NEUROLOGY 2006;67:1189-1194
© 2006 American Academy of Neurology
The Motor Activity Log-28
Assessing daily use of the hemiparetic arm after stroke
G. Uswatte, PhD,
E. Taub, PhD,
D. Morris, PhD, PT,
K. Light, PhD, PT and
P. A. Thompson, PhD
From the Department of Psychology (G.U., E.T.), University of Alabama at Birmingham; Department of Physical Therapy (G.U., D.M.), School of Allied Health; University of Alabama at Birmingham, Birmingham, AL; Department of Physical Therapy (K.L.), University of Florida, Gainesville, FL; and Division of Biostatistics (P.A.T.), Washington University School of Medicine, St. Louis, MO.
Address correspondence and reprint requests to Dr. Gitendra Uswatte, University of Alabama at Birmingham, 1530 3rd Avenue South, CH415, Birmingham, AL 35294; e-mail: guswatte{at}uab.edu
Background: Data from monkeys with deafferented forelimbs and humans after stroke indicate that tests of the motor capacity of impaired extremities can overestimate their spontaneous use. Before the Motor Activity Log (MAL) was developed, no instruments assessed spontaneous use of a hemiparetic arm outside the treatment setting.
Objective: To study the MAL’s reliability and validity for assessing real-world quality of movement (QOM scale) and amount of use (AOU scale) of the hemiparetic arm in stroke survivors.
Methods: Participants in a multisite clinical trial completed a 30-item MAL before and after treatment (n = 106) or an equivalent no-treatment period (n = 116). Participants also completed the Stroke Impact Scale (SIS) and wore accelerometers that monitored arm movement for three consecutive days outside the laboratory. All were 3 to 12 months post-stroke and had mild to moderate paresis of an upper extremity.
Results: After an item analysis, two MAL tasks were eliminated. Revised participant MAL QOM scores were reliable (r =0.82). Validity was also supported. During the first observation period, the correlation between QOM and SIS Hand Function scale scores was 0.72. The corresponding correlation for QOM and accelerometry values was 0.52. Participant QOM and AOU scores were highly correlated (r = 0.92).
Conclusions: The participant Motor Activity Log is reliable and valid in individuals with subacute stroke. It might be employed to assess the real-world effects of upper extremity neurorehabilitation and detect deficits in spontaneous use of the hemiparetic arm in daily life.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 10 issue to find the title link for this article.
Supported in part by grants from the National Institutes of Health (HD 37606, HD34273) and American Heart Association Southeast Affiliate (0365163B).
Disclosure: The authors report no conflicts of interest.
Received November 29, 2005. Accepted in final form June 12, 2006.
This article has been cited by other articles:
|
|
|
|
 
K.-c. Lin, Y.-a. Chen, C.-l. Chen, C.-y. Wu, and Y.-f. Chang
The Effects of Bilateral Arm Training on Motor Control and Functional Performance in Chronic Stroke: A Randomized Controlled Study
Neurorehabil Neural Repair,
January 1, 2010;
24(1):
42 - 51.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. Schweighofer, C. E. Han, S. L. Wolf, M. A. Arbib, and C. J. Winstein
A Functional Threshold for Long-Term Use of Hand and Arm Function Can Be Determined: Predictions From a Computational Model and Supporting Data From the Extremity Constraint-Induced Therapy Evaluation (EXCITE) Trial
Physical Therapy,
December 1, 2009;
89(12):
1327 - 1336.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. V. Gauthier, E. Taub, V. W. Mark, C. Perkins, and G. Uswatte
Improvement After Constraint-Induced Movement Therapy Is Independent of Infarct Location in Chronic Stroke Patients * Supplemental Methods
Stroke,
July 1, 2009;
40(7):
2468 - 2472.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K.-c. Lin, Y.-f. Chang, C.-y. Wu, and Y.-a. Chen
