Motor Assessment Scale: Difference between revisions

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'''Original Editor '''- [[User:Sinead Greenan|Sinead Greenan]]


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== Objective<br>  ==
== Objective<br>  ==


The '''Motor Assessment Scale''' (MAS) is used to assess everyday motor function in patients with stroke.  
The '''Motor Assessment Scale''' (MAS) is used to assess everyday motor function in patients with stroke.  
[[Category:Outcome_Measures]]


== Intended Population<br>  ==
== Intended Population<br>  ==


Used widely in assessing functional ability for patients with stroke
Used widely in assessing functional ability for patients with stroke  


== Method of Use  ==
== Method of Use  ==


<u>Description:</u>
<u>Description:</u>  


*8 items assess 8 areas of motor function
*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)
*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.
*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>).
*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>).


<br>


<u>Equipment Required:</u>


<u>Equipment Required:</u>
<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  
 
<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


== Reference<br>  ==
== Reference<br>  ==
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=== Reliability  ===
=== Reliability  ===


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


<u></u>''Chronic Stroke:''  
<u></u>''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>
(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)
*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:''  
<u></u>''Chronic &amp; 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)&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 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).
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=== Validity  ===
=== Validity  ===


<u>Criterion Validity:</u>
<u>Criterion Validity:</u>  


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


*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>


 
<u>Construct Validity:</u>  
<u>Construct Validity:</u>


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


MAS and functional balance test:
MAS and functional balance test:  


*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**)


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


=== Responsiveness  ===
=== Responsiveness  ===
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''Chronic &amp; Acute Stroke:''  
''Chronic &amp; 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:
(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:  


{| width="400" border="1" cellpadding="1" cellspacing="1"
{| width="400" border="1" cellpadding="1" cellspacing="1"
|-
|-
| nowrap="nowrap" | Item
| nowrap="nowrap" | Item  
| Dimension
| Dimension  
| Effect
| Effect  
| Effect Size (d)
| Effect Size (d)  
| % Change
| &nbsp;% Change
|-
|-
| 1
| 1  
| Rolling
| Rolling  
| Large
| Large  
| 1.03
| 1.03  
| 31.1
| 31.1
|-
|-
| 2
| 2  
| Lie to sit
| Lie to sit  
| Moderate
| Moderate  
| 0.74
| 0.74  
| 44.3
| 44.3
|-
|-
| 3
| 3  
| Balanced Sitting
| Balanced Sitting  
| Moderate
| Moderate  
| 0.61
| 0.61  
| 60.7
| 60.7
|-
|-
| 4
| 4  
| Sit to Stand
| Sit to Stand  
| Large&nbsp;
| Large&nbsp;  
| 0.85
| 0.85  
| 18
| 18
|-
|-
| 5
| 5  
| Walking
| Walking  
| Large
| Large  
| 1.02
| 1.02  
| 19.7
| 19.7
|-
|-
| 6
| 6  
| Upper arm function
| Upper arm function  
| Small
| Small  
| 0.36
| 0.36  
| 44.3
| 44.3
|-
|-
| 7
| 7  
| Hand movements
| Hand movements  
| Small
| Small  
| 0.43
| 0.43  
| 55.7
| 55.7
|-
|-
| 8
| 8  
| Advanced hand activities
| Advanced hand activities  
| Moderate
| Moderate  
| 0.50
| 0.50  
| 63.9
| 63.9
|}
|}


=== Miscellaneous<span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span><br>  ===
=== Miscellaneous<br>  ===


== Links  ==
== Links  ==


[http://www.rehabmeasures.org/PDF%20Library/Motor%20Assessment%20Scale%20Testing%20Form.pdf Motor Assessment Scale for Stroke]
[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])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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References will automatically be added here, see [[Adding References|adding references tutorial]].  
References will automatically be added here, see [[Adding References|adding references tutorial]].  


<references />
<references />  
 
[[Category:Outcome_Measures]]

Revision as of 12:18, 4 September 2014

 

Objective
[edit | edit source]

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

Intended Population
[edit | edit source]

Used widely in assessing functional ability for patients with stroke

Method of Use[edit | edit source]

Description:

  • 8 items assess 8 areas of motor function
  • 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
  • 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.
  • 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 (Carr et al, 1985[1]).


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

Reference
[edit | edit source]

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) [2]

  • 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) [4]

  • 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) [5]

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[edit | edit source]

Chronic & Acute Stroke:

(English et al, 2006) [6]

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

Miscellaneous
[edit | edit source]

Links[edit | edit source]

Motor Assessment Scale for Stroke

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. Carr, J. H., Shepherd, R. B., et al. "Investigation of a new motor assessment scale for stroke patients." Phys Ther 1985 65: 175-180
  2. Carr, J. H., Shepherd, R. B., et al. "Investigation of a new motor assessment scale for stroke patients." Phys Ther 1985 65: 175-180
  3. Carr, J. H., Shepherd, R. B., et al. "Investigation of a new motor assessment scale for stroke patients." Phys Ther 1985 65: 175-180
  4. 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
  5. Tyson, S. F. and DeSouza, L. H. "Reliability and validity of functional balance tests post stroke." Clin Rehabil 2004 18(8): 916-923
  6. 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