Psychometric properties of the Pediatric Motor Activity Log used for children with cerebral palsy

Abstract

The Pediatric Motor Activity Log (PMAL) is a parent‐report measure of the use, by children with hemiplegic cerebral palsy (CP), of their affected upper limb in everyday activities. The aim of this study was to examine the psychometric properties of both scales of the PMAL (‘How Often’ and ‘How Well’ scales) using Rasch measurement modelling. Sixty‐one parents of children with hemiplegic CP completed the PMAL and 31 completed it again 3 weeks later. The mean age of children was 4 years 6 months (SD 1y 9mo); 35 males, 26 females. Children were at Gross Motor Function Classification System (GMFCS) levels I (83%) and II (17%), and Manual Ability Classification System levels I (35%), II (52%), and III (14%). The original scales were found to have disordered rating scale structure. Further Rasch modelling with collapsed rating scale structures resulted in both scales conforming to the expectations of the Rasch model, yielding strong evidence for construct validity and reliability. One item from the How Often scale failed to conform to Rasch expectations and was deleted in subsequent analyses. Test–retest reliability of both scales was high (the intraclass correlation coefficient for the How Often scale was 0.94, and for the How Well scale 0.93). The revised scales possess good psychometric properties, specifically a logical item hierarchy, evidence of unidimensionality, adequate rating scale structure, and good test–retest reliability. We conclude that the revised PMAL has the capacity to yield valid and reliable scores except for children at the extremes of upper limb ability.

Efficacy of Upper Limb Therapies for Unilateral Cerebral Palsy: A Meta-analysis

“…57 The original version 6 lacks sufficient evidence of reliability and validity. Subsequently, a revised version submitted to Rasch analysis was reported 58 in addition to a second alternative revision. 59 Both revisions were called PMAL-R, causing confusion over the version used in each study.…”

“…A further validity study of the original PMAL found only fair criterion validity for the how well domain (how well the child uses their impaired UL) but suggested that the measure was markedly sensitive to change. 60 Because each version of the PMAL, however, has different items, rating scales, mode of administration, and overall limited psychometric data, 58 we chose to exclude these data from meta-analysis. Future studies using the PMAL to evaluate realworld use of the impaired UL should accurately cite the relevant version used.…”

Constraint Induced Movement Therapy and Real-World Arm Use in Children With Hemiparesis

“…Both scales, which range from 0-5, are anchored at six points by abbreviated phrases and longer definitions; interviewees may select scores halfway between the anchors. Conversion for HW items scores (0, 1, or 2 = 0; 3 = 1; 4 or 5 = 2) and HO item scores (0 or 1 = 0; 2 or 3 = 1; 4 or 5 = 2) based on the mean of the item scores used to derive the total scores for each scale [13]. The PMAL-R had high internal consistency and Convergent validity was supported by a strong correlation between changes in PMAL-R scores and more-affected arm use during play which verify The PMAL-R interview as a reliable and valid measure of upper-extremity pediatric neurorehabilitation [14].…”

Tecnologia assistiva para a promoção de atividades da vida diária com crianças em contexto hospitalar

“…Wallen et al (2008) Stewart et al (2010), foi avaliado um teste australiano que auxilia cuidadores a acessar informações, organizar ideias e se comunicar a respeito da criança. Já Fingerhut (2009), desenvolveu o Life Participation for Parents (LPP), que avalia a satisfação dos pais em relação à sua própria eficiência e eficácia na participação em muitas esferas da vida, enquanto criam uma criança com deficiência.…”

“…Alguns artigos demonstraram a tendência do uso de abordagens centradas na família (CUSICK; LANNIN; LOWE, 2007;FINGERHUT, 2009;GALVIN et al, 2010;HARRIS;DANIELS, 1996;HOYT-HALLETT et al, 2009;MAJNEMER;ROSENBLATT, 1994;STEWART et al, 2010;WALLEN et al, 2008). Segundo Galvin et al (2010) esta prática está baseada na idéia de que os pais são os especialistas quando se trata de sua criança e de que cada família é única.…”