Motor Activity Log (MAL)

 

Motor Activity Log (MAL) Evaluation Summary

  What does the tool measure? Real life upper limb performance.
  What types of clients can the tool be used for? Individuals following stroke and their caregivers.
  Is this a screening or assessment tool? Assessment
  What domain of the ICF does this measure? Activity/participation
Time to administer 20 minutes
  Versions MAL-30
MAL-28
MAL-26
MAL-14
MAL-12
Graded Motor Activity Log
Lower-Functioning Motor Activity Log (LF-MAL)
Lower-Extremity Motor Activity Log
Pediatric Motor Activity Log – Revised
Languages Brazilian-Portuguese, English, German, Portuguese, Turkish.
Measurement Properties
  Reliability

Internal consistency:
– MAL-14: 2 studies reported excellent internal consistency.
– MAL: 1 study reported excellent internal consistency; 1 study reported excellent internal consistency among patients with mild-moderate hemiparesis and adequate to excellent internal consistency among patients with severe hemiparesis.
– MAL-28 (Turkish): 1 study reported excellent internal consistency.
– MAL-30 (German): 1 study reported excellent internal consistency.
– Grade 4/5 MAL: 1 study reported excellent internal consistency.

Test-retest reliability:
MAL-14: 1 study reported excellent test-retest reliability; 1 study reported adequate to excellent test-retest reliability.
– MAL: 1 study reported excellent test-retest reliability; 1 study reported adequate to excellent test-retest reliability.
– MAL-28 (Turkish): 1 study reported excellent test-retest reliability.
– MAL-28 (Brazilian): 1 study reported excellent test-retest reliability.
– MAL-45: 1 study reported excellent test-retest reliability.
– Grade 4/5 MAL: 1 study reported excellent test-retest reliability.

Intra-rater reliability:
– No studies have reported on the intra-rater reliability of the MAL.

Inter-rater reliability:
– MAL-14: 1 study reported adequate inter-rater reliability.

  Validity

Content:
No studies have reported on content validity of the MAL.

Criterion:
Concurrent:
– MAL-14: 1 study reported excellent correlations with accelerometry.
– MAL: 3 studies reported an excellent correlation with SIS – Hand function domain; adequate correlations with the BBT, ARAT, FAI; poor to adequate correlations with SIS, SS-QOL, NEADL; and poor correlations with the Nine Hole Peg Test.
– MAL-30 (German): 1 study reported excellent negative correlations with WMFT-PT; excellent correlations with WMFT-FA and Grip strength scores, CMSA – Arm and Hand scores, isometric strength.
– MAL-45: 1 study reported excellent correlations with the Abilhand.
Predictive
– No studies have reported on predictive validity of the MAL.

Construct:
– MAL-14: 1 study reported excellent correlations between QOM and AOU patient/carer change scores; 1 study reported an excellent correlation between AOU and QOM scales.
– MAL: 1 study reported an excellent correlation between AOU and QOM scales; 1 study reported an adequate correlation between AOU and QOM scales; 1 study conducted item analysis and removed 2 items due to low item-total correlations and reliability coefficients; 1 study conducted item fit analysis and principal component analysis.
– MAL (Brazilian): 1 study reported an excellent correlation between AOU and QOM scales.
– MAL-30 (German): 1 study reported excellent correlations between AOU and QOM scales.
– MAL-28 (Turkish): 1 study reported an excellent correlation between AOU and QOM scales.
– LF-MAL: 1 study reported an adequate correlation between the AOU and QOM scales.

Convergent/Discriminant:
– MAL-14: 3 studies reported excellent correlations with ARAT, accelerometry, Simple Test for Evaluating Hand Function (STEF).
– MAL: 7 studies reported excellent correlations with Actual Amount of Use Test, WMFT; adequate to excellent correlations with accelerometry ratios, SIS 2.0 – Hand function scale, FMA-UE; adequate correlations with ARAT, Motor Assessment Scale – Upper Extremity, 16 Hole Peg Test, grip strength; SF-36 – Physical domain; poor to adequate correlations with accelerometry ratios of the less affected arm; poor correlations with the SIS 2.0 – Mobility scale.
– MAL-28 (Turkish): 1 study reported excellent correlations with WMFT-FA; adequate negative correlations with the WMFT-PT.
– MAL (Brazilian): 1 study reported adequate correlations with grip strength of the more affected arm.

Known Group:
– MAL: 1 study reported correlations with accelerometry was stronger among patients with paresis of the dominant arm vs. the non-dominant arm.

  Floor/Ceiling effect – Floor effects are evident when detecting change in lower level and passive functional tasks.
– One study found modest floor effects when the MAL-28 was administered to patients with upper extremity motor recovery at Brunnstrom stage III and higher; and modest floor effects when the LF-MAL was administered to patients with upper extremity motor recovery at Brunnstrom stage III and lower.
  Does the tool detect change in patients? The MAL can be used to detect change.
  Acceptability

The MAL reflects real life functional performance. It is simple and non-invasive to administer.

Feasibility The MAL is a free tool that requires no additional equipment. It can be administered in the clinical setting or the patient’s home. No additional training is required.
How to obtain the tool? Click here to see the Motor Activity Log manual.