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

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 ( r = 0.72, p < 0.001) and WMFT ( r = 0.79, p < 0.001), weak non-significant correlations with NHPT ( r = 0.16–0.17, p > 0.05), and moderate negative correlations with MAS ( r = –0.62, p < 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. Rehabilitation specialists can interpret patient scores in the MAL30-Ar to measure the amount of used and quality of movement of the affected side in activities of daily living for patients with stroke Patients with unchanged clinical status will have similar scores in the MAL30-Ar with repeated scale administrations over time. The MAL30-Ar can be used in clinical practice and research studies to measure patients’ performance in ...