Hammersmith Functional Motor Scale Expanded (HFMSE)

The HFMSE measures what a person with spinal muscular atrophy can physically do, and is the standard motor outcome in SMA clinical trials. It covers a wide functional range in one scale — from rolling and sitting through transfers and standing to walking, running, and jumping — arranged in order of increasing difficulty.

Thirty-three items are each scored 0, 1, or 2: unable, able with modification or adaptation, or able without adaptation. The total runs 0 to 66, with higher meaning more motor function. It was designed for later-onset SMA, type 2 and type 3, in people aged two and above. Equipment needs are minimal and the layout accounts for fatigue, which matters in this population.

Licensing Notes: Distributed through ePROVIDE/Mapi Trust, which manages permissions and translations. A users' manual and scoring sheet accompany the scale.

Learn More: A 3-point change is treated as clinically meaningful — it means the person improved on at least two motor skills. Reported intra-rater reliability is ICC 0.99, and the HFMSE correlates almost perfectly with the GMFM (r = 0.98).