The evaluation of non-use of the upper limb in chronic hemiparesis is influenced by the level of motor impairment and difficulty of the activities-proposal of a new version of the Motor Activity Log

Abstract

This study aims to evaluate the influence of the degree of difficulty of the activities in Motor Activity Log (MAL) scores for patients with mild, moderate, and severe hemiparesis, and to estimate the correlation between motor impairment levels of hemiparesis and MAL scores in post-stroke patients. Sixty-six patients with chronic hemiparesis (49 with mild-moderate hemiparesis, and 17 with severe hemiparesis) were evaluated by the Fugl-Meyer upper-limb section and versions of MAL for different degrees of motor impairment. The Rasch model was used to analyze the level of difficulty of the activities of the different versions of MAL. The Spearman's correlation tested the relationship between the Fugl-Meyer Assessment upper-limb section and MAL. The MAL version, developed to evaluate patients with severe hemiparesis, does not contain the easier activities as employed by the Rasch analysis. There was positive correlation between the Fugl-Meyer Assessment upper-limb section scores and Amount of Use of the three versions of the MAL (r = 0.76, 0.78, and 0.77). The difficulty of the activities seems to influence the quantity and quality of use of the affected upper limb in individuals with chronic hemiparesis. A new version of MAL is proposed for individuals with severe motor impairment.

Keywords: Stroke; physical therapy; rehabilitation; upper extremity.