MOTOR FUNCTION MEASURE for neuromuscular diseases M F M

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MOTOR FUNCTION MEASURE for neuromuscular diseases M F M SCORING SHEET 1 Patient birth s name, surname: Married name: Date of birth: / / Patient age: / year month day years months Assessment date: / / year month day Evaluator s name: Tiredness of the patient at the beginning of the MFM compared to its usual state (patient s opinion): Fitter in its usual state more tired much more tired The MFM is an evaluation scale that is developed and validated by the MFM study group for the measurement of functional motor abilities of subjects with neuromuscular diseases. When repeated over time, the MFM measures the change in the motor function abilities of the subject. The following scoring scale should serve as a general indication. For each item, specific instructions are given for scoring ; the use of these instructions is imperative. These directions are given in the User s Manual 1. Scoring basis 0 = Cannot initiate the task 1 = Partially performs the task 2 = Performs the movement incompletely, or completely but imperfectly (compensatory movements, position maintained for an insufficient duration of time, slowness, uncontrolled movement) 3 = Performs the task fully and normally ; the movement is controlled, mastered, directed, and performed at constant speed. For all informations, contact : Doctor Carole Bérard, Service de Rééducation Pédiatrique l Escale, HFME, Aile A1, 59 bd Pinel, 69677 Bron Cedex, France. 04 72 12 94 50. Mail : carole.berard@chu-lyon.fr For all information about the databank MFM, look at the website: http://www.motor-function-measure.org/data-bank.aspx 1 The User s Manual and the scoring sheet are downloaded from the website: http://www.motor-function-measure.org/user-smanual.aspx Copyright : Motor Function Measure is protected by international copyright with all rights reserved to MFM steering committee. Don t use without permission. For all informations or using consent of Motor Function Measure, thanks to contact carole.berard@chu-lyon.fr

Items MFM 32 (from 6 to 60 years). Items MFM 20 (child <7 years old) 1. SUPINE, HEAD IN MIDLINE POSITION: holds the head for 5 seconds in midline position and turns it completely from one side to the other. comments :... 2. SUPINE: raises the head and maintains the raised position for 5 seconds comments :... 3. SUPINE: flexes the hip and knee more than 90 o by raising the foot during the whole movement. comments :... 4. SUPINE, LEG SUPPORTED BY EXAMINER: from the plantar flexion, dorsiflexes the foot to at least 90 in relation to the lower part of the leg. 5. SUPINE: raises the hand and moves it to the opposite shoulder. 6. SUPINE, LOWER LIMBS HALF-FLEXED, KNEECAPS AT THE ZENITH AND FEET RESTING ON THE MAT SLIGHTLY APART: maintains for 5 seconds the starting position then raises the pelvis ; the lumbar spine, the pelvis and the thighs are aligned and the feet slightly apart. 7. SUPINE: turns over into prone and frees both upper limbs from under the trunk. 8. SUPINE: without upper limb support sits up. 9. SEATED ON THE MAT: without upper limb support, maintains the seated position for 5 seconds and is then capable of maintaining contact 5 seconds between the two hands. 10. Seated on the mat, THE tennis ball placed in front of the PERSON: without upper limb support, leans forward, touches the ball and sits back again. comments:... 11. SEATED ON THE MAT: without upper limb support, stands up. D1 D2 D3

Items D1 D2 D3 12. STANDING: without upper limb support, sits down on the chair with the feet slightly apart. 13. SEATED ON THE CHAIR: without upper limb support nor leaning against the back of the chair, maintains the seated position for 5 seconds, with the head and trunk in midline position. 14. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, HEAD IN FLEXION: from head in complete flexion, raises the head then maintains it raised for 5 seconds, the head stays in midline position throughout the movement and the holding position. 15. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, FOREARMS ON THE TABLE BUT NOT ELBOWS: places both hands on top of the head at the same time while the head and trunk remain in midline position. 16. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, THE PENCIL ON THE TABLE: without moving the trunk, reaches the pencil with one hand, forearm and hand off the table with the elbow in full extension at the end of the movement... 17. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, 10 COINS ON THE TABLE: successively picks up and holds 10 coins in one hand during the 20-second period... 18. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, ONE FINGER PLACED IN THE CENTER OF THE FIXED CD: goes round the edge of the CD with the same finger without hand support on the table... 19. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, THE PENCIL ON THE TABLE: picks up the pencil and draws a continuous series of loops inside the frame and over its full length touching the top and bottom line of the frame. Trial n 1 Trial n 2 20. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, HOLDING THE SHEET OF PAPER: tears the sheet of paper folded in 4, beginning from the fold edge.

