日本語版Grade-4/5MALの信頼性と妥当性の検討

Examining reliability and validity of the Japanese version of the Grade-4/5 MAL

要旨：本研究の目的は，Grade-4/5MALの日本語版を作成し，脳卒中後の片麻痺患者を対象に信頼性と妥当性を検討した．翻訳はガイドラインに準じて行った．信頼性と妥当性の検討は，片麻痺患者53名を対象として実施し，検者間信頼性・検者内信頼性・再検査信頼性，内的一貫性いずれも高い信頼性を認めた．また，基準関連妥当性は，MAL-14と高い相関を認めた．構成概念妥当性は，FMA（下位項目の各小計，合計点），ARAT（下位項目の各小計，合計点），FIM運動項目と有意なかなり強い相関を認めた．日本語版Grade-4/5MALは，麻痺側上肢のADLでの使用を促す評価ツールとして，臨床での活用に期待ができる．

　The purpose of this study was to develop the Japanese version of the Grade-4/5 Motor Activity Log (MAL) and evaluate its reliability and validity in stroke patients with hemiparesis. The translation was a product of forward translation, back translation, and expert review. Reliability and validity were tested with 53 hemiparetic stroke patients. The inter-rater reliability, intra-rater reliability, test-retest reliability, and internal consistency were high. Criterion-related validity was supported by a significant correlation between the Grade-4/5 MAL and the MAL-14. Construct-related validity was supported by significant correlations with the FMA (subscale scores and total score), ARAT (subscale scores and total score), and FIM (motor items). The Japanese version of the Grade-4/5 MAL is expected to be a valuable assessment tool for evaluating and promoting the use of the paretic upper-extremity function in ADL.