Deans' stroke musings: The Motor Activity Log-28 Assessing daily use of the hemiparetic arm after stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, May 14, 2024

The Motor Activity Log-28 Assessing daily use of the hemiparetic arm after stroke

Assessments are completely worthless unless they point directly to the 100% recovery protocols. I see nothing here that suggests you go from the assessment to the chosen 100% recovery protocol. When the hell will the stroke medical world do ANYTHING TO GET STROKE SOLVED? I'd have you all fired! A lot of dead wood needs to removed in stroke and until that occurs stroke will never be solved!

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

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.

NEUROLOGY 2006;67:1189–1194