van der Lee J H, Beckerman H, Knol D L, de Vet H C W, Bouter L M
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Stroke. 2004 Jun;35(6):1410-4. doi: 10.1161/01.STR.0000126900.24964.7e. Epub 2004 Apr 15.
The Motor Activity Log (MAL) is a semistructured interview for hemiparetic stroke patients to assess the use of their paretic arm and hand (amount of use [AOU]) and quality of movement [QOM]) during activities of daily living. Scores range from 0 to 5. The following clinimetric properties of the MAL were quantified: internal consistency (Cronbach alpha), test-retest agreement (Bland and Altman method), cross-sectional construct validity (correlation between AOU and QOM and with the Action Research Arm [ARA] test), longitudinal construct validity (correlation of change on the MAL during the intervention with a global change rating [GCR] and with change on the ARA), and responsiveness (effect size).
Two baseline measurements 2 weeks apart and 1 follow-up measurement immediately after 2 weeks of intensive exercise therapy either with or without immobilization of the unimpaired arm (forced use) were performed in 56 chronic stroke patients.
Internal consistency was high (AOU: alpha=0.88; QOM: alpha=0.91). The limits of agreement were -0.70 to 0.85 and -0.61 to 0.71 for AOU and QOM, respectively. The correlation with the ARA score (Spearman rho) was 0.63 (AOU and QOM). However, the improvement on the MAL during the intervention was only weakly related to the GCR and to the improvement on the ARA, Spearman rho was between 0.16 and 0.22. The responsiveness ratio was 1.9 (AOU) and 2.0 (QOM).
The MAL is internally consistent and relatively stable in chronic stroke patients not undergoing an intervention. The cross-sectional construct validity of the MAL is reasonable, but the results raise doubt about its longitudinal construct validity.
运动活动日志（MAL）是一种针对偏瘫性脑卒中患者的半结构化访谈，用于评估其在日常生活活动中患侧手臂和手的使用情况（使用量[AOU]）及运动质量[QOM]）。评分范围为0至5分。对MAL的以下临床测量特性进行了量化：内部一致性（克朗巴哈系数）、重测一致性（布兰德-奥特曼法）、横断面结构效度（AOU与QOM之间以及与动作研究臂[ARA]测试的相关性）、纵向结构效度（干预期间MAL的变化与整体变化评分[GCR]以及与ARA变化的相关性）和反应性（效应量）。
对56例慢性脑卒中患者进行了两次间隔2周的基线测量，以及在2周强化运动治疗后立即进行的1次随访测量，运动治疗分为患侧手臂固定（强制使用）或不固定两种情况。
内部一致性较高（AOU：α=0.88；QOM：α=0.91）。AOU和QOM的一致性界限分别为-0.70至0.85和-0.61至0.71。与ARA评分的相关性（斯皮尔曼等级相关系数）为0.63（AOU和QOM）。然而，干预期间MAL的改善与GCR以及ARA的改善仅存在微弱相关性，斯皮尔曼等级相关系数在0.16至0.22之间。反应性比率为1.9（AOU）和2.0（QOM）。
在未接受干预的慢性脑卒中患者中，MAL具有内部一致性且相对稳定。MAL的横断面结构效度合理，但结果对其纵向结构效度提出了质疑。
