The pediatric motor activity log-revised: assessing real-world arm use in children with cerebral palsy.
OBJECTIVE
Widely accepted models of disability suggest that actual use of an impaired upper extremity in everyday life frequently deviates from its motor capacity, as measured by laboratory tests. Yet, direct measures of real-world use of an impaired upper extremity are rare in pediatric neurorehabilitation. This paper examines how well the Pediatric Motor Activity Log-Revised (PMAL-R) measures this parameter, when the PMAL-R is administered as a structured interview as originally designed.


METHODS
Parents of 60 children between 2 and 8 years of age with upper-extremity hemiparesis due to cerebral palsy completed the PMAL-R twice. Additionally, the children were videotaped during play structured to elicit spontaneous arm use. More-affected arm use was scored by masked raters; it was thought to reflect everyday activity since no cues were given about which arm to employ. Testing sessions were separated by 3 weeks, during which 29 children received upper-extremity rehabilitation and 31 did not.


RESULTS
The PMAL-R had high internal consistency (Cronbach's alpha = .93) and test-retest reliability (r = .89). Convergent validity was supported by a strong correlation between changes in PMAL-R scores and more-affected arm use during play, r(53) = .5, p < .001.


CONCLUSIONS
The PMAL-R interview is a reliable and valid measure of upper-extremity pediatric neurorehabilitation outcome.
Department of Psychology, University of Alabama at Birmingham.
Gitendra
G
Uswatte
Department of Psychology, University of Alabama at Birmingham.
Edward
E
Taub
Department of Physical Therapy and Occupational Therapy, Children's Hospital of Alabama, University of Alabama at Birmingham.
Angi
A
Griffin
Department of Occupational Therapy, University of Alabama at Birmingham.
Laura
0000-0003-4559-0537
L
Vogtle
Department of Occupational Therapy, University of Alabama at Birmingham.
Jan
J
Rowe
Department of Psychology, University of Alabama at Birmingham.
Joydip
J
Barman
D000203:Activities of Daily Living / Q000145:classification; D001132:Arm; D002547:Cerebral Palsy / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D010291:Paresis / Q000175:diagnosis / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011446:Prospective Studies