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Adaptação transcultural e análise das propriedades psicométricas da versão brasileira do instrumento Motor Activity Log Cross-cultural adaptation and analysis of the psychometric properties of the Brazilian version of the Motor Activity Log

By Viviane Amaral Saliba, Lívia de Castro Magalhães, Christina Danielli Coelho de Morais Faria, Glória Elizabeth Carneiro Laurentino, Janine Gomes Cassiano and Luci Fuscaldi Teixeira-Salmela

Abstract

OBJETIVO: Traduzir para o português brasileiro e adaptar transculturalmente o Motor Activity Log (MAL), instrumento específico que avalia a função do membro superior mais afetado (MSMA) em hemiplégicos. MÉTODOS: O MAL foi traduzido e adaptado seguindo instruções padronizadas e submetido a exame de confiabilidade teste-reteste (coeficiente de correlação intraclasse, CCI). As demais propriedades psicométricas foram investigadas pela análise de Rasch em 77 hemiplégicos crônicos (41 homens, média de idade = 57,5 ± 12,4 anos). RESULTADOS: Tanto a escala de quantidade como a escala de qualidade do MAL obtiveram excelente CCI (0,98) para as pontuações totais. Quanto ao grau de dificuldade, "usar a chave para destrancar a porta" foi o item mais difícil na escala quantitativa, sendo "lavar as mãos" o item mais fácil. Na escala qualitativa, o mais difícil foi "utilizar o controle remoto da TV", e o mais fácil, "secar as mãos". A análise mostrou que o conjunto dos itens enquadrou-se no modelo; entretanto, quatro itens não se encaixaram nas expectativas do modelo nas escalas quantitativa (itens 21, 16, 14 e 13) e qualitativa (itens 9, 21, 23 e 22). Foram localizadas pessoas com padrão errático de respostas, e cinco indivíduos tiveram pontuação mínima. Constatou-se discrepância entre dificuldade dos itens e habilidade da amostra, indicando que as habilidades dos indivíduos estavam abaixo da dificuldade dos itens. Houve correlação significativa entre a força de preensão do MSMA e as medidas de habilidade dos indivíduos na escala quantitativa (r = 0,51; P & lt; 0,0001) e qualitativa (r = 0,57; P < 0,0001), e ainda entre as duas escalas nas medidas de habilidades dos indivíduos (r = 0,97; P < 0,0001). CONCLUSÕES: O MAL-Brasil apresenta potencial para avaliação do uso do MSMA de hemiplégicos crônicos brasileiros. Entretanto, apresenta limitação para uso em indivíduos com comprometimento severo do MSMA. Ainda, a validade de construto foi comprometida pela presença de itens erráticos. O MAL-Brasil deve ser aplicado em outras amostras para que sua validade seja mais amplamente investigada.<br>OBJECTIVE: To describe the translation into Brazilian Portuguese and cross-cultural adaptation of the Motor Activity Log (MAL), an instrument specifically designed to assess function of the more severely affected upper limb in hemiplegics. METHODS: The MAL was translated and adapted according to standardized procedures and submitted to test-retest reliability assessment (intraclass correlation coefficient, ICC). Other psychometric properties were investigated using Rasch analysis in 77 chronic hemiplegics (41 men, mean age = 57.5 ± 12.4 years). RESULTS: An excellent ICC (0.98) was obtained for the total scores of both the quantity and quality MAL scales. When assessing degree of difficulty, "using a key to unlock the door" was the most difficult item on the quantity scale, whereas "washing hands" was the easiest one. On the quality scale, the most difficult item was "using the TV remote control," and the easiest one was "drying hands." The analyses showed that the set of items as a whole fit into the model; however, the individual analyses indicated that four items did not meet the expectations of the model in both the quantity (items 21, 16, 14, and 13) and quality (items 9, 21, 23, and 22) scales. Irregular response patterns were observed, and five subjects obtained the minimum score. There was disagreement between item difficulty and sample ability, suggesting that the abilities of individuals were below the degree of difficulty of the assessed items. A significant correlation was observed between grip strength of the more severely affected upper limb and motor skill measurement among individuals on the quantity (r = 0.51, P < 0.0001) and quality scales (r = 0.57, P < 0.0001), and also between the two scales when measuring the individuals' motor skills (r = 0.97, P < 0.0001). CONCLUSIONS: MAL-Brazil is potentially useful to evaluate the more severely affected upper limb in Brazilian patients with chronic hemiplegia. However, the instrument has limitations for use with individuals with severe limb impairments. Also, construct validity was affected by the presence of irregular score patterns. MAL-Brazil should be applied to additional samples to further investigate its validity

Topics: Acidente cerebral vascular, psicometria, membro superior, validade dos testes, reprodutibilidade dos testes, Stroke, psychometrics, upper extremity, validity of tests, reproducibility of results, LCC:Public aspects of medicine, LCC:RA1-1270, LCC:Medicine, LCC:R, DOAJ:Public Health, DOAJ:Health Sciences
Publisher: Organización Panamericana de la Salud
Year: 2011
OAI identifier: oai:doaj.org/article:b417db6eb13a4a179d0fa101bf214978
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