Validity and responsiveness of the German version of the Motor Activity Log for the assessment of self-perceived arm use in hemiplegia after stroke.
BACKGROUND
Rehabilitation of patients after stroke requires valid and responsive assessments for arm and hand function to determine the effectiveness of rehabilitative interventions. The Motor Activity Log (MAL) aims to assess self-perceived arm and hand use after stroke. Its clinimetric properties are incomplete and contradictory.


OBJECTIVE
To investigate internal consistency, concurrent validity and responsiveness of the German MAL-30 in patients after stroke with minimal to moderate arm and hand function.


METHODS
42 patients were included in this longitudinal prospective cohort study. Internal consistency was determined in a complete-case analysis with Cronbach's α. Concurrent validity was assessed with Spearman' rho by comparing the German MAL-30 with Wolf Motor Function Test, Chedoke McMaster Stroke Assessment, isometric elbow, shoulder and grip strength at baseline, post-treatment and 6 month follow-up. Responsiveness was determined separately for lower and higher arm and hand function by calculating the standardized response mean.


RESULTS
Internal consistency was excellent (Cronbach's α = 0.94-0.99), concurrent validity good to excellent (Spearman's rho = 0.64-0.99). Responsiveness was high for both functional levels from baseline to discharge (SRM = 0.93-1.43) and to follow-up (SRM = 0.95-1.34).


CONCLUSIONS
The German MAL-30 is a valid and responsive assessment for self-perceived arm and hand use after stroke even when function is low.
Department of Neurology and Neurorehabilitation, Rehabilitation Center Valens, Valens, Switzerland.
Christine
C
Meier Khan
Peter
P
Oesch
D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D018737:Hand Strength / Q000502:physiology; D006429:Hemiplegia / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012649:Self Concept; D020521:Stroke / Q000150:complications
Stroke; arm- and hand use; assessment; self-perceived