Responsiveness of the Manual Ability Measure-36 (MAM-36): Changes in Hand Function Using Self-Reported and Clinician-Rated Assessments

Headnote

MeSH TERMS

* activities of daily living

* hand strength

* recovery of function

* reproducibility of results

* task performance and analysis

OBJECTIVE. To examine the responsiveness of the Manual Ability Measure-36 (MAM-36) compared with a clinician-administered functional assessment.

METHOD. The MAM-36 was administered to 46 patients (Cohort A, n = 20; Cohort B, n = 26) with various upper-extremity conditions. All patients received occupational therapy intervention for 2-37 wk and were retested at discharge. Additionally, the Smith Hand Function Test (SHFT), including task performance speeds and grip strength measurements, was administered to Cohort B at intake and discharge.

RESULTS. Manual ability improved significantly at discharge in all patients. Patients also showed significant improvement on the SHFT. The correlation between gain in MAM-36 and gain in grip strength was moderate. The standardized response mean for the MAM-36 was 1.18.

CONCLUSION. The MAM-36 was responsive to changes in hand function in patients receiving occupational therapy services. MAM-36 results correlated positively with improvements in task performance speeds and grip strength.

Chen, C. C., Palmon, O., & Amini, D. (2014). Responsiveness of the Manual Ability Measure-36 (MAM-36): Changes in hand function using self-reported and clinician-rated assessments. American Journal of Occupational Therapy, 68, 187-193. http://dx.doi.org/10.5014/ajot.2014.009258

Occupational therapy advocates client-centered practice to promote client function and occupational performance (Law, Baum, & Dunn, 2005). However, research documenting therapy effectiveness in promoting actual functional outcome is sparse (Aldehag, Jonsson, & Ansved, 2005; Case-Smith, 2003; Jack & Estes, 2010; Rønningen & Kjeken, 2008; van der Giesen et al., 2007), with the measurement of treatment effectiveness often limited to impairment-focused measurement (Schoneveld, Wittink, & Takken, 2009). For example, although occupational therapists often treat patients with tendonitis who receive steroid injections and those who are not fit for steroid injections, no studies have systematically compared short-term functional improvement or long-term outcomes in these two groups. Likewise, no studies have compared treatment outcomes in patients who received steroid injections alone with those of patients who received a combination of injections and occupational therapy. As a result, whether and to what extent patients with tendonitis benefit from occupational therapy hand rehabilitation is not known.

This phenomenon is not unique to occupational therapy. In the field of hand surgery, studies have often reported pain and impairment...