The Motor Activity Log-28
Assessing daily use of the hemiparetic arm after stroke
Abstract
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.
Get full access to this article
View all available purchase options and get full access to this article.
Supplementary Material
References
1.
Fugl-Meyer AR, Jaasko L, Leyman I, Olson S, Steglind S. The post-stroke hemiplegic patient: a method for evaluation of physical performance. Scand J Rehabil Med 1975;7:13–31.
2.
Tiffin J, Asher EJ. The Purdue Pegboard: norms and studies of reliability and validity. J Appl Psychol 1948;32:234–247.
3.
Mahoney RI, Barthel DW. Functional evaluation: the Barthel Index. Midstate Med J 1965;14:61–65.
4.
Uswatte G, Taub E, Morris D, Vignolo M, McCulloch K. Reliability and validity of the upper-extremity Motor Activity Log-14 for measuring real-world arm use. Stroke 2005;36:2493–2496.
5.
Taub E, Miller NE, Novack TA, et al. Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil 1993;74:347–354.
6.
Taub E, Uswatte G, King DK, Morris D, Crago J, Chatterjee A. A placebo controlled trial of Constraint-Induced Movement therapy for upper extremity after stroke. Stroke 2006;37:1045–1049.
7.
Uswatte G, Taub E. Implications of the learned nonuse formulation for measuring rehabilitation outcomes: lessons from Constraint-Induced Movement therapy. Rehabil Psychol 2005;50:34–42.
8.
Andrews K, Stewart J. Stroke recovery: he can but does he? Rheumatol Rehabil 1979;18:43–48.
9. . Abstract.
Uswatte G, Box L, Mark V, et al. Validity of a brief observational test of upper extremity motor nonuse. J Neurol Phys Ther 2003;27:172
10.
Sterr A, Freivogel S, Schmalohr D. Neurobehavioral aspects of recovery: assessment of the learned nonuse phenomenon in hemiparetic adolescents. Arch Phys Med Rehabil 2002;83:1732–1735.
11.
Winstein CJ, Miller P, Blanton S, et al. Methods for a multisite randomized trial to investigate the effect of constraint-induced movement therapy in improving upper extremity function among adults recovering from a cerebrovascular stroke. Neurorehabil Neural Repair 2003;17:137–152.
12.
Taub E. Somatosensory deafferentation research with monkeys: implications for rehabilitation medicine. In: Ince LP, ed. Behavioral psychology in rehabilitation medicine: clinical applications. New York: Williams & Wilkins, 1980:371–401.
13.
Taub E, Morris DM, Bowman M, Uswatte G. Upper-extremity Motor Activity Log [manual]. (Available from Edward Taub, Psychology Department, UAB, CH415, 1530 3rd Avenue S., Birmingham, AL 35294), 2000.
14.
Uswatte G, Foo WL, Olmstead H, Lopez K, Holand A, Simms ML. Ambulatory monitoring of arm movement using accelerometry: an objective measure of upper-extremity rehabilitation in persons with chronic stroke. Arch Phys Med Rehabil 2005;86:1498–1501.
15. . Abstract.
Uswatte G, Taub E. Participant-centered and objective measures of real-world arm function in persons with stroke. Circulation 2004;109:e243
16.
Uswatte G, Miltner WHR, Foo B, Varma M, Moran S, Taub E. Objective measurement of functional upper extremity movement using accelerometer recordings transformed with a threshold filter. Stroke 2000;31:662–667.
17.
Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke 1999;30:2131–2140.
18.
Melanson Jr EL Freedson PS. Validity of the Computer Science Applications, Inc. (CSA) activity monitor. Med Sci Sports Exerc 1995;27:934–940.
19.
Patterson SM, Krantz LC, Montgomery LC, Deuster PS, Hedges SM, Nebel LE. Automated physical activity monitoring: validation and comparison with physiological and self-report measures. Psychophysiology 1993;30:296–305.
20.
Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 1959;56:81–105.
21.
Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979;86:420–428.
22.
Cohen J. Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
23.
National Center for Health Statistics. Health, United States, 2004 with Chartbook on Trends in the Health of Americans. Hyattsville, MD: Centers for Disease Control, 2004.
24. . Abstract.
Uswatte G, Lopez K, Taub E. Reliability of a new observation system for measuring arm function in the home. Rehabil Psychol 2002;47:376
25.
van der Lee J, Beckerman H, Knol DL, de Vet HCW, Bouter LM. Clinimetric properties of the Motor Activity Log for the assessment of arm use in hemiparetic patients. Stroke 2004;35:1–5.
26.
Taub E. Movement in nonhuman primates deprived of somatosensory feedback. In: Exercise and sports science reviews. Santa Barbara, CA: Journal Publishing Affiliates, 1977:335–374.
Information & Authors
Information
Published In
Copyright
© 2006.
Publication History
Published online: October 9, 2006
Published in print: October 10, 2006
Authors
Metrics & Citations
Metrics
Citation information is sourced from Crossref Cited-by service.
Citations
Download Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.
Cited By
- Vibration-Induced Illusory Movement Task Can Induce Functional Recovery in Patients With Subacute Stroke, Cureus, (2024).https://doi.org/10.7759/cureus.66667
- Enhancing Activity Recognition After Stroke: Generative Adversarial Networks for Kinematic Data Augmentation, Sensors, 24, 21, (6861), (2024).https://doi.org/10.3390/s24216861
- Data Augmentation Techniques for Accurate Action Classification in Stroke Patients with Hemiparesis, Sensors, 24, 5, (1618), (2024).https://doi.org/10.3390/s24051618
- Optimizing Epoch Length and Activity Count Threshold Parameters in Accelerometry: Enhancing Upper Extremity Use Quantification in Cerebral Palsy, Sensors, 24, 4, (1100), (2024).https://doi.org/10.3390/s24041100
- Brain state-dependent repetitive transcranial magnetic stimulation for motor stroke rehabilitation: a proof of concept randomized controlled trial, Frontiers in Neurology, 15, (2024).https://doi.org/10.3389/fneur.2024.1427198
- The use of accelerometer bracelets to evaluate arm motor function over a stroke rehabilitation period – an explorative observational study, Journal of NeuroEngineering and Rehabilitation, 21, 1, (2024).https://doi.org/10.1186/s12984-024-01381-2
- Comparisons of three different modes of digital mirror therapy for post-stroke rehabilitation: Preliminary results of randomized controlled trial, DIGITAL HEALTH, 10, (2024).https://doi.org/10.1177/20552076241260536
- Effects of a Wearable-Based Intervention on the Hemiparetic Upper Limb in Persons With Stroke: A Randomized Controlled Trial, Neurorehabilitation and Neural Repair, (2024).https://doi.org/10.1177/15459683241283412
- Wearable-Based Kinematic Analysis of Upper-Limb Movements During Daily Activities Could Provide Insights into Stroke Survivors’ Motor Ability, Neurorehabilitation and Neural Repair, 38, 9, (659-669), (2024).https://doi.org/10.1177/15459683241270066
- Patient Outcomes After Peripheral Nerve Injury Depend on Bimanual Dexterity and Preserved Use of the Affected Hand, Neurorehabilitation and Neural Repair, 38, 2, (134-147), (2024).https://doi.org/10.1177/15459683241227222
- See more
Loading...
View Options
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Personal login Institutional LoginPurchase Options
The neurology.org payment platform is currently offline. Our technical team is working as quickly as possible to restore service.
If you need immediate support or to place an order, please call or email customer service:
- 1-800-638-3030 for U.S. customers - 8:30 - 7 pm ET (M-F)
- 1-301-223-2300 for customers outside the U.S. - 8:30 - 7 pm ET (M-F)
- [email protected]
We appreciate your patience during this time and apologize for any inconvenience.