Overview
The Leg Activity measure is a patient or carer-rated 33-item measure of difficulty in passive and active leg function, as well as spasticity related qualityof-life (symptoms and participatory impact). It comprises a nine-item Passive function subscale, a fifteen-item Active function subscale and a nine-item symptoms and impact on quality-of-life subscale, and uses a Likert scoring system between 0 (No difficulty) and 4 (unable to do task). The Passive function scale scores range from 0 (high function) to 36 (no function), Active function scale Psychometric evaluation the Leg Activity measure 11 scores from 0 (high function) to 60 (no function) and Symptoms and Impact scale from 0 (high function) to 36 (no function)
How is LegA rated?
Section A asks about ‘caring’ for your affected leg either yourself or by a carer or a combination of both of these.
Section B asks what activities you can do with your affected leg. For each of the activities listed, please indicate (circle):
- The amount of difficulty that you (or your carer) experience in doing the task, based on your activity over the last 7 days. Please estimate if you do the task but have not done so in the last 7 days.
- If the task is never done, but this has nothing to do with your leg or is never done with your affected leg, score 0 = No difficulty.
Rating of the passive and active subscale items is done on the following scale:
Level of difficulty
- 0 = No difficulty
- 1 = Mild difficulty
- 2 = Moderate difficulty
- 3 = Severe difficulty
- 4 = Unable to do activity
Section C asks what general symptoms and difficulties you are having related to your leg which impact on your life.
For these questions you will need to score the extent to which each item impacts on you in your life based on the last 7 days.
If you are unable to complete the questionnaire independently, you may:
- Ask a carer/caregiver or professional to write your responses for you
- Ask a carer/caregiver or professional to help you understand and complete the questionnaire, question by question
- Ask a carer/caregiver or professional to respond to the questions on your behalf
Development of the LegA included two rounds of Delphi consultation. Further rounds were not required due to the high degree (80%) of agreement between respondents in rounds one and two. From an initial shortlist of 126 items, 29 items were initially identified for inclusion in LegA, and subsequently refined to a 24-item (two sub-scales) tool consisting of 9 passive function sub-scale items and 15 active function sub-scale items. The Delphi consultation ensured content validity, due to the experience of the clinicians in this area of practice and therefore appropriate reduction of items. In common with previous work in the upper limb, a 5-point ordinal scaling structure was chosen, with ratings based on activity over the preceding 7 days.
Source references
Ashford S, Jackson D, Mahaffey P, Vanderstay R & Turner-Stokes L.,Conceptualisation and development of the Leg Activity Measure (LegA) for patient and carer reported assessment of activity (function) in the paretic leg in people with acquired brain injury, Physiotherapy Reasearch International, 2016.
SA Ashford, RJ Siegert, H Williams, A Nair, S Orridge, L Turner-Stokes. Psychometric evaluation of the leg activity measure (LegA) for outcome measurement in people with brain injury and spasticity. Disability and Rehabilitation 43 (7), 976-987, 2021.
HYPERLINK "https://web.archive.org/web/20210117193452/https:/kclpure.kcl.ac.uk/portal/en/publications/conceptualisation-and-development-of-the-leg-activity-measure-lega-for-patient-and-carer-reported-assessment-of-activity-function-in-the-paretic-leg-in-people-with-acquired-brain-injury(7ed02e58-6b45-425a-b323-173ba03fbb99).html"
SA Ashford, A Nair, D Hancock, S Orridge, H Williams, L Turner-Stokes. The Leg Activity measure, a new measure of passive and active function and impact on quality of life; informing goal setting and outcome evaluation in leg spasticity, Disability and Rehabilitation 43 (16), 2366-2374, 2022.
Key publications
Royal College of Physicians, British Society of Rehabilitation Medicine, Chartered Society of Physiotherapy, and Association of Chartered Physiotherapists Interested in Neurology (2009) Spasticity in adults: management using botulinum toxin. National Guidelines. Royal College of Physicians, London.
- S Ashford, J Jacinto, R Zorowitz, F Calvi-Gries, P Maisonobe, C Hannes Leg Activity Measure (LegA) sensitivity to change following treatment of lower limb spasticity with a single cycle of abobotulinumtoxinA in an ambulant population (P12-8.010). Neurology 100 (17 Supplement 2). 2023.
- A Esquenazi, R Zorowitz, S Ashford, F Calvi-Gries, P Maisonobe, S Page Baseline presentation and goal setting for patients undergoing treatment for lower limb spasticity with abobotulinumtoxinA in routine practice. Data from the AboLiSh study (S10 …Neurology 98 (18 Supplement). 2022.
- A Esquenazi, S Ashford, A Brashear, P Maisonobe, A Lysandropoulos. An International, Multicenter, Observational, Longitudinal Study to Assess the Effectiveness of AbobotulinumtoxinA Injections for Adult Lower Limb Spasticity: The AboLiSH Study …Neurology 94 (15 Supplement), 2020.
Translations
French, German and Welsh translations are being developed.