on April 15, 2004
Published online before print April 15, 2004, doi: 10.1161/01.STR.0000126900.24964.7e
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Submitted on July 31, 2003
From Department of Rehabilitation Medicine (J.H.v.d.L., H.B.) and Institute for Research in Extramural Medicine (EMGO Institute) (J.H.v.d.L., H.B., D.L.K., H.C.W.d.V., L.M.B.), VU University Medical Center, Amsterdam, the Netherlands. Present affiliation for J.H.v.d.L.: Center for Pediatric Clinical Epidemiology, Academic Medical Center, Amsterdam, the Netherlands. * To whom correspondence should be addressed. E-mail: J.H.vanderLee{at}amc.uva.nl.
Background and Purpose--The Motor Activity Log (MAL) is a semistructured interview for hemiparetic stroke patients to assess the use of their paretic arm and hand (amount of use [AOU]) and quality of movement [QOM]) during activities of daily living. Scores range from 0 to 5. The following clinimetric properties of the MAL were quantified: internal consistency (Cronbach Methods--Two baseline measurements 2 weeks apart and 1 follow-up measurement immediately after 2 weeks of intensive exercise therapy either with or without immobilization of the unimpaired arm (forced use) were performed in 56 chronic stroke patients. Results--Internal consistency was high (AOU: Conclusion--The MAL is internally consistent and relatively stable in chronic stroke patients not undergoing an intervention. The cross-sectional construct validity of the MAL is reasonable, but the results raise doubt about its longitudinal construct validity.
Revised on January 12, 2004
Accepted on February 17, 2004
Clinimetric Properties of the Motor Activity Log for the Assessment of Arm Use in Hemiparetic Patients
J. H. van der Lee MD, PhD*;
), test-retest agreement (Bland and Altman method), cross-sectional construct validity (correlation between AOU and QOM and with the Action Research Arm [ARA] test), longitudinal construct validity (correlation of change on the MAL during the intervention with a global change rating [GCR] and with change on the ARA), and responsiveness (effect size).=0.88; QOM: =0.91). The limits of agreement were -0.70 to 0.85 and -0.61 to 0.71 for AOU and QOM, respectively. The correlation with the ARA score (Spearman 
) was 0.63 (AOU and QOM). However, the improvement on the MAL during the intervention was only weakly related to the GCR and to the improvement on the ARA, Spearman was between 0.16 and 0.22. The responsiveness ratio was 1.9 (AOU) and 2.0 (QOM).
Key words: rehabilitation • disability evaluation • outcome assessment
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