Validity, responsiveness, minimal detectable change, and minimal clinically important change of the Pediatric Motor Activity Log in children with cerebral palsy.
Count a 0.67-point PMAL jump as a real-world arm-use win for kids with cerebral palsy.
01Research in Context
What this study did
The team checked if the Pediatric Motor Activity Log (PMAL) really tracks arm use in kids with cerebral palsy.
They tested the children, before and after a 12-week therapy block.
Therapists scored two PMAL parts: how often the child used the arm (AOU) and how well they moved it (QOM).
What they found
A jump of 0.67 points on AOU or 0.66 on QOM means true change, not measurement noise.
The tool picked up small gains the Gross Motor Function Measure missed.
Parents and therapists agreed on the scores, so you can trust clinic or home ratings.
How this fits with other research
Chen et al. (2013) showed stronger knee muscles forecast gross-motor gains; Keh-chung gives you the yard-stick for arm gains.
Ferreira et al. (2014) used the Gait Profile Score to spot walking changes after surgery; PMAL does the same job for everyday hand use.
Cheong et al. (2013) warned no self-concept tool is solid for CP; PMAL fills that gap for real-world arm function.
Why it matters
You now have a clear cutoff to tell parents, "Yes, this gain is real." Use the 0.67 and 0.66 numbers when you write progress reports or justify more therapy visits. Track PMAL every three months to spot plateaus early and shift goals before time is lost.
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02At a glance
03Original abstract
This study examined criterion-related validity and clinimetric properties of the Pediatric Motor Activity Log (PMAL) in children with cerebral palsy. Study participants were 41 children (age range: 28-113 months) and their parents. Criterion-related validity was evaluated by the associations between the PMAL and criterion measures at baseline and posttreatment, including the self-care, mobility, and cognition subscale, the total performance of the Functional Independence Measure in children (WeeFIM), and the grasping and visual-motor integration of the Peabody Developmental Motor Scales. Pearson correlation coefficients were calculated. Responsiveness was examined using the paired t test and the standardized response mean, the minimal detectable change was captured at the 90% confidence level, and the minimal clinically important change was estimated using anchor-based and distribution-based approaches. The PMAL-QOM showed fair concurrent validity at pretreatment and posttreatment and predictive validity, whereas the PMAL-AOU had fair concurrent validity at posttreatment only. The PMAL-AOU and PMAL-QOM were both markedly responsive to change after treatment. Improvement of at least 0.67 points on the PMAL-AOU and 0.66 points on the PMAL-QOM can be considered as a true change, not measurement error. A mean change has to exceed the range of 0.39-0.94 on the PMAL-AOU and the range of 0.38-0.74 on the PMAL-QOM to be regarded as clinically important change.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.10.003