXTREMITY (FMA-LE) Date:
Assessment of sensorimotor function Examiner:
Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S: The post-stroke hemiplegic patient. 1. a method for evaluation of physical
performance. Scand J Rehabil Med 1975, 7:13-31.

E. LOWER EXTREMITY
I. Reflex activity, supine position none can be elicited
Flexors: knee flexors 0 2
Extensors: patellar, achilles (at least one) 0 2
Subtotal I (max 4)

II. Volitional movement within synergies supine position none partial full
Flexor synergy: Maximal hip flexion Hip flexion 0 1 2
(abduction/external rotation), maximal flexion in Knee flexion 0 1 2
knee and ankle joint (palpate distal tendons to
ensure active knee flexion). Ankle dorsiflexion 0 1 2
Extensor synergy: From flexor synergy to the hip Hip extension 0 1 2
extension/adduction, knee extension and ankle
adduction 0 1 2
plantar flexion. Resistance is applied to ensure
active movement, evaluate both movement and Knee extension 0 1 2
strength (compare with the unaffected side) Ankle plantar flexion 0 1 2
Subtotal II (max 14)

III. Volitional movement mixing synergies none partial full

sitting position, knee 10cm from the edge of the chair/bed
Knee flexion from no active motion 0
actively or passively less than 90° active flexion, palpate tendons of hamstrings 1
extended knee more than 90° active flexion 2

Ankle dorsiflexion no active motion 0

compare with limited dorsiflexion 1
unaffected side complete dorsiflexion 2
Subtotal III (max 4)

IV. Volitional movement with little or no synergy none partial full

standing position, hip at 0°
Knee flexion to 90° no active motion or immediate, simultaneous hip flexion 0
hip at 0°, balance less than 90° knee flexion and/or hip flexion during movement 1
support is allowed at least 90° knee flexion without simultaneous hip flexion 2

Ankle dorsiflexion no active motion 0

compare with limited dorsiflexion 1
unaffected side complete dorsiflexion 2
Subtotal IV (max 4)

V. Normal reflex activity supine position, assessed only if full score of 4

hyper lively normal
points is achieved in part IV, compare with the unaffected side
Reflex activity 2 of 3 reflexes markedly hyperactive 0
knee flexors, 1 reflex markedly hyperactive or at least 2 reflexes lively 1
Patellar, Achilles, maximum of 1 reflex lively, none hyperactive 2
Subtotal V (max 2)

Total E (max 28)

Approved by Fugl-Meyer AR 2010 1 Updated 2019-03-03

FMA-LE PROTOCOL Rehabilitation Medicine, University of Gothenburg

F. COORDINATION/SPEED, supine, after one trial with both legs, eyes

marked slight none
closed, heel to knee cap of the opposite leg, 5 times as fast as possible
Tremor at least 1 completed movement 0 1 2
pronounced or unsystematic 0
Dysmetria
slight and systematic 1
no dysmetria 2
≥ 6s 2 - 5s < 2s
Time 6 or more seconds slower than unaffected side 0
start and end with the 2-5 seconds slower than unaffected side 1
hand on the knee less than 2 seconds difference 2

Total F (max 6)

H. SENSATION, lower extremity hypoesthesia or

eyes closed, compare with the unaffected side anesthesia normal
dysesthesia
leg 0 1 2
Light touch
foot sole 0 1 2
less than 3/4 3/4 correct or correct 100%,
correct or considerable little or no
absence difference difference
hip 0 1 2
Position
knee 0 1 2
small alterations in the
ankle 0 1 2
position
great toe (IP-joint) 0 1 2

Total H (max12)

I. PASSIVE JOINT MOTION, lower extremity J. JOINT PAIN during passive

supine position, compare with the unaffected side motion, lower extremity
only few decreased normal pronounced pain during some no
degrees movement or very marked pain pain pain
(<10° hip) at the end of the movement
Flexion 0 1 2 0 1 2
Hip Abduction 0 1 2 0 1 2
External rotation 0 1 2 0 1 2
Internal rotation 0 1 2 0 1 2
Knee Flexion 0 1 2 0 1 2
Extension 0 1 2 0 1 2
Ankle Dorsiflexion 0 1 2 0 1 2
Plantar flexion 0 1 2 0 1 2
Foot Pronation 0 1 2 0 1 2
Supination 0 1 2 0 1 2

Total (max 20) Total (max 20)

E. LOWER EXTERMTY /28

F. COORDINATION / SPEED /6

TOTAL E-F (motor function) /34

H. SENSATION /12

I. PASSIVE JOINT MOTION /20

J. JOINT PAIN /20

Approved by Fugl-Meyer AR 2010 2 Updated 2019-03-03