Items D1 D2 D3 21. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, THE TENNIS BALL ON THE TABLE: picks up the ball, and turns the hand over completely holding the ball. 22. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, ONE FINGER PLACED IN THE CENTER OF THE DIAGRAM: raises the finger and places it successively on the 8 drawings without touching the lines... 23. SEATED ON THE CHAIR OR IN THE WHEELCHAIR, UPPER LIMBS ALONG THE TRUNK: places the two forearms and/or the hands on the table at the same time without moving the trunk. 24. SEATED ON THE CHAIR: without upper limb support, stands up with the feet slightly apart. 25. STANDING WITH UPPER LIMB SUPPORT ON EQUIPMENT: without upper limb support, maintains a standing position for 5 seconds with the feet slightly apart, the head, trunk and limbs in midline position 26. STANDING WITH UPPER LIMB SUPPORT ON EQUIPMENT: without upper limb support, raises the foot for 10 seconds... side support : right : left : 27. STANDING: without support, touches the floor with one hand and stands up again. 28. STANDING WITHOUT SUPPORT: takes 10 steps forward on both heels. 29. STANDING WITHOUT SUPPORT: takes 10 steps forward on a line. 30. STANDING WITHOUT SUPPORT: runs 10 meters. 31. STANDING ON ONE FOOT WITHOUT SUPPORT: hops 10 times in place. 32. STANDING WITHOUT SUPPORT: without upper limb support, manages to squat and gets up twice in a row. * All calculations are automatic when the data are entered into the database MFM * D1= D2= D3=

Patient cooperation: zero medium optimum Comments :.. SCORES MFM 32* : SCORES in % D1. Standing and transfers Total Dimension 1 = X 100 =,... % 13 x 3 39 D2. Axial and proximal motor function Total Dimension 2 = X 100 =,... % 12 x 3 36 D3. Distal motor function Total Dimension 3 = X 100 =,... % 7 x 3 21 TOTAL SCORE = Total mark = X 100 =,... % 32 x 3 96 SCORES MFM 20*: SCORES en % D1. Station debout et transferts Total Dimension 1 X 100 = X 100 =,... % 24 24 D2. Motricité axiale et proximale Total Dimension 2 X 100 = X 100 =,... % 24 24 D3. Motricité distale Total Dimension 3 X 100 = X 100 =,... % 12 12 SCORE TOTAL = Total des cotations X 100 = X 100 =,... % 20 X 3 60 * All calculations are automatic when the data are entered into the MFM database

Additional information for the MFM database The overall severity of motor impairment is: mild moderate severe very severe Laterality: right Wheelchair available: no left manual undetermined, ambidextrous manual + electrical unknown Vignos grade: 1 - walks and climbs stairs without assistance 2 - walks and climbs stairs with aid of railing 3 - walks and climbs stairs slowly with aid of railing (over 12 seconds for 4 standard steps) 4 - walks unassisted and rises from chair but cannot climb stairs 5 - walks unassisted but cannot rise from chair or climb stairs 6 walks only with assistance or walks independently with long leg braces 7 walks in long leg braces but requires assistance for balance 8 stands in long leg braces but unable to walk even with assistance 9 is in wheelchair. 10 is confined to bed. Brooke Grade: 1 - starting with arms at the sides, the patient can abduct the arms in a full circle until they touch above the head. 2 - can raise arms above head only by flexing the elbow (i.e. shortening the circumference of the movement) or using accessory muscles. 3 - cannot raise hands above head but can raise an 180ml glass of water to mouth (using both hands if necessary). 4 - can raise hands to mouth but cannot raise an 180ml glass of water to mouth. 5 - cannot raise hand to mouth but can use hands to hold pen or pick up pennies from the table. 6 - cannot raise hands to mouth and has no useful function of hands. Don t forget to check the medical data: Diagnosis: Date of first clinical signs: Participation in a clinical trial: Medications : Surgical history : Data entered: yes no