Motor Assessment Scale
Original Editor - Sinead Greenan
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Objective[edit | edit source]
The Motor Assessment Scale (MAS) is a performance-based scale used to assess level of impairment and everyday motor function in patients with stroke[1][2].
Intended Population[edit | edit source]
Used widely in assessing functional ability for patients with stroke by Physical therapists and Occupational therapists.
Method of Use[edit | edit source]
Description:
- 9 items to assess areas of motor function. Takes 15 mins to complete.
- Patients perform each task 3 times, only the best performance is recorded.
- Items (with the exception of the general tonus item*) are assessed using a 7-point scale (0 to 6)
- A score of 6 indicates optimal motor behavior
*For the general tonus item, the score is based on continuous observations throughout the assessment. A score of 4 on this item indicates a consistently normal response, a score > 4 indicates persistent hypertonus, and a score < 4 indicates various degrees of hypotonus[3].
The 9 items assessment evaluates 5 Mobility and 3 Upper Limb activities, and 1 the severity of involuntary movements UMN lesions (clonus):
- Supine to Side-Lying to intact side
- Supine to Sitting over side of bed
- Balance sitting
- Sitting to standing
- Walking
- Upper arm function
- Hand movements
- Advanced Hand Activities
- General Clonus
Equipment Required:
- Stopwatch
- 8 Jellybeans
- Polystyrene cup
- Rubber ball
- Stool
- Comb
- Spoon
- Pen
- 2 Tea cups
- Water
- Prepared sheet for drawing lines
- Cylindrical shaped object like a jar
- Table
Scoring:
- Item scores (with the exception of the general tonus item) are summed to provide an overall score (out of 48 points)
- For MAS 1 to 5, completing a higher-level item suggests successful performance on lower-level items and thus lower-items can be skipped.
- The upper limb section (MAS 6-8) should be scored non-hierarchical, meaning that every item within the subsets should be scored regardless of its position within the hierarchy[4].
Evidence[edit | edit source]
Reliability[edit | edit source]
Test-retest Reliability:
Chronic Stroke:
(Carr et al, 1985; n = 15; mean age = 70 years, range = 42 to 85)[3]
- Excellent test-retest reliability: r ranged from 0.87 to 1.00 (mean r = 0.98)
Interrater/Intrarater Reliability:
Chronic & Acute Stroke:
(Carr et al, 1985; 20 clinical raters; n = 5; mean age = 65 years, range = 55 to 78; mean time since stroke onset = 14 (range = 6 to 40) weeks)[3]
- Excellent Interrater Reliability; 87% overall agreement between raters (mean correlation r = 0.95; most agreement = balanced sitting (r = 0.99); least agreement = sitting to standing (r = 0.89).
Validity[edit | edit source]
Criterion Validity:
Acute Stroke:
(Malouin et al, 1994, n = 32, mean age = 60 years, mean time since stroke = 64.5 days)[5]
- Excellent Concurrent Validity with Fugl-Meyer (FMA) total scores (r = 0.96, not including general tonus items)
- Adequate to Excellent item level Concurrent Validity between MAS items and similar FMA items (r = 0.65 to 0.93)
- Poor Concurrent Validity with MAS and FMA sitting balance (r = -0.10)
Construct Validity:
Acute Stroke:
(Tyson & DeSouza, 2004; n = 48; mean age = 66.7 (12.5) years; median time since stroke = 11 weeks)[6]
MAS and functional balance test:
- Adequate Convergent Validity: Sitting arm raise (no. of raises; r = 0.33*)
- Adequate Convergent Validity: Sitting forward reach (cm, r = 0.54**)
*p < 0.05
** p < 0.01
Content Validity:
The MAS was developed by Carr and Shepherd (1985) based on many years of experience with similar measures[3]
Responsiveness[edit | edit source]
Chronic & Acute Stroke:
MAS sensitivity[7]:
| Item | Dimension | Effect | Effect Size (d) | % Change |
| 1 | Rolling | Large | 1.03 | 31.1 |
| 2 | Lie to sit | Moderate | 0.74 | 44.3 |
| 3 | Balanced Sitting | Moderate | 0.61 | 60.7 |
| 4 | Sit to Stand | Large | 0.85 | 18 |
| 5 | Walking | Large | 1.02 | 19.7 |
| 6 | Upper arm function | Small | 0.36 | 44.3 |
| 7 | Hand movements | Small | 0.43 | 55.7 |
| 8 | Advanced hand activities | Moderate | 0.50 | 63.9 |
Links[edit | edit source]
References[edit | edit source]
- ↑ Dean, C. M., Mackey, F. M. Motor assessment scale scores as a measure of rehabilitation outcome following stroke. Aust J Physiother. 1992; 38, 31-35.
- ↑ Carr JH, Shepherd RB, Nordholm L, Lynne D. Investigation of a new motor assessment scale for stroke patients. Physical therapy. 1985 Feb 1;65(2):175-80.
- ↑ 3.0 3.1 3.2 3.3 Carr, J. H., Shepherd, R. B., Nordholm, L., Lynne, D. Investigation of a new motor assessment scale for stroke patients. Phys Ther 1985 65: 175-180
- ↑ Pickering RL, Hubbard IJ, Baker KG, Parsons MW. Assessment of the upper limb in acute stroke: the validity of hierarchal scoring for the Motor Assessment Scale. Australian Occupational Therapy Journal. 2010 Jun;57(3):174-82.
- ↑ Malouin, F., Pichard, L., Bonneau, C., Durand, A., Corriveau, D . Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale. Arch Phys Med Rehabil 1994; 75: 1206-1212
- ↑ Tyson, S. F. and DeSouza, L. H. Reliability and validity of functional balance tests post stroke. Clin Rehabil 2004; 18(8): 916-923
- ↑ English, C. K., Hillier, S. L. The sensitivity of three commonly used outcome measures to detect change among patients receiving inpatient rehabilitation following stroke. Clin Rehabil, 2006; 20(1): 52-55
