oru.sePublikationer
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Responsiveness and validity of the Motor Activity Log in patients during the subacute phase after stroke
Örebro University, School of Health and Medical Sciences. Örebro University Hospital, Örebro, Sweden.
Uppsala Univ, Dept Neurosci, Sect Physiotherapy, Uppsala, Sweden.
2010 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 14, 1184-1193 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate the responsiveness and cross-sectional and longitudinal validity of the Motor Activity Log (MAL) in the subacute phase after stroke.

Method: Data were collected pre-intervention, post-intervention, and at 3-month follow-up evaluations from 30 patients with stroke participating in a randomized trial of forced use. Assessments included MAL, the Fugl-Meyer test, the 16-hole peg test, grip strength, the Action Research Arm Test, and the Motor Assessment Scale. Measurements of responsiveness were effect size, standardized response mean (SRM), and responsiveness ratio (RR). Relationships between the MAL and the other measures were determined with Spearman correlations.

Results: The MAL is responsive to change, with effect size, SRM, and RR ›1.0 at the 3-month follow-up, and SRM and RR ›1.0 at post-intervention. Correlations at the separate test occasions between MAL and the other measures were mostly close to 0.50, which shows fair to moderate construct validity. Correlations between changes in MAL and in the other measures were weaker than cross-sectional relationships.

Conclusions: The MAL is a responsive measure of daily hand use in patients participating in rehabilitation in the subacute phase after stroke. Correlations of construct validity indicate that daily hand use may need to be measured separately from body function and activity capacity, in line with the underlying constructs of International Classification of Functioning, Disability and Health. To strengthen our findings, they should be repeated in larger samples of patients.

Place, publisher, year, edition, pages
London, United Kingdom: Informa Healthcare, 2010. Vol. 32, no 14, 1184-1193 p.
Keyword [en]
Stroke, motor activity log, upper limb
National Category
Physiotherapy Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-9597DOI: 10.3109/09638280903437253ISI: 000278592900007PubMedID: 20128630Scopus ID: 2-s2.0-77952932502OAI: oai:DiVA.org:oru-9597DiVA: diva2:292092
Available from: 2010-02-04 Created: 2010-02-04 Last updated: 2017-02-15Bibliographically approved
In thesis
1. Forced use on arm function after stroke: clinically rated and self-reported outcome and measurement during the sub-acute phase
Open this publication in new window or tab >>Forced use on arm function after stroke: clinically rated and self-reported outcome and measurement during the sub-acute phase
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
”Forced use” för armfunktion efter stroke : kliniskt bedömda och självrapporterade resultat samt mätmetoder i subakut fas
Abstract [en]

The overall aim was to evaluate the effectiveness of forced use on arm and hand recovery after stroke by applying a restraining sling on the non-affected arm and to investigate psychometric properties of selected upper limb measures.

Papers I and II reported a randomised trial with 1- and 3-month follow-ups. Thirty patients 1 to 6 months after stroke were included and received regular training for 2 weeks of intervention. The forced-use group had in addition a restraining sling on the non-paretic arm. Outcome measures were the Fugl-Meyer Assessment, the Modified Ashworth scale, the 16-hole peg test, grip force, the Action Research Arm test, and the Motor Assessment Scale (Paper I), and the Motor Activity Log (MAL) (Paper II). Results in Papers I and II showed no statistical difference in change between groups. Both groups improved over time.

Paper III assessed the responsiveness of the MAL and its cross-sectional and longitudinal validity. The MAL was responsive to change, with Standardised Response Means and Responsiveness Ratios larger than 1.0. Correlations between the MAL and the other measures were mostly close to 0.50.

Paper IV investigated test–retest intra-rater reliability of measuring grip force with Grippit, and assessed relationships between grip forces of both hands, and between sustained and peak grip force. The paretic hand needs to score a change of 10% or 50 N to exceed the measurement error. The mean ratio between sides was 0.66, and between sustained and peak grip force, 0.80–0.84.

In conclusion, this thesis provides preliminary evidence that forced use does not generate greater improvement on upper limb motor impairment, capacity, and performance of activity than regular rehabilitation. The findings indicate that the MAL is a responsive measure of daily hand use in patients with stroke. Correlations of construct validity indicated that daily hand use might need to be measured separately from body function and activity capacity. The coefficients calculated for repeatability and reproducibility were acceptable, and the Grippit instrument can be recommended.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2010. 101 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 39
Keyword
stroke, upper limb, reliability, validity, ICF, forced use, motor function, effectiveness, rehabilitation, physiotherapy, grip force
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-9601 (URN)978-91-7668-715-4 (ISBN)
Public defence
2010-03-19, Wilandersalen, Universitetssjukhuset Örebro, M-huset, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-02-09 Created: 2010-02-04 Last updated: 2013-05-16Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedScopus

Search in DiVA

By author/editor
Hammer, Ann M.
By organisation
School of Health and Medical Sciences
In the same journal
Disability and Rehabilitation
PhysiotherapyMedical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 363 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf