Article

The Motor Activity Log (MAL) and Lower-Functioning MAL (LF-MAL) are
used to assess the amount of use of the more impaired arm and the quality of
movement during activities in real-life situations for patients with stroke.
This study used Rasch analysis to examine the psychometric properties
of the MAL and LF-MAL in patients with stroke. Design:
This is a methodological
study. Methods: The MAL and LF-MAL include 2 scales: the amount of use (AOU) and
the quality of movement (QOM). Rasch analysis was used to examine the
unidimensionality, item difficulty hierarchy, targeting, reliability, and
differential item functioning (DIF) of the MAL and LF-MAL. Results: A total of
403 patients with mild or moderate stroke completed the MAL, and 134 patients
with moderate/severe stroke finished the LF-MAL. Evidence of disordered
thresholds and poor model fit were found both in the MAL and LF-MAL. After the
rating categories were collapsed and misfit items were deleted, all items of the
revised MAL and LF-MAL exhibited ordering and constituted unidimensional
constructs. The person-item map showed that these assessments were difficult for
our participants. The person reliability coefficients of these assessments ranged
from .79 to .87. No items in the revised MAL and LF-MAL exhibited bias related to
patients' characteristics. Limitations: One limitation is the recruited patients,
who have relatively high-functioning ability in the LF-MAL. Conclusions: The
revised MAL and LF-MAL are unidimensional scales and have good reliability. The
categories function well, and responses to all items in these assessments are not
biased by patients' characteristics. However, the revised MAL and LF-MAL both
showed floor effect. Further study might add easy items for assessing the
performance of activity in real-life situations for patients with stroke.

Langue : ANGLAIS