The Reliability of the Wolf Motor Function Test for Assessing Upper Extremity Function After Stroke* 1 (original) (raw)
Related papers
2011
Background: The Wolf Motor Function Test (WMFT) evaluates the upper limb (UL) performance of adults with hemiparesis by combining time and quality of movement measures in both isolated movements and functional tasks. Objectives: To translate and adapt the WMFT form, functional ability scale (FAS) and manual to Brazilian Portuguese and evaluate the intra and inter-rater reliabilities. Methods: Fifteen individuals with a mean age of 57.9±11.1 years and a mean time since stroke onset of 68.5±53.5 months participated. The WMFT was administered by one physiotherapist based on information in the manual, and video observations were assessed by two other independent physical therapists. Information regarding compensatory movements was included in the FAS. Intra-class correlation coefficients (ICCs) and Bland-Altman plots were calculated to examine the intra-and inter-rater reliabilities for performance time and FAS, whereas weighted kappa (Kp) was used to examine the agreement strength for FAS. Results: The inter-rater ICC values for performance time were above 0.75 in 13 of the 15 tasks. For the FAS, they ranged from 0.87-0.99 for all evaluated tasks, with Kp values ranging from 0.63-0.92. For intra-rater reliability, the ICC ranged from 0.99-1.0 and from 0.96-1.0 for time measurement and FAS, respectively. Kp values ranged from 0.79-0.96 for individual and 0.93 for total scores. Conclusion: The Brazilian version of the WMFT showed adequate intra-and inter-rater reliabilities for evaluating the paretic UL of individuals with stroke.
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.
Interrater Reliability of the Wolf Motor Function Test-Functional Ability Scale: Why It Matters
Neurorehabilitation and neural repair, 2014
Background. One important objective for clinical trialists in rehabilitation is determining efficacy of interventions to enhance motor behavior. In part, limitation in the precision of measurement presents a challenge. The few valid, low-cost observational tools available to assess motor behavior cannot escape the variability inherent in test administration and scoring. This is especially true when there are multiple evaluators and raters, as in the case of multisite randomized controlled trials (RCTs). One way to enhance reliability and reduce variability is to implement rigorous quality control (QC) procedures. Objective. This article describes a systematic QC process used to refine the administration and scoring procedures for the Wolf Motor Function Test (WMFT)-Functional Ability Scale (FAS). Methods. The QC process, a systematic focus-group collaboration, was developed and used for a phase III RCT, which enlisted multiple evaluators and an experienced WMFT-FAS rater panel. Resu...
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...
Minimal Detectable Change Scores for the Wolf Motor Function Test
NEUROREHABILITATION AND NEURAL REPAIR, 2009
Background. The Wolf Motor Function Test (WMFT) is an impairment-based test whose psychometrics have been examined by previous reliability and validity studies. Standards for evaluating whether a given change is meaningful, however, have not yet been addressed. Objectives. To determine the standard error of measurement (SEM) and minimal detectable change (MDC) for the WMFT. Methods. Data were collected from 6 university laboratories that participated in the EXCITE national clinical trial and included 96 individuals with sub-acute stroke (3-9 months). Measurements were made by blinded evaluators who were trained and standardized to administer the WMFT, which was completed on 2 occasions 2 weeks apart. No intervention was given between testing sessions. Results. The WMFT Performance Time score has a SEM of 0.2 seconds and a MDC 95 of 0.7 seconds. The individual task timed items MDC 95 ranged from 1.0 second (turn key in lock) to 3.4 seconds (reach and retrieve) with individual task items demonstrating notablly higher variability than the average WMFT Performance Time. The average WMFT Functional Ability Scale SEM and MDC 95 is 0.1 points. Conclusions. When assessing the effect of a therapeutic intervention, if an individual experiences an amount of change equal to or greater than the MDC, then one may be 95% confident that this margin of change is truly larger than measurement error and not a chance result. Thus, the determination of SEM and MDC in outcome assessments allows researchers and clinicians to distinguish which results are actual differences versus which results are simply changes resulting from error or chance.
Confiabilidade da versão brasileira do Wolf Motor Function Test em adultos com hemiparesia
Brazilian Journal of Physical Therapy, 2011
Background: The Wolf Motor Function Test (WMFT) evaluates the upper limb (UL) performance of adults with hemiparesis by combining time and quality of movement measures in both isolated movements and functional tasks. Objectives: To translate and adapt the WMFT form, functional ability scale (FAS) and manual to Brazilian Portuguese and evaluate the intra and inter-rater reliabilities. Methods: Fifteen individuals with a mean age of 57.9±11.1 years and a mean time since stroke onset of 68.5±53.5 months participated. The WMFT was administered by one physiotherapist based on information in the manual, and video observations were assessed by two other independent physical therapists. Information regarding compensatory movements was included in the FAS. Intra-class correlation coefficients (ICCs) and Bland-Altman plots were calculated to examine the intra-and inter-rater reliabilities for performance time and FAS, whereas weighted kappa (Kp) was used to examine the agreement strength for FAS. Results: The inter-rater ICC values for performance time were above 0.75 in 13 of the 15 tasks. For the FAS, they ranged from 0.87-0.99 for all evaluated tasks, with Kp values ranging from 0.63-0.92. For intra-rater reliability, the ICC ranged from 0.99-1.0 and from 0.96-1.0 for time measurement and FAS, respectively. Kp values ranged from 0.79-0.96 for individual and 0.93 for total scores. Conclusion: The Brazilian version of the WMFT showed adequate intra-and inter-rater reliabilities for evaluating the paretic UL of individuals with stroke.
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.