Making if-then plans counteracts learned non-use in stroke patients: A proof-of-principle study

Reliability and Validity of the Motor Activity Log (MAL-30) Scale for Post-Stroke Patients in a Spanish Sample

BACKGROUND

The validation of assessment instruments is of great importance when they are applied in clinical and healthcare settings, since their safe and reliable use is essential for the application of appropriate and high-quality treatments. The motor activity log (MAL-30) is an instrument widely used by professionals in the clinic, which has been validated in different countries, languages and populations. The aim of this study was to determine the reliability and validity of the MAL-30 scale for post-stroke patients in a Spanish sample.

METHODS

For this purpose, internal consistency tests were carried out using Cronbach's alpha, item-item and item-total correlations, and a half-and-half test for reliability. For the validation, criterion validity tests were performed using the Fugl-Meyer assessment scale as the gold standard, and the convergent validity tests were carried out by correlation with the action research arm test (ARAT), box and block test (BBT), functional independence measure (FIM)-functional assessment measure (FAM), Lawton and Brody index and stroke quality of life scale (ECVI-38).

RESULTS

The results showed good internal consistency, as well as a good criterion and convergent validity.

CONCLUSIONS

The MAL-30 instrument can be considered a valid and reliable tool for assessing the quantity and quality of the use of the affected upper limb in the performance of the activities of daily living and the instrumental activities of daily living after stroke in a Spanish sample.

Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function

BACKGROUND

Constraint-Induced Movement therapy (CIMT) has controlled evidence of efficacy for improving real-world paretic limb use in non-progressive physically disabling disorders (stroke, cerebral palsy).

OBJECTIVE

This study sought to determine whether this therapy can produce comparable results with a progressive disorder such as multiple sclerosis (MS). We conducted a preliminary phase II randomized controlled trial of CIMT versus a program of complementary and alternative medicine (CAM) treatments for persons with MS, to evaluate their effect on real-world disability.

METHODS

Twenty adults with hemiparetic MS underwent 35 hours of either CIMT or CAM over 10 consecutive weekdays. The primary clinical outcome was change from pretreatment on the Motor Activity Log (MAL).

RESULTS

The CIMT group improved more on the MAL (2.7 points, 95% confidence interval 2.2-3.2) than did the CAM group (0.5 points, 95% confidence interval -0.1 to 1.1; P < .001). These results did not change at 1-year follow-up, indicating long-term retention of functional benefit for CIMT. The treatments were well tolerated and without adverse events.

CONCLUSION

These results suggest that CIMT can increase real-world use of the more-affected arm in patients with MS for at least 1 year.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov NCT01081275.