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Physical assessments for individuals with spinal muscular atrophy (SMA)

Various scales are used to evaluate changes in motor function and physical ability.
These assessments should only be performed by a trained
healthcare provider (HCP)

A healthcare provider (HCP) will determine an appropriate assessment based on age and physical ability (ambulatory vs nonambulatory).
Select from the options below to learn more about some of these assessments.
Infants with SMA

View the assessments for infantile-onset (Type 1) SMA

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Children and Adults with SMA

View the assessments for later-onset (Types 2 and 3) SMA

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Physical assessments for infantile-onset SMA

The Hammersmith Infant Neurological Examination (HINE) Section 2

The HINE Section 2 measures changes in key developmental motor milestones in infants and weaker children with SMA. Results are measured on a point system used to score improvement or worsening in motor milestone achievement.

8 motor milestones scored:
8 motor milestones scored in Hammersmith Infant Neurological Examination (HINE) Section 2
See the full
HINE Sec 2 criteria

Assessment criteria

Spinal Muscular Atrophy HINE Criteria
Spinal Muscular Atrophy HINE Criteria
Spinal Muscular Atrophy HINE Criteria

The Children’s Hospital of Philadelphia Infant Test of Neurological Disorders (CHOP INTEND)

The CHOP INTEND measures incremental motor function changes such as increased movement, flexibility and strength.

16 motor functions scored within 4 categories:

8 motor milestones scored in Hammersmith Infant Neurological Examination (HINE) Section 2
See the full CHOP
INTEND criteria

Assessment criteria

Spinal Muscular Atrophy CHOP INTEND Criteria
Spinal Muscular Atrophy CHOP INTEND Criteria
Spinal Muscular Atrophy CHOP INTEND Criteria

Physical assessments for children and adults with SMA

The Hammersmith Functional Motor Scale – Expanded (HFMSE)

The HFMSE measures motor function changes in a broad range of ambulatory and nonambulatory individuals. An increase of ≥2 points is typically considered a clinically meaningful improvement.

This assessment should be performed by a physical therapist or trained HCP.

33 functions scored using 7 categories:

Hammersmith Functional Motor Scale – Expanded in children and adults with spinal muscular atrophy
See the full
HFMSE criteria

Assessment criteria

Spinal Muscular Atrophy Hammersmith Criteria
Spinal Muscular Atrophy Hammersmith Criteria
Spinal Muscular Atrophy Hammersmith Criteria

The 6-Minute Walk Test (6MWT)

The 6MWT is a dynamic exercise assessment that measures fatigue-related changes in walking ability. Participants are instructed to walk as fast as possible along a 25-meter course, turn around, and return in the opposite direction. The course is repeated as often as possible for 6 minutes. Running or jogging is not permitted.

The walking course:
The Six-Minute Walk Test (6MWT) in individuals with spinal muscular atrophy

Assessment criteria

Spinal Muscular Atrophy 6-Minte Walk Criteria
Spinal Muscular Atrophy 6-Minte Walk Criteria
Spinal Muscular Atrophy 6-Minte Walk Criteria

The Revised Upper Limb Module (RULM)

The RULM is an updated version of the Upper Limb Module (ULM) assessment. It includes more activities related to daily life such as lifting heavier objects. The RULM measures upper limb strength in most individuals with SMA while the ULM is typically for weaker, nonambulatory individuals with SMA.

19 activities scored using 7 items:
Upper Limb Module assessment in individuals with spinal muscular atrophy

Assessment criteria

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Graphic
Graphic

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