The Development of the Taiwanese Version of the Manual Ability Measure for Burns

　　Background: To evaluate hand function of hand-burn patients with adequate tools is essential. However, it seems that no burn-specific hand function measurement tools are available, while common-used tools lack validation in burn population. The quality of hand function evaluation and the following rehabilitation intervention might therefore be jeopardized. The Manual Ability Measure (MAM-36) is a questionnaire evaluates self-perceived manual ability. It can help to recognize clients’ subjective first-priority problems and is clinically more convenient to administer, but has not been validated in burn population.
　　Objectives: This study aimed to develop and validate Taiwanese Version of the Manual Ability Measure for Burns (T-MAM for Burns), an evaluation tool adapted from the MAM-36, to assess self-perceived manual ability of burn patients.
　　Methods: The original MAM-36 was translated and cultural-adapted first and burn-specific items were added, forming a preliminary version of the T-MAM for Burns. The preliminary T-MAM for Burns was field-tested in a consecutive sample of 45 hand-burn patients with rehabilitation needs, and a three-month follow-up was done. Items of the final T-MAM for Burns were selected based on the results of psychometric analysis. Psychometric properties such as reliability and validity of the T-MAM for Burns were investigated, as well as its responsiveness at the first and third month follow-ups.
　　Results: Twenty items were selected into the final T-MAM for Burns, with three additional items as clinical reference (not to be counted into the total score). The T-MAM for Burns was found to have excellent internal consistency and test-retest reliability (Cronbach’s α = 0.947; ICC = 0.987). Concurrent validity results showed that the T-MAM for Burns score was highly correlated to the short form Disabilities of the Arm, Shoulder and Hand (QuickDASH) (r = -0.786) and moderately correlated to the Jebsen-Taylor Hand Function Test (r = -0.487) and grip/pinch power (r = 0.660 and 0.631, respectively). The effect sizes at the first and third month follow-ups were 0.24 and 0.44, respectively, showing a small to moderate responsiveness. Regarding the discriminant validity, no significant difference in total score was found between two groups divided by TBSA = 25%, but the scoring was significantly different between the high and low T-MAM for Burns score groups.
　　Conclusions: The T-MAM for Burns is a valid and reliable tool to assess the perceived manual ability among burn patients. It can reflect the changes of manual ability over time, and can be used as an outcome measure in burns rehabilitation.