Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale

Matuti, Gabriela da Silva; Santos, Juliana Firmo dos; Silva, Ana Carolina Rodrigues da; Eras-Garcia, Rafael; Uswatte, Gitendra; Taub, Edward

doi:10.1590/0004-282X20160084

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Sumário

Clinical Scales Criteria and Tools • Arq. Neuro-Psiquiatr. 74 (7) • July 2016 • https://doi.org/10.1590/0004-282X20160084 copy

Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale

Tradução e adaptação transcultural da escala Pediatric Motor Activity Log-Revised

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The standardized instrument developed to assess the use of the affected upper limb in children with cerebral palsy (CP) is the Pediatric Motor Activity Log Revised (PMAL-R).

Objectives

To translate PMAL-R and adapt for the Brazilian culture; analyze the reliability and the internal consistency of the Brazilian version.

Method

Translation of PMAL-R to the Portuguese-Brazil and back translation. The back-translated version was revised by the authors of the scale. The final version was administered to a sample of 24 patients with spastic hemiparesis CP between 2–8 years.

Results

The reliability intra and inter-rater were suitable (how often = 0.97 and 0.98, how well = 0.98 and 0.99 respectively) and so the internal consistency (0.98).

Conclusion

The Brazilian version of PMAL-R has adequate internal consistency, reliability intra and inter raters and can be used to assess the spontaneous use of the upper limb of children with CP type spastic hemiparesis, aged 2–8 years.

cerebral palsy; upper extremity; activities of daily living; evaluation

	Shoulder	Elbow	Wrist	Fingers	Thumb
Grade 2	Flexion & Abduction ≥ 45°	Extension ≥ 20° from a 90° flexed starting position	Extension ≥ 20°	Extension of all MCP and IP (either PIP or DIP) joints ≥ 10°; may be assessed by attempting to pick up and drop tennis ball	Extension or abduction of thumb ≥ 10°
Grade 3	Flexion & Abduction ≥ 45°	Extension ≥ 20° from a 90° flexed starting position	Extension ≥ 10°	Extension of MCP and IP (either PIP or DIP) joints of at least 2 fingers ≥ 10°; may be assessed by attempting to pick up and drop a washcloth	Extension or abduction of thumb ≥ 10°
Grade 4	Flexion & Abduction ≥ 45°	Extension ≥ 20° from a 90° flexed starting position	Extension ≥ 10°	Extension of at least 2 fingers > 0° and < 10°; may be assessed by attempting to pick up and drop a washcloth	Extension or abduction of thumb ≥ 10°
Grade 5
Subclass A	Flexion, abduction, or scaption ≥ 30°	Initiate extension & flexion at the elbow	Must be able to either initiate extension of the wrist or initiate extension of any digit.
Subclass A	Flexion, abduction, or scaption ≥ 30°	Initiate extension & flexion at the elbow	Maximal Motor Criteria: wrist extension >10°, thumb abduction >10°, and initiate extension of at least 2 additional digits
Subclass B	Flexion, abduction, or scaption ≥ 30°	Extension ≥ 20° from a 90° flexed starting position.	No active movement required for the wrist, fingers, or thumb.
Subclass B	Flexion, abduction, or scaption ≥ 30°	Extension ≥ 20° from a 90° flexed starting position.	Maximal Motor Criteria: wrist extension >10°, thumb abduction >10°, and initiate extension of at least 2 additional digits

Variable	Patients (n = 24)
Age (years)	5.0 ± 1.7
Age (months)	66.2 ± 20.6
Gender n (%)
Male	10 (41.7)
Female	14 (58.3)
Topographic diagnosis
Left	14 (58.3)
Right	10 (41.7)
Motor degrees n (%)
2	12 (50)
3	12 (50)

Questioned terminology (understandable / not understandable)	Percentage of not understandable (NU%)		Suggestions

	High stratum	Low stratum
6. Put arm through sleeve of garment	0 (0)	9 (60)	Wear a shirt, put the arm inside the shirt sleeve, dressing the arm through the sleeve of a shirt.
18. Hold a small ball	3 (20)	9 (60)	Holding a small ball with one hand, holding a ping-pong ball (or the same size).
19. Throwing a ball or a small object	0 (0)	3 (20)	Size of the ball, give an example.
20. Use a cylindrical object (e.g., highlighter, crayons)	1 (7)	0 (0)	Cylindrical word, should give an example.

Variable	ICC	Confidence interval (95%)	p
Intra rater reliability
HO	0.97	(0.94–0.99)	< 0.0001
HW	0.98	(0.96–0.99)	< 0.0001
Inter rater reliability
HO	0.98	(0.97–0.99)	< 0.0001
HW	0.997	(0.994–0.999)	< 0.0001

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[1] Correspondence: Gabriela da Silva Matuti; Rua Lourdes Lopes Sanches, 300; 07190-033 Guarulhos SP, Brasil; E-mail: gabrielamatuti@hotmail.com