Published online before print April 15, 2004, doi: 10.1161/01.STR.0000126900.24964.7e
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(Stroke. 2004;35:1410.)
© 2004 American Heart Association, Inc.
Original Contributions |
Clinimetric Properties of the Motor Activity Log for the Assessment of Arm Use in Hemiparetic Patients
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.
Correspondence to J. H. van der Lee, AMC-KEK H3-144, PO Box 22660, 1100 DD Amsterdam, the Netherlands. 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 
), 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).
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: =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).
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.
Key Words: rehabilitation • disability evaluation • outcome assessment
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