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Bruininks Motor Ability Test
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Dara, Armiyau, Malika, Sam
Bruininks Motor Ability Test
Background
The BMAT was developed by Brett D. Bruininks, PhD and Robert H. Bruininks, PhD in 2012
The BMAT is a comprehensive motor assessment, individually administered, standardized test of gross and fine motor skills for adults. The BMAT assesses:
- Fine Motor Integration
- Manual Dexterity
- Coordination
- Balance and Mobility
- Strength and Flexibility
Cost: $625 (Expensive!)
Population
- It is an adult adaptation of the BOT-2, and was developed to be the new adult motor ability test
- Administered to both men and women
- Used with older adults aged 40 to 85+ years who have problems with fine and gross motor skills, manual dexterity, coordination, balance and mobility, or strength and flexibility
Purpose
- Used to assess motor abilities related to improvement in physical functioning and/or requirements for ADL’s
- Used as a practice tool for guiding treatment, setting treatment goals, and monitoring progress towards these goals
- Can be used anytime as a standardized assessment of the motor abilities of an adult 40+ is desired. There is the full-length version and the short form.
Two primary needs that the tests serves:
1. Living situation placement/support decisions (individuals ability to perform ADL’s independently) and
2. Treatment planning and evaluation
Helpful in research on adult motor ability
Practitioners
Professionals in:
- Occupational and Physical therapies
- Nursing
- Human Performance
- Physical rehabilitation
Used to determine if clients’ motor function issues need to be addressed before they can live independently.
Administration
Settings:
All clinical settings, but especially used in:
- Inpatient
- Outpatient
- Acute care
- Long Term Acute Care
- Home Health
- research on adult motor ability.
Used to assess the gross and fine motor abilities of adults age 40 and older
Subsets
Five Subsets (each with corresponding record form for scoring):
- Subset 1: Fine Motor Integration: 7 items, with focus on precise hand and finger active movement and coordination, with the integration of visual stimuli. Ex: drawing tasks, folding paper, use of scissors to cut.
- Subset 2: Manual Dexterity: 5 items, with emphasis on goal directed tasks. Ex: Reaching and grasping objects and bimanual coordination tasks such as sewing. Emphasis placed on accuracy, thus tests are timed (use of a stopwatch).
- Subset 3: Coordination: 6 items, where assessment of one’s ability to coordinate movements of the hand, arm, and feet occurs. Ex: Tossing and catching a ball.
- Subset 4: Balance and mobility: 7 items, with emphasis on assessment of motor control skills needed for standing, walking, and navigating stairs. Ex: Up/Down stepping, balance maintained with vision occluded, walking in alternating directions.
- Subset 5: Strength and Flexibility: 7 items, one measure examines flexibility of the lower back while the other six items measure strength and flexibility of muscle groups throughout the body (legs, torso, arms, hands). Ex: Sit to stands, seated bicep curls, grip strength, wall push-ups.
+
Minimum Motor Requirements Per Subset (Confirm prior to administration):
- Subset 1 and 2: Ability to sit at a table and use both UEs
- Subset 3: Ability to sit in a chair, use both UEs, and tap both feet
- Subset 4: Ability to walk without AD or assistance from another individual
- Subset 5: Ability to sit in a chair, stand, and use both UEs
Flow
Options
- Total Test: Administration of all subsets gives a comprehensive analysis of one’s motor abilities and limitations. Duration is approximately 55 minutes or more. Administration time will increase or decrease based on a client’s diagnosis, comorbidities affecting function, and motor impairments. Duration is also affected by the examiners familiarity with the testing materials and procedures.
- Individual subsets: Each BMAT subset provides specific information on related to areas of fine and gross motor coordination. Each subset takes approximately 8-16 minutes. Above-mention affects on administration time are the same.
- Combination of subsets: An examiner can choose to focus on subset combination specific to a client. Administration time varies based on subsets used and above-mentioned affects on administration.
- Short Form Administration: Total of 10 items, 2 from each of the 5 BMAT subsets. Administration duration 15-25 minutes to administer with consideration of above-mentioned affects on administration. This is a good option for brief, but comprehensive assessments, and when there are time constraints.
Scoring
Manual Scoring: By Hand
- The use of a computer is not necessary.
- Longer scoring duration
Use of a Q-global scoring system: Web based/online scoring system
- The use of a computer is necessary.
- Secure method that is easily accessible
- Offered by online databases such as Pearson to generate scores and produce reports.
Manual
Q-Global
Psychometrics
- Validity: “When compared to other assessments, such as Nine Hole Peg Test (9-HPT), Berg Balance Test (BBT), Beery-Buktenica Developmental Test of Visual Motor Integration (Beery VMI), the BMAT in general and its subsets appear to be practical and valid standardized tests of adult motor proficiency” (Bruininks & Bruininks, 2012).
- Standard deviation: “The BMAT provides derived scores that will assist you in interpreting performance. Standard scores (mean = 500, standard deviation = 20), confidence intervals, and percentile ranks are used to describe composite performance” (Bruininks & Bruininks, 2012).
- Statistical significance: Reliable and valid test, with demographic trends of declining scores with increase in age (reflected across all subsets). Differentiation of effect size when necessary (motor impairment versus non-motor impairments) (Pearson Assessments U.S., 2018).
Reliability
Test-retest reliability:
o Subset 1: Fine motor integration
r = .76
o Subset 2: Manual Dexterity
r = .90
o Subset 3: Coordination
r = .80
o Subset 4: Balance and mobility
r = .83
o Subset 5: Strength and Flexibility
r = .92
Interator Reliability: Good to Excellent
o Subset 1: Fine motor integration
r = .96
o Subset 2: Manual Dexterity
r = .99
o Subset 3: Coordination
r = .97
o Subset 4: Balance and mobility
r = .97
o Subset 5: Strength and Flexibility
r = .99
(Bruininks & Bruininks, 2012 & Pearson Assessments U.S., 2018)
Application
Article: Constraints on motor planning across the life span: Physical, cognitive, and motor factors
“This study investigated the constraints on movement planning across the lifespan, including executive functions, general motor ability, physical constraints to movement and motor imagery ability. One hundred and twenty-two participants aged 20-81 years completed an end-state-comfort task with increasing levels of complexity. Individuals’ executive functions, motor control, motor imagery ability and perceived rotation span were also examined. Age-related decline was shown in planning for sequential movements but not in simple single-step movements. Motor planning demonstrated an age-related difference, which was associated with an increasing number of constraints as age increased, and in older adults chronological age influenced the effect of each constraint on motor planning.” (Wang et al., 2019)
Further
“[Individuals’ general motor ability was assessed using the short version of the Bruininks Motor Ability Test (BMAT-short; Bruininks & Bruininks, 2012). A raw total score was calculated for each participant and then standardized using age appropriate bands. This standardized BMAT score was used as the measure of motor ability. A conservative cut-off of z-scores falling three standard deviations above or below the mean was adopted, along with p values.]” (Wong et al., 2019)
From this study, it can be inferred that test bias relates to a decrease in scores on the BMAT (i.e. motor function and efficacy), as one increases in age.
Graphic
Relevance
The underlying goal of all OT practice is to enable clients to live more full and independent lives. Motor function deficiencies, both gross and fine motor, can significantly hinder one’s ability to function independently, and can impact all activities of daily living.
Why BMAT?
BMAT is one of the most valid and reliable tests for measuring gross and fine motor abilities and is therefore relevant in occupational therapy interventions and practice. Using the BMAT will allow for occupational therapists to determine if occupational therapy services are necessary.
Benefits
Moreover, the test can help to identify fine or gross motor processing deficits and writing difficulties as well as other developmental coordination disorder. The BMAT is also relevant for Occupational Therapy practice because it allows for occupational Therapists to establish goals and monitor the progress of the intervention process.
Advantages
The BMAT has many features such as coordination, manual dexterity, balance and mobility and strength and flexibility. BMAT also has several advantages over other motor assessments, including three areas of evaluation; fine motor, gross motor, and total motor
Frame of Reference:
Rehabilitative: focuses on identifying deficits to help therapist and patient adapt or find solutions
Theory/FOR
Conclusion
- The BMAT is a specialized version of the BOT-2 for older adults
- Main focus is gross and fine motor skills
- Benefits include a long-form and short-form, as well as 2 categories and 5 subsets that can be completed individually
- Pearson assessments can be scored by hand but can also be scored using the Q-Global software
Usefulness
- The BMAT is useful in it's specialization and adaptability
- OT's can use the assessment in whatever way best suits their needs
- The assessment is easily scored and has established reliability and validity
Challenges
- This assessment is fairly new and it's use is not yet widespread
- The assessment is often overshadowed by the BOT-2
- Specialization is a plus but also creates a challenge with limited population
Future
- With the benefits stated previously, this assessment is set to become more popular and wide-spread in the coming years
- Testing should continue for different subsets of the population (i.e. different diagnoses, geographical locations, etc.)
References
Asher, I. E. (2014). Asher's occupational therapy assessment tools: an annotated index. Bethesda, MD: AOTA Press.
Bruininks, B., & Bruininks, R. (2012). Bruininks Motor Ability Test: Comprehensive Form Report Sample. http://images.pearsonclinical.com/images/assets/BMAT/BMAT_Comprehensive_Form_Sample_Report.pdf
Bruininks, B., & Bruininks, R. (2012). Occupational Therapy: Bruininks Motor Ability Test. https://wgdesigngroup.com/flipbooks/Pearson/8/#zoom=z
Cole, M. B., & Tufano, R., (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK
Pearson Education Inc. (2012). Bruininks Motor Ability Test. https://www.pearsonassessments.com/content/dam/school/global/clinical/us/assets/bmat/bmat-flyer.pdf
Pearson Assessments. (2018). U.S. Adult Motor Ability Assessment Overview of the Bmat. https://www.youtube.com/watch?reload=9&v=L7aFVSXtDcs
Probst, M., & Skjaerven, L. H. (2018). Physiotherapy in mental health and psychiatry: a scientific and clinical based approach. Edinburgh: Elsevier.
Wang, S., Williams, J., & Wilmut, K. (October, 2019). Constraints on motor planning across the life span: Physical, cognitive, and motor factors. Psychology and Aging. doi: 10.1037/pag0000408