Article

Efficacy of task-oriented training can be reliably trusted only when
the inherent measurement variability is determined. The Actual Amount of Use Test
(AAUT) and the Motor Activity Log (MAL) have been used together as measures of
spontaneous arm use after an intervention; however, the minimal detectable change
(MDC) of AAUT and MAL has not been addressed. OBJECTIVE: To compare the MDC(9)(0)
of the AAUT and the MAL in the context of a randomized controlled trial of a
neurorehabilitation intervention, the Extremity Constraint-Induced Therapy
Evaluation trial. METHODS: A preplanned secondary analysis was conducted using
pre-post test data from the control group. Estimated MDC(9)(0) were normalized to
the maximum value of the scale of the AAUT and the MAL for each subscale: amount
of use (AAUTa, MALa) and quality of movement (AAUTq, MALq). RESULTS: . The
MDC(9)(0) of the AAUTq and the MALq were 14.4% and 15.4%, respectively. However,
the MDC(9)(0) required greater change for the AAUTa (24.2%) than the MALa
(16.8%). The training-induced spontaneous arm use exceeded the MDC(9)(0) for the
MAL but fell below that for the AAUT immediately after the intervention and at
1-year follow-up visit. CONCLUSIONS: The greater variability and insensitivity to
treatment effect for the AAUTa is likely because of the low resolution of its
scoring system. As such, there is a considerable need to develop valid and
reliable tools that capture purposeful arm use outside the laboratory, perhaps
through leveraging new sensing technologies with objective activity monitoring.

Langue : ANGLAIS