學院

醫學院

系所

職能治療學系

題名

Using Rasch analysis to validate the Motor Activity Log and the Lower Functioning Motor Activity Log in patients with stroke

作者

Chuang, I-C., Lin, K-C., Wu, C-Y.*, Hsieh, Y-W., Liu, C-T., & Chen, C-L.

期刊名稱

Physical Therapy

發表日期

2017

著作性質

原著

語文

英文

關鍵字

stroke, Rasch analysis, rehabilitation, validity, Motor Activity Log, Lower Functioning Motor Activity Log

摘要

Background. 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.

Objective. 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.