Effects of Constraint-Induced Therapy Versus Bilateral Arm Training on Motor Performance, Daily Functions, and Quality of Life in Stroke Survivors
Neurorehabil Neural Repair,
June 1, 2009;
23(5):
441 - 448.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K.-c. Lin, Y.-h. Huang, Y.-w. Hsieh, and C.-y. Wu
Potential Predictors of Motor and Functional Outcomes After Distributed Constraint-Induced Therapy for Patients With Stroke
Neurorehabil Neural Repair,
May 1, 2009;
23(4):
336 - 342.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. Hammer and B. Lindmark
Is forced use of the paretic upper limb beneficial? A randomized pilot study during subacute post-stroke recovery
Clinical Rehabilitation,
May 1, 2009;
23(5):
424 - 433.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Brogardh, U.-B. Flansbjer, and J. Lexell
What is the long-term benefit of constraint-induced movement therapy? A four-year follow-up
Clinical Rehabilitation,
May 1, 2009;
23(5):
418 - 423.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Rijntjes, K. Haevernick, A. Barzel, H. van den Bussche, G. Ketels, and C. Weiller
Repeat Therapy for Chronic Motor Stroke: A Pilot Study for Feasibility and Efficacy
Neurorehabil Neural Repair,
March 1, 2009;
23(3):
275 - 280.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K.-c. Lin, C.-y. Wu, J.-s. Liu, Y.-t. Chen, and C.-j. Hsu
Constraint-Induced Therapy Versus Dose-Matched Control Intervention to Improve Motor Ability, Basic/Extended Daily Functions, and Quality of Life in Stroke
Neurorehabil Neural Repair,
February 1, 2009;
23(2):
160 - 165.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S.-W. Park, S. L. Wolf, S. Blanton, C. Winstein, and D. S. Nichols-Larsen
The EXCITE Trial: Predicting a Clinically Meaningful Motor Activity Log Outcome
Neurorehabil Neural Repair,
September 1, 2008;
22(5):
486 - 493.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. Dahl, T. Askim, R. Stock, E. Langorgen, S. Lydersen, and B. Indredavik
Short- and long-term outcome of constraint-induced movement therapy after stroke: a randomized controlled feasibility trial
Clinical Rehabilitation,
May 1, 2008;
22(5):
436 - 447.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. L Wolf
On "Modified constraint-induced therapy..." Page et al. Phys Ther. 2008;88:333-340.
Physical Therapy,
May 1, 2008;
88(5):
680 - 684.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. V. Gauthier, E. Taub, C. Perkins, M. Ortmann, V. W. Mark, and G. Uswatte
Remodeling the Brain: Plastic Structural Brain Changes Produced by Different Motor Therapies After Stroke * Supplemental Material
Stroke,
May 1, 2008;
39(5):
1520 - 1525.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V.W. Mark, E. Taub, C. Perkins, L.V. Gauthier, G. Uswatte, and J. Ogorek
Poststroke Cerebral Peduncular Atrophy Correlates with a Measure of Corticospinal Tract Injury in the Cerebral Hemisphere
AJNR Am. J. Neuroradiol.,
February 1, 2008;
29(2):
354 - 358.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K.-C. Lin, C.-Y. Wu, T.-H. Wei, C. Gung, C.-Y. Lee, and J.-S. Liu
Effects of modified constraint-induced movement therapy on reach-to-grasp movements and functional performance after chronic stroke: a randomized controlled study
Clinical Rehabilitation,
December 1, 2007;
21(12):
1075 - 1086.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. L. Wolf, C. J. Winstein, J. P. Miller, S. Blanton, P. C. Clark, and D. Nichols-Larsen
Looking in the Rear View Mirror When Conversing With Back Seat Drivers: The EXCITE Trial Revisited
Neurorehabil Neural Repair,
October 1, 2007;
21(5):
379 - 387.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. L. Wolf, C. J. Winstein, J. P. Miller, E. Taub, G. Uswatte, D. Morris, C. Giuliani, K. E. Light, D. Nichols-Larsen, and for the EXCITE Investigators
Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial.
JAMA,
November 1, 2006;
296(17):
2095 - 2104.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
