Reliability and validity of the Turkish version of the Infant Motor Activity Log in infants with upper extremity functional asymmetry: how often and how well?

Background/aim: Functional asymmetry in the upper extremities may occur in infants with neuromotor problems due to neurodevelopmental or musculoskeletal disorders. The aim of this study was to investigate the validity and reliability of the Turkish version of the Infant Motor Activity Log (IMAL-T), which assesses the frequency (how often) and quality (how well) of the affected arm usage during activities in infants with functional asymmetry in the upper extremities.

Materials and methods: The IMAL-T was administered face-to-face to the parents of 102 infants [60 infants at high risk of developing cerebral palsy (CP) and 42 infants with brachial plexus birth injury (BPBI)], aged 6-24 months, with functional asymmetry in the upper extremities. One week later, the IMAL-T was administered again to 22 parents to determine the test-retest reliability. Cronbach's alpha and the intraclass correlation coefficient (ICC) were used to determine the internal consistency and test-retest reliability. Discriminant validity was assessed using the manual ability level (Mini Manual Ability Classification System) and the nerve injury type was evaluated using the independent samples t test. For concurrent validity, the relationship between the IMAL-T and the Pediatric Evaluation of Disability Inventory (PEDI) self-care was examined using Spearman's correlation coefficient.

Results: Internal consistency (Cronbach's alpha ≥ 0.91) and test-retest reliability (ICC ≥ 0.93) of the IMAL-T were adequate. The IMAL-T scores differed according to the mini-MACS and nerve injury type (p < 0.05). Moderate to strong (CP, r ≥ 0.706, p < 0.001; BPBI, r ≥ 0.579, p < 0.001) correlation coefficients were found between the IMAL-T and PEDI self-care scores.

Conclusion: The IMAL-T is a reliable and valid parent-reported outcome measure that indicates the frequency and quality of the affected arm use during age-appropriate real-life activity in infants aged 6-24 months with upper extremity functional asymmetry due to neuromotor problems. The IMAL-T can be used in early intervention to assess upper extremity functional asymmetry in Turkish infants.