RESUMO
PURPOSE: This study examined the clinimetrics of the Brazilian-Portuguese translation of the Grade-4/5 Motor Activity Log (MAL 4/5), which assesses everyday use of the more affected upper-limb (UL) in stroke survivors with moderate/severe or severe motor impairment. MATERIALS AND METHODS: The translated MAL 4/5 was administered to 47 stroke survivors with moderate/severe or severe UL motor impairment. Accelerometers were worn on participants' wrists for five days on average prior to the first assessment. Test-retest and inter-rater reliabilities were assessed using the intraclass correlation coefficient (ICC), internal consistency using Cronbach's α, and construct validity was tested with correlations with the accelerometry. The measurement error (SEM) and the minimal detectable change (MDC) were calculated. RESULTS: MAL4/5-Brazil's test-retest reliability (AOU: ICC = 0.84; QOU: ICC = 0.90), inter-rater reliability (AOU: ICC = 0.83; QOU: ICC = 0.91), internal consistency (Cronbach's α = 0.91 and 0.95 for AOU and QOU scales, respectively), the SEM and MDC were 0.3 and 0.8 points for the AOU subscale and 0.2 and 0.5 points for the QOU subscale, respectively. The construct validity (AOU scale: r = 0.67; QOU scale: r = 0.76) was high. CONCLUSION: Grade-4/5 Motor Activity Log-Brazil is a reliable and valid instrument for assessing the more-affected UL use of stroke patients with moderate/severe or severe UL motor impairments.
Reliability and concurrent validity of the Grade-4/5 MAL-Brazil were established in adults with hemiparesis moderate/severe or severe upper extremity post Stroke.The minimum detectable change for the Grade-4/5 MAL-Brazil was 0.8 points for the Amount of Use scale and 0.5 points for the Quality of Use scale.Data from the accelerometry supports the construct validity of this instrument.The assessment can now be used clinically and for research in adults with impairment upper extremity moderate/severe or severe post Stroke.
RESUMO
Introdução: Os movimentos dos membros superiores são frequentemente realizados em conjunto com outras tarefas, o que pode afetar o seu desempenho. Objetivos: Avaliar o desempenho de movimentos dirigidos a alvos em jovens, quando uma tarefa cognitiva é realizada simultaneamente. Método: Vinte jovens sadios, destros, realizaram traçados entre dois alvos, o mais rápido possível, sobre uma mesa digitalizadora, com o membro direito e esquerdo, isoladamente e durante a tarefa cognitiva. Alvos de diferentes dimensões (0,5 cm, 1 cm e 1,5 cm) ou posicionados em distâncias distintas do ponto de partida (15 cm, 25 cm e 35 cm) foram utilizados. Resultados: A duração foi maior para completar o traçado quando realizando a tarefa cognitiva, principalmente para os homens. A duração e o erro de linearidade foram maiores em razão da distância do alvo. Conclusão: A execução de uma tarefa cognitiva secundária interfere negativamente no desempenho de movimentos dos membros superiores dirigidos ao alvo.
Introduction: Upper limb movements are often performed in conjunction with other tasks, which may affect its performance. Objectives: To evaluate the performance of movements toward a target in younger when a cognitive task is simultaneously performed. Methods: Twenty young adults, right-handed, traced a line between two targets, as fast as possible, on a tablet, with the right and left upper limb, isolated and during the cognitive task. Targets of different dimensions (0.5 cm, 1 cm and 1.5 cm) or placed on distinct distances from the initial point (15 cm, 25cm and 35 cm) were used. Results: The duration was greater to reach the target when the cognitive task was performed simultaneously, in particular for the men. The duration and the linearity error were greater for targets placed more distant. Conclusion: The execution of a secondary cognitive task interferes negatively on the performance of the upper limb movements toward a target.
