Correlação do nível de comprometimento da hemiparesia com o uso do membro superior parético

Abstract

The Motor Activity Log (MAL) assesses the spontaneous use of the affected upper limb during daily activities in real environments in after hemiparetic individuals stroke, reflecting their functional ability. There have been no studies analyzing the correlation between MAL Scales and sensorimotor impairment different levels in individuals post-stroke assessed by the Fugl-Meyer Scale. Objectives: To verify if there is a correlation between sensoriomotor impairment different levels of hemiparesis and the use of the paretic upper limb; to observe the differences between the MAL scales scores applied to individuals with varying degrees of impairment and to verify the dimensionality of the level of activity of scales MAL using Rasch analysis. Methods: Included 66 patients with chronic hemiparesis (n=49 - mild-moderate hemiparesis, n=17 - severe hemiparesis). All subjects were evaluated by Fugl-Meyer Scale, Mini Mental State Examination, and MAL (versions 30, 4/5 and MAL 50 – sum of the versions). The Pearson correlation test verified the correlation between the Fugl- Meyer for upper limb and the amount and quality of use scales of MAL. A one-way ANOVA for repeated measures with Bonferroni adjustment was used for each group to verify differences between MAL scales scores. In addition, the level of difficulty of the MAL activities was evaluated by the Rasch model. Results: There was high significant positive correlation between the scores of Fugl-Meyer scale and amount of use scale of MAL 30 (r = 0.76; p <0.001), MAL 4/5 (r = 0.78; p <0.001) and MAL 50 (r = 0.77; p <0.001). The amount of use and quality scale of the 3 results were different for mildmoderate hemiparesis (p <0.001). The MAL 4/5 showed the highest score compared to MAL 30 and MAL 50 in severe hemiparesis (p <0.001). The activities were ordered as the difficulty of execution, however, the MAL 4/5 activities were not the easiest. Conclusion: The higher the degree of motor impairment in hemiparesis, lower the use of the affected upper limb evaluated by MAL scale and the difficulty of the activities influences the amount of use and the quality of the affected upper limb in these individuals. The MAL 4/5, developed for individuals with severe motor impairment, does not present all the activities with less difficulty than the original scale.