| → | CHOP INTEND |
| → | HFMSE |
| → | HINE |
| → | 6MWT |
| → | CMAP、MUNE |
上肢肌力測試（ULM）是為了評估無法行走的SMA病患所開發的，它可以了解患者日常生活中的身體行動能力。對於較虛弱病人，HFMSE只能評估部分的上肢肌力。17ULM對SMA病患（30個月大至27歲）的評估已經證實有效，其中包括無法行走的年輕病患和虛弱的孩童。18 該模組包含9個可以在短時間內（5-10分鐘）利用普通器具執行的任務（例如，用鉛筆繪製連續的線條、拿起硬幣並放入杯子、按下按鈕來開啟一盞燈、舉起一個飲料罐飲用、從塑料容器上移開蓋子、提起一個重物並將其在預先印製的紙上從一個圈移動到另一個圈）。18 
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ULM的分數在12個月內可能保持相對穩定。17研究人員對晚發型SMA（II型和III型）無法行走的病患（n = 74）做了研究；年齡範圍為3.5〜29歲（平均年齡10.22，標準差 6.15）。17相較於基線 (平均10.23，標準差 4.81)，第12個月ULM分數增加0.04分 (標準差1.17)。 大部分大於或等於2分的變化發生在小於或等於5歲的兒童中。7
ULM中大於±1-2分的變化被認為可能有臨床意義。17 |
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修訂版的上肢肌力測試 (RULM)：解決ULM的天花板效應，讓測試能更廣泛地運用在SMA病患群中。RULM共有20個項目，最高分數為37分。各項目評分為0至2分19，包含評估肩膀、手肘、手腕、手指部位的運動功能。以下為施測前的重點注意事項，以維持評估的信度：
RULM 測試前注意事項
須有椅背、椅面和地面平行、雙腳能踩到地面或輪椅踏板
桌椅擺放位置一致、桌面調至輪椅扶手或病人肚臍高度
按量表題項順序執行
每次都由同一位治療師施測，減少評估過程之變異性
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依照患者狀態選用較適合的運動功能評估工具
目前仍無一個運動功能評估工具能適用於所有的 SMA 患者。評估者應依照病患的功能狀態，選用適合的運動功能評估工具34 ，避免如天花板或地板效應，讓患者真實的進步得以反應。
REFERENCES
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SMA患者的基本活動能力與病情進展如何決定日常活動與生活方式？
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