Motor Assessment Scale
Original Editor - Sinead Greenan
Top Contributors - Sinead Greenan, Kim Jackson, Andeela Hafeez, Rucha Gadgil, Vanessa Rhule, Evan Thomas, WikiSysop, Samuel Winter, 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 everyday motor function in patients with stroke.[1]
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. 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[2].
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[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) [2]
- 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) [3]
- 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) [4]
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) [5]
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]
MAS has been modified into 2 forms:
- Modified Motor Assessment Scale (MMAS). This scale modified item descriptions and deleted the general tonus item. It demonstrated acceptable inter-rater reliability and is still scored on a 7-point scale from 0 – 6[6].
- Upper Limb/Extremity Motor Assessment Scale (UL-MAS or UE-MAS). In this form of the MAS, only the three upper limb items are used as a scale to assess upper limb function. In a study evaluating this version, substantial reliability and validity (Cronbachs alpha = 0.83; Spearmans rho = 0.70)[7][8]
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.
- ↑ 2.0 2.1 2.2 Carr, J. H., Shepherd, R. B., et al. "Investigation of a new motor assessment scale for stroke patients." Phys Ther 1985 65: 175-180
- ↑ 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
- ↑ 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., 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
- ↑ Loewen, S. C., Anderson, B. A. Reliability of the Modified Motor Assessment Scale and the Barthel Index. Phys Ther,1988. 68, 1077-1081.
- ↑ Lannin, N. A. Reliability, validity and factor structure of the upper limb subscale of the Motor Assessment Scale (UL-MAS) in adults following stroke. Disability & Rehabilitation, 2004, 26(2), 109-116.
- ↑ Hsueh, I-P., Hsieh, C-L.Responsiveness of two upper extremity function instruments for stroke inpatients receiving rehabilitation. Clinical Rehabilitation, 2002, 16(6), 617-624.
