A Revised Motor Activity Log Following Rasch Validation (Rasch-Based MAL-18) and Consensus Methods in Chronic Stroke and Multiple Sclerosis

I'd have to say this is useless for rehab.

Motor Activity Log (MAL)

Subjective so not useful for determining what rehab protocols should be used. Of course such protocols don't exist yet.

 

A Revised Motor Activity Log Following Rasch Validation (Rasch-Based MAL-18) and Consensus Methods in Chronic Stroke and Multiple Sclerosis 

Ann Van de Winckel PhD, MSPT, PT, Lynne Gauthier, PhD

First Published August 18, 2019 Brief Report

https://doi.org/10.1177/1545968319868717

Article information

Abstract

Objectives. To derive a shorter version of the Motor Activity Log Quality-of-Movement Scale (MAL-28) with enhanced content and construct validity.
Design. Validation cohort.
Setting. Outpatient rehabilitation within an academic laboratory.  
Participants. Retrospective consecutive sample of 149 community-dwelling adults with chronic mild/moderate upper-extremity hemiparesis caused by stroke or multiple sclerosis (MS). Intervention. Not applicable.  
Methods. Participants received the MAL-28 at baseline and following upper-extremity rehabilitation. Rasch Measurement Theory informed threshold ordering of scoring categories, tests of fit, differential item functioning, targeting, response dependency, local dependency, and reliability (person separation index [PSI]). Seasoned examiners rated the content validity of each item. Test-retest reliability of the revised scale was calculated.  
Results. We established content and construct validity for 18 items. The resultant 18-item MAL fit the model (χ² = 77.93; df = 72; P = .30) and targeted the population—that is, minimal floor (12.08%) or ceiling effects (0%), with acceptable reliability (PSI = 0.84) and good test-retest reliability [ICC(1, 1) = 0.86]. The hierarchy of item difficulty was independent of sex, age, affected side, diagnosis, or intervention type used, and there was local dependency in 3 pairs of items. Responses from a subsequent testing session were dependent on the responses from prior testing, indicating response dependency, for which a correction was proposed. Once response dependency was neutralized, there was a 15% greater treatment response.  
Conclusions. Content and construct validity are established for Rasch-based MAL-18 for chronic stages of stroke and MS. A Rasch-based conversion table enables clinical use of the MAL-18.

Keywords validity, Motor Activity Log, stroke, multiple sclerosis, Rasch, upper extremity

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