Original research| Volume 102, ISSUE 4, P626-632, April 2021

Reliability and Validity of the Lower Extremity Motor Activity Log for Measuring Real-World Leg Use in Adults With Multiple Sclerosis

Published:November 20, 2020DOI:



      To determine the test-retest reliability and validity of the Lower Extremity Motor Activity Log (LE-MAL) for assessing LE use in the community in adults with multiple sclerosis (MS).


      Prospective analysis of measures conducted by trained examiners.


      Participants were evaluated by telephone on several measures of LE use.


      Adults with MS (N=43).


      Not applicable.

      Main Outcome Measures

      The LE-MAL has 3 subscales (Assistance, Functional Performance, and Confidence). It was administered twice, at least 2 weeks apart. The Multiple Sclerosis Walking Scale (MSWS-12), Patient Determined Disease Steps (PDDS), and Mobility Scale were only administered during the first call.


      The test-retest reliability of the composite and the 3 subscale LE-MAL scores were high (intraclass correlation, >0.94). The composite and subscale LE-MAL scores were strongly correlated with the MSWS-12, PDDS, and Mobility Scale scores (r=–0.56 to –0.77; P<.001).


      This initial study suggests that the LE-MAL reliably and validly measures LE use in the community in adults with MS.


      List of abbreviations:

      AS (Assistance Scale), CFA (confirmatory factor analysis), CFI (comparative fit index), CS (Confidence Scale), FP (Functional Performance Scale), ICC (intraclass correlation coefficient), LE (lower extremity), LE-MAL (Lower Extremity Motor Activity Log), MAL (Motor Activity Log), MS (multiple sclerosis), MSWS-12 (Multiple Sclerosis Waking Scale), PDDS (Patient Determined Disease Steps), PT (physical therapy), RMSEA (root mean square error of approximation), TLI (Tucker-Lewis index), UE (upper extremity)
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