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Paediatric Motor Activity Log

What is the PMAL?

The PMAL is a structured interview intended to examine how often and how well a child uses his/her involved upper extremity (UE) in their natural environment outside the therapeutic setting.

How is the PMAL Completed

The child’s primary caregiver is asked standardized questions about the amount of use of the child’s involved arm (How Often Scale) and the quality of the child’s movement during the functional activities specified in the instrument (How Well Scale). These two scales range from 0 to 5. The HO and HW scales are printed on separate sheets of paper and are placed in front of the caregiver during test administrations. Caregivers should be told that they can give half scores if this is reflective of their ratings.

During the first (pre-treatment) test administration, the test should be given by the therapist after the therapist has had a period of time to observe a child’s behavior. The tester should discuss the rating with the caregiver to develop the common frame of reference. The frame of reference for each child should be their less affected UE. The therapist should verify the response (e.g., “So, you rated that activity a ‘3’. However, your child moved his/her arm just as well as the less affected arm. According to the frame of reference for this outcome measure that would be scored more like a ‘5’. Do you agree?”). The final rating must be agreed to by the caregiver. Then 2 weeks following the completion of the programme we request that the caregiver repeat the PMAL questionnaire so that we can gain a level of their progress following a CIMT programme.

Amount Scale

  1. Not Used - Your child did not use the weaker arm for the activity.
  2. Very Rarely - 5% - 10% of the time - Your child occasionally used the weaker arm for the activity, but only very rarely.
  3. Rarely - About 25% of the time - Your child used the weaker arm at times but did the activity with the stronger arm most of the time.
  4. Sometimes - About 50% of the time - The weaker arm was used in performing the activity, but only about half as much as the stronger arm.
  5. Often - About 75% of the time - The weaker arm was used in performing the activity regularly, but just three-quarters as often as the stronger arm.
  6. Normal - 90% - 100% of the time - The weaker arm was used as often as the stronger arm to perform the activity.

How Well Scale

  1. Not Used - Your child did not use the weaker arm at all for the activity.
  2. Very Poor - Your child had very little functional use of the weaker arm for the activity. The arm may have moved during the activity but was of no real functional help.
  3. Poor - Your child had minor functional use of the weaker arm dor the activity. The arm actively participated in the activity, but the stronger arm or caregiver did most of the work.
  4. Fair or Moderate - The weaker arm was used to accomplish the activity, but the performance was very slow and/or involved great difficulty.
  5. Almost Normal - the weaker arm was able to accomplish the activity independently, but did so with some difficulty and/or inaccuracy.
  6. Normal - The weaker arm did the activity normally.
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What length of programme is best?

Our therapists will recommend programme length based on their assessment findings. Generally the less functional movement to start with, the longer the programme recommendation. We offer a minimum programme length of 2 weeks – the evidence does not support any less!

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Call us on 0330 223 0077 or email to speak to one of our specialist CIMT therapists.