The Hammersmith Functional Motor Scale (HFMS) was originally developed to assess the physical abilities of children with non-ambulant Spinal Muscular Atrophy, it was developed by Marion Main and colleagues at the Hammersmith Hospital in 2003. It consists of 20 items which they felt were important to to measure the physical functioning of those with SMA type 2 and those who are SMA type 3 who are no longer independently mobile, and was ordered in level of item difficulty. The physiotherapist asks the person with SMA to do a specific activity such as rolling and they then grade the quality and execution of that movement on a scale of 0 being unable, 1 performed with some compensation, and 2 unaided. The total score achievable on the orginal HFMS is 40 (Main et al, 2003).
The Modified Hammersmith Functional Motor Scale (MHFMS) contains the exact same items (20), scoring (0, 1, 2) and total score (40) as the original HFMS but it is arranged in a different order this was due to minimise any impact of fatigue on the assessment and to enable it's use in clinical trials (Krosschell et al., 2006). Therefore the HFMS was re-ordered to limit positional changes, the Hammersmith Scale as used in the UK is ordered as the MHFMS although it is still referred to as the HFMS.
The Hammersmith Functional Motor Scale Expanded (HFMSE) is as the name suggests, is an expanded version of the HFMS. It starts with the modified order of the MHFMS containing the original 40 items of the Hammersmith Scale but is expanded to contain additional items for the ambulant (mobile) type 3 SMA population. O'Hagen et al. (2007) looked at another scale known as the Gross Motor Function Measure (initially designed for use in Cerebral Palsy) to find additional items which may be relevant to the SMA type 3 population. They found 13 items relevant for use and expanded the HFMS to incorporate these items for example, rising from the floor, squatting, jumping, using the stairs. Therefore the HFMSE is a scale used for the assessment of physical abilities in type 2 and 3 SMA. It contains 33 items which are scored on a scale of 0, 1, 2 with a total achievable score of 66.
The Hammersmith Scale in its two main forms MHFMS and HFMSE is routinely used in clinical practice and in clinical trials internationally. The manual for the HFMSE can be found here.
SMA REACH UK has been working on an international collaborative project to improve the measurement properties of the HFMSE and expand it's utility further given the exciting developments currently occurring in the SMA field, to ensure we have an outcome measure which is fit for purpose for today's standards. This resulted in the development of the Revised Hammersmith Scale; this is a 36 item scale (maximum score 69) with two timed tests which tests the abilities of people with type 2 and 3 SMA, it was published in February 2017, for more information on this new scale please click here.
One further version of the original Hammersmith Scale is the MHFMS-Extend, it contains 8 additional items (28 total) and a timed test module containing 5 further items, this is used by the Project Cure SMA group in the United States of America but has not been adopted by the SMA community as a whole.
Danielle Ramsey, 19th November 2016 (updated 7th May 2017).
The Hammersmith Functional Motor Scale Expanded (HFMSE) is as the name suggests, is an expanded version of the HFMS. It starts with the modified order of the MHFMS containing the original 40 items of the Hammersmith Scale but is expanded to contain additional items for the ambulant (mobile) type 3 SMA population. O'Hagen et al. (2007) looked at another scale known as the Gross Motor Function Measure (initially designed for use in Cerebral Palsy) to find additional items which may be relevant to the SMA type 3 population. They found 13 items relevant for use and expanded the HFMS to incorporate these items for example, rising from the floor, squatting, jumping, using the stairs. Therefore the HFMSE is a scale used for the assessment of physical abilities in type 2 and 3 SMA. It contains 33 items which are scored on a scale of 0, 1, 2 with a total achievable score of 66.
The Hammersmith Scale in its two main forms MHFMS and HFMSE is routinely used in clinical practice and in clinical trials internationally. The manual for the HFMSE can be found here.
SMA REACH UK has been working on an international collaborative project to improve the measurement properties of the HFMSE and expand it's utility further given the exciting developments currently occurring in the SMA field, to ensure we have an outcome measure which is fit for purpose for today's standards. This resulted in the development of the Revised Hammersmith Scale; this is a 36 item scale (maximum score 69) with two timed tests which tests the abilities of people with type 2 and 3 SMA, it was published in February 2017, for more information on this new scale please click here.
One further version of the original Hammersmith Scale is the MHFMS-Extend, it contains 8 additional items (28 total) and a timed test module containing 5 further items, this is used by the Project Cure SMA group in the United States of America but has not been adopted by the SMA community as a whole.
Danielle Ramsey, 19th November 2016 (updated 7th May 2017).
RSS Feed