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).