The Motor Activity Log (MAL) assesses the spontaneous use of the most affected upper limb with the amount of use (AOU) and quality of movement (QOM) scales during daily activities in real environments in individuals with chronic stroke. Objectives: This study translated the testing manual into Portuguese and assessed the inter-rater and test-retest reliabilities of the MAL, based upon the Brazilian manual version. Methods: The inter-rater reliability was evaluated by comparing the results of two examiners, and the test-retest reliability was tested by comparing the results of two evaluations, repeated one-week apart with 30 individuals with chronic hemiparesis (55.8±15.1 years). Results: The intra-class correlation coefficients (ICCs) for the total scores were adequate for both the inter-rater (0.98 for the AOU and 0.91 for QOM) and test-retest reliabilities (0.99 for both scales). Conclusions: The results suggested that the MAL was reliable to evaluate the spontaneous use of the most affected upper limb after stroke.

Introduction : The Graded Wolf Motor Function Test (GWMFT) was developed as a modification of the Wolf Motor Function Test (WMFT), designed to address moderate-to-severe upper-extremity motor impairment, consequent to a stroke or brain injury, by combining time and quality of movement measures in both isolated movements and functional tasks. Objectives : To translate and adapt the GWMFT form and instructions manual to Brazilian Portuguese and evaluate the inter-rater reliability. Materials and methods : Ten individuals, mean age 53.2 ± 11.39 (range: 28-72) years and a mean time since stroke onset of 82.5 ± 85.83 (16-288) months participated in the study. After translation and cultural adaptation, two independent evaluators, based on the instructions manual information, administered GWMFT. Video observations were used to rate the time and the compensatory movements in the Functional Ability Scale (FAS). Intra-class Correlation Coefficients (ICCs) and Bland-Altman plots were calculated to examine the inter-rater reliability for performance time and FAS. Results : The translated and adapted version obtained a total ICC inter-rater time 0.99 (0.95-1.00), showing less reliability in the task of lifting a pen, with ICC = 0.71 (- 0.15-0.93). The ICC of the total FAS was 0.98 (0.92-0.99) and the task of elbow extension has shown the lowest ICC rate = 0.83 (0.31-0.96). Conclusion : The GWMFT scale reliability proved to be appropriate to evaluate the paretic upper limb in individuals with chronic hemiparesis post severe stroke.

Background: The Wolf Motor Function Test (WMFT) evaluates the upper limb (UL) performance of adults with hemiparesis by combining

BACKGROUND: People with stroke excessively move their trunk, when reaching and grasping objects. OBJECTIVE: To determine if the addition of trunk restraint to modified constraint-induced movement therapy (mCIMT) was better than mCIMT alone in improving strength, function, and quality of life after stroke. METHODS: A pilot randomized double-blinded clinical trial was conducted. Twenty-two participants with chronic stroke were randomly assigned to an experimental group that received mCIMT plus trunk restraint, or a control group (only mCIMT). Primary outcomes were the amount of use and quality of movement of the paretic upper limb (UL), determined by the Motor Activity Log (MAL) scores. Secondary outcomes included the observed performance of the paretic UL during unimanual and bimanual tasks, kinematics of reaching, strength, and quality of life. RESULTS: Both groups demonstrated significant improvements in the MAL scores and in the time to perform bimanual activities immediately after the interventions. However, no between-group differences were observed. CONCLUSIONS: The addition of trunk restraint to mCIMT resulted in no additional benefits, compared with mCIMT alone with stroke individuals with mild to moderate impairments. Unimanual and bimanual improvements were observed after mCIMT, regardless of trunk restraint, and the intervention did not adversely affect their reaching patterns.

Objective:To investigate the influence of hand dominance on the maintenance of gains after home-based modified constraint-induced movement therapy (mCIMT). Method:Aprevious randomized controlled trial was conducted to examine the addition of trunk restraint to the mCIMT. Twenty-two chronic stroke survivors with mild to moderate motor impairments received individual home-based mCIMT with or without trunk restraints, five times per week, three hours daily over two weeks. In this study, the participants were separated into dominant group, which had their paretic upper limb as dominant before the stroke (n=8), and non-dominant group (n=14) for analyses. The ability to perform unimanual tasks was measured by the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL), whereas the capacity to perform bimanual tasks was measured using the Bilateral Activity Assessment Scale (BAAS). Results:Analysis revealed significant positive effects on the MAL amount of use and quality of the movement scales, as well as on the BAAS scores after intervention, with no differences between groups. Both groups maintained the bimanual improvements during follow-ups (BAAS-seconds 0.1, 95% CI -10.0 to 10.0), however only the dominant group maintained the unilateral improvements (MAL-amount of use: 1.5, 95% CI 0.7 to 2.3; MAL-quality: 1.3, 95% CI 0.5 to 2.1). Conclusions:Upper limb dominance did not interfere with the acquisition of upper limb skills after mCIMT. However, the participants whose paretic upper limb was dominant demonstrated better abilities to maintain the unilateral gains. The bilateral improvements were maintained, regardless of upper limb dominance.