Self-reported use of the paretic lower extremity of people with stroke: A reliability and validity study of the Lower-Extremity Motor Activity Log (LE-MAL) – Brazil

• Published in: Physiotherapy theory and practice Vol. 39; no. 8; pp. 1727 - 1735
• Main Authors: Cristine de Faria, Lisandra, Barbosa Marques, Darlene, Hellen dos Santos Cerqueira Gomes, Laura, dos Anjos, Sarah, Pereira, Natalia Duarte
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 03.08.2023
• Subjects: Brazil; Clinical assessment; Cross-Sectional Studies; Humans; Limbs; Lower Extremity; Lower limbs; Measures; Motor Activity; Rehabilitation; Reliability; Reproducibility of Results; Self Report; Stroke; Stroke - diagnosis; Stroke Rehabilitation; Translation; Validation studies; Validity; Brazil; self-reported; gait; Outcome assessment; stroke; lower extremity
• ISSN: 0959-3985; 1532-5040; 1532-5040
• DOI: 10.1080/09593985.2022.2043966

Most measures to assess the lower extremity (LE) after a neurological injury assess the lower limb motor capacity in the laboratory or clinical settings as the lower-extremity motor subscale of Fugl Meyer Assessment (FMA-LE). The LE Motor Activity Log (LE-MAL) measures the use of paretic LE in real-life conditions, which for many researchers and stakeholders is considered an important goal of rehabilitation. Investigate the reliability, validity, floor, and ceiling effects of the Brazilian version of the LE-MAL. Cross-sectional study to examine the reliability and validity of LE-MAL in patients with chronic stroke. The translation and adaptation of LE-MAL was carried out for the Brazilian version. After this stage, to ensure the inter-rater reliability two raters (LCF, DBM) applied the translated version of LE-MAL in the 21 selected participants. Subsequently, the concurrent validity was calculated by the correlation with the FMA-LE. The translation and retro-translation of the LE-MAL was approved to the Brazilian context. A floor effect was not observed, and there was no ceiling effect for the LE-MAL total scores. The Inter-rater reliability ranged between 0.80 and 0.86. The Bland-Altman analysis showed difference of LE-MAL scores ranged from 0.8 to 1.6. The Cronbach's alpha coefficients for LE-MAL and subscales were high ranging between 0.86 and 0.80. There was a significant moderate correlation between the LE-MAL and FMA-LE (Pearson correlation 0.55 (p = .009)). The Brazilian version LE-MAL is valid and reliable to assess real-world use of the paretic LE of individuals with chronic stroke.