A Revised Motor Activity Log Following Rasch Validation (Rasch-Based MAL-18) and Consensus Methods in Chronic Stroke and Multiple Sclerosis.
Ann Van de Winckel, Lynne Gauthier
PMID 31423899WHAT IT FOUND
A revised 18-item Motor Activity Log gives therapists a clearer way to rate how well a person with stroke or MS uses their affected arm in daily life.
It removes items that are not universally applicable and includes a table to convert scores.
Key findings
01The revised scale kept 18 items after content review and model fit checks removed other items.
02A table converts original Motor Activity Log scores into Rasch-based scores.
03When the same person was rated before and after treatment, scores needed correction; without correction, change was underestimated by 15.05%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The MS group was smaller than the stroke group, so item calibration is based primarily on people with stroke. The data came from four laboratory-based CI therapy studies, not from routine clinical practice. Test-retest reliability was checked in only 19 participants, 9 with stroke. The Amount-of-Use scale was excluded, so the revised scale does not separately measure amount of arm use. The scale is a self-assessment, so scores depend on the participant's report rather than observed performance. Some daily activities were removed because they were not universally applicable or did not require upper-extremity use, which may limit coverage of all arm tasks. Response dependency required correction for stacked pre- and post-treatment scores, so uncorrected comparisons may misstate change.
Declared interests
Funding included NIH extramural and non-U.S. government support. Dr Van de Winckel disclosed nothing. Dr Gauthier reported grants or contracts from PCORI, AHA, Rudi Schulte Foundation, and National MS Society during the conduct of the study.
The easy way to misread this
Do not read this as evidence that constraint-induced movement therapy or comparator interventions improve arm use. The study validates a measurement scale. The 15.05% figure is about correcting pre- and post-treatment scores, not a treatment benefit.