Motor Assessment Scale: Difference between revisions
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'''Original Editor '''- [[User:Sinead Greenan|Sinead Greenan]] | '''Original Editor ''' - [[User:Sinead Greenan|Sinead Greenan]] | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
</div> | </div> | ||
== Objective == | |||
= | The Motor Assessment Scale (MAS) is a performance-based scale used to assess level of impairment and everyday motor function in patients with [[stroke]]<ref name="Dean and Mackey">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.</ref><ref>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.</ref>.<br> | ||
Used widely in assessing functional ability for patients with stroke | == Intended Population == | ||
Used widely in assessing functional ability for patients with stroke by Physical therapists and Occupational therapists.<br> | |||
== Method of Use == | == Method of Use == | ||
<u>Description:</u> | <u>Description:</u> | ||
*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. | ||
*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) | *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 | *A score of 6 indicates optimal motor behavior | ||
* | <nowiki>*</nowiki>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<ref name="p2">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</ref>. | ||
<u>The 9 items assessment evaluates 5 Mobility and 3 Upper Limb activities, and 1 the severity of involuntary movements UMN lesions (clonus):</u> | |||
# 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 | |||
<u>Equipment Required:</u> | <u>Equipment Required:</u> | ||
*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 | |||
<u>Scoring</u>: | |||
*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<ref>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.</ref>. | |||
== Evidence == | |||
== | |||
=== Reliability === | === Reliability === | ||
Line 40: | Line 59: | ||
<u>Test-retest Reliability:</u> | <u>Test-retest Reliability:</u> | ||
''Chronic Stroke:'' | |||
(Carr et al, 1985; n = 15; mean age = 70 years, range = 42 to 85) | (Carr et al, 1985; n = 15; mean age = 70 years, range = 42 to 85)<ref name="p2" /> | ||
*Excellent test-retest reliability: r ranged from 0.87 to 1.00 (mean r = 0.98)<br> | |||
<u>Interrater/Intrarater Reliability:</u> | <u>Interrater/Intrarater Reliability:</u> | ||
''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) | (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)<ref name="p2" /> | ||
*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). | *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). | ||
Line 60: | Line 76: | ||
<u>Criterion Validity:</u> | <u>Criterion Validity:</u> | ||
''Acute Stroke:'' | |||
(Malouin et al, 1994, n = 32, mean age = 60 years, mean time since stroke = 64.5 days) | (Malouin et al, 1994, n = 32, mean age = 60 years, mean time since stroke = 64.5 days)<ref>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</ref> | ||
*Excellent Concurrent Validity with Fugl-Meyer (FMA) total scores (r = 0.96, not including general tonus items) | *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) | *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) | *Poor Concurrent Validity with MAS and FMA sitting balance (r = -0.10)<br> | ||
<br> | |||
<u>Construct Validity:</u> | <u>Construct Validity:</u> | ||
''Acute Stroke:'' | |||
(Tyson & DeSouza, 2004; n = 48; mean age = 66.7 (12.5) years; median time since stroke = 11 weeks) | (Tyson & DeSouza, 2004; n = 48; mean age = 66.7 (12.5) years; median time since stroke = 11 weeks)<ref>Tyson, S. F. and DeSouza, L. H. Reliability and validity of functional balance tests post stroke. Clin Rehabil 2004; 18(8): 916-923</ref> | ||
MAS and functional balance test: | MAS and functional balance test: | ||
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*Adequate Convergent Validity: Sitting arm raise (no. of raises; r = 0.33*) | *Adequate Convergent Validity: Sitting arm raise (no. of raises; r = 0.33*) | ||
*Adequate Convergent Validity: Sitting forward reach (cm, r = 0.54**) | *Adequate Convergent Validity: Sitting forward reach (cm, r = 0.54**) | ||
<nowiki>*</nowiki>p < 0.05<br>** p < 0.01 | |||
*p < 0.05<br>** p < 0.01 | |||
<u>Content Validity:</u> | <u>Content Validity:</u> | ||
The MAS was developed by Carr and Shepherd (1985) based on many years of experience with similar measures<ref name="p2" /> | |||
=== Responsiveness === | === Responsiveness === | ||
''Chronic & | ''Chronic & Acute Stroke:'' | ||
<br>MAS sensitivity<ref>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</ref>: | |||
{| width="400" border="1" cellpadding="1" cellspacing="1" | {| width="400" border="1" cellpadding="1" cellspacing="1" | ||
|- | |- | ||
Line 123: | Line 132: | ||
| 4 | | 4 | ||
| Sit to Stand | | Sit to Stand | ||
| Large | | Large | ||
| 0.85 | | 0.85 | ||
| 18 | | 18 | ||
Line 151: | Line 160: | ||
| 63.9 | | 63.9 | ||
|} | |} | ||
== Links == | == Links == | ||
*[https://www.sralab.org/rehabilitation-measures/motor-assessment-scale Motor Assessment Scale] | |||
== References == | |||
== References | |||
<references /> | <references /> | ||
[[Category:Outcome_Measures]] [[Category:Stroke]] [[Category: | [[Category:Outcome_Measures]] | ||
[[Category:Assessment]] | |||
[[Category:Neurology]] | |||
[[Category:Neurological - Assessment and Examination]] | |||
[[Category:Neurological - Outcome Measures]] | |||
[[Category:Neurological - Outcome Measures]] | |||
[[Category:Stroke]] | |||
[[Category:Stroke - Assessment and Examination]] | |||
[[Category:Stroke - Outcome Measures]] | |||
[[Category:Head]] | |||
[[Category:Head - Assessment and Examination]] | |||
[[Category:Head - Outcome Measures]] | |||
[[Category:Occupational Health]] |
Latest revision as of 16:06, 10 January 2024
Original Editor - Sinead Greenan
Top Contributors - Sinead Greenan, Kim Jackson, Andeela Hafeez, Rucha Gadgil, Vanessa Rhule, Samuel Winter, Evan Thomas, WikiSysop, Candace Goh, Amrita Patro, Scott Buxton, Oyemi Sillo and Naomi O'Reilly
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