Minimal Detectable Change Scores for the Wolf Motor Function Test (original) (raw)
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Neurorehabilitation and Neural Repair, 2009
Objectives. This study aimed to establish the minimal detectable change (MDC) and clinically important differences (CID) of the Wolf Motor Function Test (WMFT) in patients with stroke, and to assess the proportions of patients' change scores exceeding the MDC and CID after stroke rehabilitation. Methods. A total of 57 patients received 1 of the 3 treatments for 3 weeks and underwent clinical assessments before and after treatment. The MDC, at 90% confidence (MDC 90), was calculated from the standard error of measurement to indicate a real change for individual patients. Anchor-based and distribution-based approaches were used to triangulate the values of minimal CID. The percentages of patients exceeding the MDC and minimal CID were also examined. Results. The MDC 90 of the WMFT was 4.36 for the performance time (WMFT time) and 0.37 for the functional ability scale (WMFT FAS). The minimal CID ranged from 1.5 to 2 seconds on the WMFT time and from 0.2 to 0.4 points on the WMFT FAS. The MDC and CID proportions ranged from 14% to 30% on the WMFT time and from 39% to 65% on the WMFT FAS, respectively. Conclusions. The change score of an individual patient has to reach 4.36 and 0.37 on the WMFT time and WMFT FAS to indicate a real change. The mean change scores of a stroke group on the WMFT time and WMFT FAS should achieve 1.5 to 2 seconds and 0.2 to 0.4 points to be regarded as clinically important changes. Furthermore, the WMFT FAS may be more responsive than the WMFT time based on the results of proportions exceeding the threshold criteria.
Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke
Stroke, 2001
Background and Purpose —The Wolf Motor Function Test (WMFT) is a new time-based method to evaluate upper extremity performance while providing insight into joint-specific and total limb movements. This study addresses selected psychometric attributes of the WMFT applied to a chronic stroke population. Methods —Nineteen individuals after stroke and with intact cognition and sitting balance were age- and sex-matched with 19 individuals without impairment. Subjects performed the WMFT and the upper extremity portion of the Fugl-Meyer Motor Assessment (FMA) on 2 occasions (12 to 16 days apart), with scoring performed independently by 2 random raters. Results —The WMFT and FMA demonstrated agreement ( P <0.0001) between raters at each session. WMFT scores for the dominant and nondominant extremities of individuals without impairment were different ( P ≤0.05) from the more and less affected extremities of subjects after stroke. The FMA score for the more affected extremity of subjects a...
Assessing the Streamlined Wolf Motor Function Test as an Outcome Measure for Stroke Rehabilitation
Neurorehabilitation and Neural Repair, 2011
Objective. This study investigates the clinimetric properties of the streamlined Wolf Motor Function Test (WMFT), a 6-item version of the performance time scale of the WMFT. Methods. The streamlined WMFT, along with 2 criterion measures, the Fugl-Meyer Assessment (FMA) and the Stroke Impact Scale (SIS), were administered to 64 stroke patients before and after a 3-week intervention. Responsiveness was examined using the Wilcoxon signed rank test and standardized response mean (SRM). Criterion-related validity was investigated using the Spearman correlation coefficient (ρ). Results. The mean score on the baseline FMA upper extremity of the patients was 44.84 (standard deviation = 12.77). The streamlined WMFT and the original performance time scale showed comparable responsiveness (SRM = 0.29 and 0.37, respectively). The concurrent validity of the streamlined WMFT was good (ρ = 0.57-0.69). For predictive validity, the streamlined WMFT showed slightly better association with the criterion measures (ρ = 0.60-0.68) than did the original scale (ρ = 0.56-0.64). Conclusions. Compared with the original scale, the streamlined WMFT showed improved clinical utility.
Review question / Objective: This scoping review aimed to compile the studies that have examined the validity and reliability of the different versions of the Wolf Motor Function Test - WMFT in patients with Cerebrovascular disease. Background: Numerous investigations in rehabilitation have used the WMFT as an instrument for the primary measurement of the results; however, to date, there are no known reviews that have compiled the reliability and validity of the wolf test in its different versions, which is considered of vital importance and constitutes critical information for decision making in the process of evaluation and follow-up of patients with stroke in clinical, academic and research environments.
The EXCITE trial: attributes of the Wolf Motor Function Test in patients with subacute stroke
Neurorehabilitation and neural repair, 2005
The Wolf Motor Function Test (WMFT) has been used in rehabilitation studies of chronic stroke patients, but until now its psychometric properties have not been evaluated in patients with subacute stroke. Two hundred twenty-nine participants with subacute stroke (3-9 months postinjury) at 7 research sites met inclusion criteria for the EXCITE Trial and were randomized into immediate or delayed (by 1 year) constraint-induced movement therapy treatment. All evaluations were undertaken by assessors standardized in the administration of the WMFT and masked to treatment designation. Participants were also assessed using the Fugl Meyer Motor Assessment (FMA). Delayed group members had measurements repeated 2 weeks following baseline assessment to determine learning or exposure effects. The results demonstrate that the WMFT differentiated higher from lower functioning participants across sites; scores were uninfluenced by hand dominance or affected side. Women exhibited slower performance t...
Archives of physical …, 2001
Morris DM, Uswatte G, Crago JE, Cook EW III, Taub E. The reliability of the Wolf Motor Function Test for assessing upper extremity function after stroke. Arch Phys Med Rehabil 2001;82:750-5. Objective: To examine the reliability of the Wolf Motor Function Test (WMFT) for assessing upper extremity motor function in adults with hemiplegia. Design: Interrater and test-retest reliability. Setting: A clinical research laboratory at a university medical center. Patients: A sample of convenience of 24 subjects with chronic hemiplegia (onset Ͼ1yr), showing moderate motor impairment.
Clinical Rehabilitation, 2012
Objective: We aimed to compare the responsiveness, concurrent and predictive validity of the shortened Fugl-Meyer Assessment (S-FMA) and the streamlined Wolf Motor Function Test (S-WMFT) in persons with subacute stroke. Design: Test-retest design. Setting: Departments of physical medicine and rehabilitation at three hospitals. Participants: Participants with first-time stroke (N = 51; 38 men, 13 women; mean age ± SD, 55.1 ± 11.7 years) based on scores of Mini-Mental State Examination and Brunnstrom stage. Interventions: Participants received one of three rehabilitation therapies for three weeks and were evaluated at baseline and end of treatment. Main outcome measures: Responsiveness was examined using the paired t-test and the standardized response mean (SRM). Criterion validity was investigated using the Pearson's correlation coefficient (r). Results: Changes from baseline to end of treatment assessed by both tests were significant (P < 0.001). The value for responsiveness of the S-FMA was significantly higher than that of the S-WMFT (SRM difference, 0.48; 95% confidence interval, 0.23-0.63). There were stronger associations between the comparison scales and the S-FMA (r = 0.57-0.68) than with the S-WMFT (r = 0.39-0.58). Conclusions: The S-FMA had better concurrent and predictive validity than the S-WMFT and was more sensitive to changes caused by rehabilitation therapies. The S-FMA is recommended for expedited assessment of arm motor function outcome in stroke patients receiving rehabilitative therapy.