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}}}} &nbsp;
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== Objective<br>  ==


The '''Motor Assessment Scale''' (MAS) is used to assess everyday motor function in patients with stroke.
== Objective  ==


== Intended Population<br> ==
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.
*8 items assess 8 areas of motor function  
*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
*Item scores (with the exception of the general tonus item) are summed to provide an overall score (out of 48 points)
<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 &gt; 4 indicates persistent hypertonus, and a score &lt; 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>.
*Completing a higher-level item suggests successful performance on lower-level items and thus lower-items can be skipped.


*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 &gt; 4 indicates persistent hypertonus, and a score &lt; 4 indicates various degrees of hypotonus (Carr et al, 1985<ref>Carr, J. H., Shepherd, R. B., et al. "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>


<br>
# 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>.


<u></u>Stopwatch<br>8 Jellybeans<br>Polystyrene cup<br>Rubber ball<br>Stool<br>Comb<br>Spoon<br>Pen<br>2 Tea cups<br>Water<br>Prepared sheet for drawing lines<br>Cylindrical shaped object like a jar<br>Table
== Evidence ==
 
== Reference<br>  ==
 
== Evidence ==


=== Reliability  ===
=== Reliability  ===
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<u>Test-retest Reliability:</u>  
<u>Test-retest Reliability:</u>  


<u></u>''Chronic Stroke:''  
''Chronic Stroke:''  
 
(Carr et al, 1985; n = 15; mean age = 70 years, range = 42 to 85)&nbsp;<ref>Carr, J. H., Shepherd, R. B., et al. "Investigation of a new motor assessment scale for stroke patients." Phys Ther 1985 65: 175-180</ref>
 
*Excellent test-retest reliability: r ranged from 0.87 to 1.00 (mean r = 0.98)


<br>  
(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>  


<u></u>''Chronic &amp; Acute Stroke:''  
''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)&nbsp;<ref>Carr, J. H., Shepherd, R. B., et al. "Investigation of a new motor assessment scale for stroke patients." Phys Ther 1985 65: 175-180</ref>  
(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>  


<u></u>''Acute Stroke:''  
''Acute Stroke:''  


(Malouin et al, 1994, n = 32, mean age = 60 years, mean time since stroke = 64.5 days)&nbsp;<ref>Malouin, F., Pichard, L., et al. "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>  
(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>  


<u></u>''Acute Stroke:''  
''Acute Stroke:''  


(Tyson &amp; DeSouza, 2004; n = 48; mean age = 66.7 (12.5) years; median time since stroke = 11 weeks)&nbsp;<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>  
(Tyson &amp; 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 &lt; 0.05<br>** p &lt; 0.01
*p &lt; 0.05<br>** p &lt; 0.01
 
<br>


<u>Content Validity:</u>  
<u>Content Validity:</u>  


<u></u>The MAS was developed by Carr and Shepherd (1985) based on many years of experience with similar measures  
The MAS was developed by Carr and Shepherd (1985) based on many years of experience with similar measures<ref name="p2" />


=== Responsiveness  ===
=== Responsiveness  ===


''Chronic &amp; Acute Stroke:''  
''Chronic & Acute Stroke:''
 
(English et al, 2006)&nbsp;<ref>English, C. K., Hillier, S. L., et al. "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><br> <br>MAS sensitivity:


<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>:
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| Sit to Stand  
| Sit to Stand  
| Large&nbsp;
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| 63.9
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=== Miscellaneous<br>  ===


== Links  ==
== Links  ==
*[https://www.sralab.org/rehabilitation-measures/motor-assessment-scale Motor Assessment Scale]


[http://www.rehabmeasures.org/PDF%20Library/Motor%20Assessment%20Scale%20Testing%20Form.pdf Motor Assessment Scale for Stroke]
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
<rss>Feed goes here!!|charset=UTF-8|short|max=10</rss>
</div>
== References  ==
== References  ==


References will automatically be added here, see [[Adding References|adding references tutorial]].
<references />
 
<references />  


[[Category:Outcome_Measures]]
[[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, WikiSysop, Samuel Winter, Evan Thomas, Scott Buxton, Oyemi Sillo, Naomi O'Reilly, Candace Goh and Amrita Patro

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):

  1. Supine to Side-Lying to intact side
  2. Supine to Sitting over side of bed
  3. Balance sitting
  4. Sitting to standing
  5. Walking
  6. Upper arm function
  7. Hand movements
  8. Advanced Hand Activities
  9. 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]

  1. ↑ 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.
  2. ↑ 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. ↑ 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
  4. ↑ 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.
  5. ↑ 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
  6. ↑ Tyson, S. F. and DeSouza, L. H. Reliability and validity of functional balance tests post stroke. Clin Rehabil 2004; 18(8): 916-923
  7. ↑ 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
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