Department of Neurology and Neurorehabilitation, Rehabilitation Center Valens, Valens, Switzerland.
NeuroRehabilitation. 2013;33(3):413-21. doi: 10.3233/NRE-130972.
Rehabilitation of patients after stroke requires valid and responsive assessments for arm and hand function to determine the effectiveness of rehabilitative interventions. The Motor Activity Log (MAL) aims to assess self-perceived arm and hand use after stroke. Its clinimetric properties are incomplete and contradictory.
To investigate internal consistency, concurrent validity and responsiveness of the German MAL-30 in patients after stroke with minimal to moderate arm and hand function.
42 patients were included in this longitudinal prospective cohort study. Internal consistency was determined in a complete-case analysis with Cronbach's α. Concurrent validity was assessed with Spearman' rho by comparing the German MAL-30 with Wolf Motor Function Test, Chedoke McMaster Stroke Assessment, isometric elbow, shoulder and grip strength at baseline, post-treatment and 6 month follow-up. Responsiveness was determined separately for lower and higher arm and hand function by calculating the standardized response mean.
Internal consistency was excellent (Cronbach's α = 0.94-0.99), concurrent validity good to excellent (Spearman's rho = 0.64-0.99). Responsiveness was high for both functional levels from baseline to discharge (SRM = 0.93-1.43) and to follow-up (SRM = 0.95-1.34).
The German MAL-30 is a valid and responsive assessment for self-perceived arm and hand use after stroke even when function is low.
脑卒中患者的康复需要有效的、可反应的上肢和手功能评估，以确定康复干预的效果。运动活动日志（MAL）旨在评估脑卒中后患者的自我感知上肢和手的使用情况。其临床测量特性不完整且相互矛盾。
调查在上肢和手功能轻度至中度的脑卒中患者中，德国 MAL-30 的内部一致性、同时效度和反应性。
这项纵向前瞻性队列研究纳入了 42 名患者。在完整病例分析中，使用 Cronbach's α 评估内部一致性。通过比较德国 MAL-30 与 Wolf 运动功能测试、Chedoke McMaster 卒中评估、等长肘、肩和握力，在基线、治疗后和 6 个月随访时，使用 Spearman' rho 评估同时效度。分别为上肢和手功能较低和较高的患者计算标准化反应均值，以确定反应性。
内部一致性极好（Cronbach's α = 0.94-0.99），同时效度良好至极好（Spearman's rho = 0.64-0.99）。从基线到出院（SRM = 0.93-1.43）和随访（SRM = 0.95-1.34），对于两种功能水平，反应性均较高。
即使功能较低，德国 MAL-30 也是一种有效的、可反应的脑卒中后自我感知上肢和手使用的评估方法。
