Cross-cultural adaptation, reliability, and validation of the Arabic version of the Motor Activity Log (MAL-30) Scale in patients with stroke in Saudi Arabia.

Abstract

The motor activity log (MAL-30) is a patient-reported outcome measure that assesses the use of the affected upper limb in daily activities after stroke. It includes two subscales: Amount of Use (AOU) and Quality of Movement (QOM). It has not been translated nor validated for Arabic-speaking patients with stroke. Thus, this study aimed to translate, culturally adapt, and evaluate the reliability and validity of the Arabic version of MAL-30 (MAL-30-Ar) for Arabic-speaking patients post-stroke. A total of 130 patients post-stroke participated. Internal consistency was assessed using Cronbach's alpha, item-item and item-total correlations, and split-half reliability. Convergent validity was evaluated by correlating MAL-30-Ar scores with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Nine-Hole Peg Test (NHPT), and Modified Ashworth Scale (MAS). The MAL-30-Ar showed excellent internal consistency (Cronbach's alpha = 0.993 for both subscales) and strong item correlations, indicating good homogeneity. The questionnaire was well understood by participants and showed satisfactory content validity (index = 0.995). MAL-30-Ar scores showed high positive correlations with FMA-UE (<i>r</i> = 0.72, <i>p</i> < 0.001) and WMFT (<i>r</i> = 0.79, <i>p</i> < 0.001), weak non-significant correlations with NHPT (<i>r</i> = 0.16-0.17, <i>p</i> > 0.05), and moderate negative correlations with MAS (<i>r</i> = -0.62, <i>p</i> < 0.001), supporting convergent validity. The MAL-30-Ar is a valid and reliable tool for assessing the amount and quality of affected upper limb use in Arabic-speaking patients post-stroke.