Motor Assessment Scale

Original Editor - Sinead Greenan

Top Contributors - Sinead Greenan, Kim Jackson, Andeela Hafeez, Rucha Gadgil, Vanessa Rhule, Samuel Winter, Evan Thomas, WikiSysop, Amrita Patro, Scott Buxton, Oyemi Sillo, Naomi O'Reilly and Candace Goh

Objective

The Motor Assessment Scale (MAS) is a performance-based scale used to assess everyday motor function in patients with stroke.

Intended Population

Used widely in assessing functional ability for patients with stroke by Physical therapists and Occupational therapists.

Method of Use

Description:

• 8 items assess 8 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.

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
  

Items Assessed:

• Supine to side lying
• Supine to sitting over the edge of a bed
• Balanced sitting
• Sitting to standing
• Walking
• Upper-arm function
• Hand movements
• Advanced hand activities

Scoring:

• Item scores (with the exception of the general tonus item) are summed to provide an overall score (out of 48 points)
• Completing a higher-level item suggests successful performance on lower-level items and thus lower-items can be skipped.

Evidence

Reliability

Test-retest Reliability:

Chronic Stroke:

(Carr et al, 1985; n = 15; mean age = 70 years, range = 42 to 85)

• 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)

• 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

Criterion Validity:

Acute Stroke:

(Malouin et al, 1994, n = 32, mean age = 60 years, mean time since stroke = 64.5 days)

• 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)

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

Responsiveness

Chronic & Acute Stroke:

MAS sensitivity:

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

• Motor Assessment Scale