Validity and responsiveness of the German version of the Motor Activity Log for the assessment of self-perceived arm use in hemiplegia after stroke

Abstract

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 ␣. 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 ␣ = 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 followup (SRM = 0.95-1.34). CONCLUSION: The German MAL-30 is a valid and responsive assessment for self-perceived arm and hand use after stroke even when function is low.

Feasibility of an individualised, task-oriented, video-supported home exercise programme for arm function in patients in the subacute phase after stroke: protocol of a randomised controlled pilot study

“…The German version is a valid, reliable and highly responsive assessment. 48 Minimal clinically important difference (MCID) values for the MAL were 1.0 and 1.1 points for the affected dominant and non-dominant hands, respectively. 49 …”

“…Self-perceived arm and hand use arm function A change in self-perceived arm and hand function will be measured by the German Motor Activity Log-30 (MAL-30), 48 a semistructured interview that scores the perceived amount of use and perceived quality of movement (QOM) in 30 ADL tasks, using a 6-point scale ranging from 0 (arm not used during activity; no satisfaction with QOM) to 5 (arm used as much as prestroke; full satisfaction with QOM). The German version is a valid, reliable and highly responsive assessment.…”

Kinematic measures of Arm-trunk movements during unilateral and bilateral reaching predict clinically important change in perceived arm use in daily activities after intensive stroke rehabilitation

“…The MAL was originally designed for patients with hemiparetic stroke and has frequently been used to evaluate the effectiveness of interventions such as CIT and BAT [ 10 , 37 , 38 ]. The MAL has shown good reliability ( r = 0.82) and concurrent validity with the Wolf Motor Function Test (Spearman ρ = 0.64–0.99) [ 39 , 40 ].…”

Den Alltag im Fokus – ausgewählte Assessments im Überblick

“…Für die alltagsbezogene Diagnostik bei Menschen mit Neglect stehen das AANA [44] und die CBS [45,46] zur Verfügung. Bei Klient*innen mit Hemiparese kommen neben dem AMAT beispielsweise der MAL [46,47] und die AD-AHA Stroke [48] infrage [10].…”

“…Das Assessment liegt in englischer Sprache vor[10], es werden im deutschsprachigen Raum Fortbildungen hierfür angeboten. Er erfragt auf der Basis eines strukturierten Interviews, wie Klient*innen den Einsatz ihres betroffenen Armes bei typischen uni-und bilateralen Tätigkeiten im Alltag einschätzen[46,47]. Er findet in der S3-Leitlinie "Rehabilitative Therapie bei Armparese nach Schlaganfall" Erwähnung[10,49].…”