Psychometric Properties of a Modified Wolf Motor Function Test for People With Mild and Moderate Upper-Extremity Hemiparesis

BackgroundFunctional limitation of the upper extremities is common in patients with stroke. An upper-extremity measure with sound psychometric properties is indispensable for clinical and research use.ObjectiveThe purpose of this study was to compare the psychometric properties of 4 clinical measures for assessing upper-extremity motor function in people with stroke: the upper-extremity subscale of the Fugl-Meyer Motor Test (UE-FM), the upper-extremity subscale of the Stroke Rehabilitation Assessment of Movement, the Action Research Arm Test (ARAT), and the Wolf Motor Function Test.DesignThis was a prospective, longitudinal study.MethodsFifty-three people with stroke were evaluated with the 4 measures at 4 time points (14, 30, 90, and 180 days after stroke). Thirty-five participants completed all of the assessments. The ceiling and floor effects, validity (concurrent validity and predictive validity), and responsiveness of each measure were examined. Interrater reliability and test-retest reliability also were examined.ResultsAll measures, except for the UE-FM, had significant floor effects or ceiling effects at one or more time points. The Spearman ρ correlation coefficient for each pair of the 4 measures was ≥.81, indicating high concurrent validity. The predictive validity of the 4 measures was satisfactory (Spearman ρ, ≥.51). The responsiveness of the 4 measures at 14 to 180 days after stroke was moderate (.52 ≤ effect size ≤ .79). The 4 measures had good interrater reliability (intraclass correlation coefficient [ICC], ≥.92) and test-retest reliability (ICC, ≥.97). Only the minimal detectable changes of the UE-FM (8% of the highest possible score) and the ARAT (6%) were satisfactory.LimitationsThe sample size was too small to conduct data analysis according to type or severity of stroke. In addition, the timed component of the Wolf Motor Function Test was not used in this study.ConclusionsAll 4 measures showed sufficient validity, responsiveness, and reliability in participants with stroke. The UE-FM for assessing impairment and the ARAT for assessing disability had satisfactory minimal detectable changes, supporting their utility in clinical settings.

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The discriminative power of the Wolf motor function test in assessing upper extremity functions in persons with stroke

International Journal of Rehabilitation Research ◽

10.1097/mrr.0b013e3280118e65 ◽

2006 ◽

Vol 29 (4) ◽

pp. 357-361 ◽

Cited By ~ 16

Author(s):

Josephine Hui Yung Ang ◽

David Wai Kwong Man

Keyword(s):

Upper Extremity ◽

Motor Function ◽

Discriminative Power ◽

Function Test ◽

Wolf Motor Function Test

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The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2018.0124 ◽

2019 ◽

Vol 26 (10) ◽

pp. 1-12

Author(s):

Thanchanok Pumprasart ◽

Noppol Pramodhyakul ◽

Pagamas Piriyaprasarth

Keyword(s):

Upper Extremity ◽

Motor Function ◽

Upper Limb ◽

Muscle Tone ◽

Chronic Stroke ◽

Rank Test ◽

Limb Function ◽

Function Test ◽

Wolf Motor Function Test ◽

Therapy Programme

Background/Aims The Bobath concept has long been used to improve postural control and limb function post-stroke, yet its effect in patients with deficits have not been clearly demonstrated. This study aimed to investigate the effect of the latest Bobath therapy programme on upper limb functions, muscle tone and sensation in chronic stroke individuals with moderate to severe deficits. Methods A pre–post test design was implemented. The participants were chronic stroke individuals (n=26). Home-based intervention based on the Bobath concept was administered 3 days per week for 6 weeks (20 repetitions × 3 sets per task each session). Outcome measures consisted of the Wolf Motor Function Test, Fugl-Meyer Assessment for the upper extremity, Modified Ashworth Scale, and the Revised Nottingham Sensory Assessment. Data were analysed using the Wilcoxon Signed rank test. Results Almost all items of the Wolf Motor Function Test and the Fugl-Meyer Assessment for the upper extremity demonstrated statistically significant differences post-intervention. Finger flexor muscle tone and stereognosis were also significantly improved. Conclusions The 6-week Bobath therapy programme could improve upper limb function and impairments in chronic stroke individuals with moderate to severe deficits. Its effects were also demonstrated in improving muscle tone and cortical sensation.

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A systematic review of the application and psychometric properties of the graded Wolf Motor Function Test

British Journal of Occupational Therapy ◽

10.1177/0308022619879074 ◽

2019 ◽

Vol 83 (5) ◽

pp. 285-296

Author(s):

Beverley Turtle ◽

Alison Porter-Armstrong ◽

May Stinson

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Motor Function ◽

Keyword Search ◽

Controlled Trial ◽

Measurement Instruments ◽

Health Measurement ◽

Clinical Measurement ◽

Function Test ◽

Wolf Motor Function Test

Introduction Adapted from the Wolf Motor Function Test, the graded Wolf Motor Function Test is an upper limb activity assessment for use following stroke and brain injury. The aim of this systematic review was to identify and appraise evidence where the test has been used or has undergone psychometric evaluation. Method A systematic review of five databases was conducted to identify studies reporting the graded Wolf Motor Function Test using a keyword search. Intervention and clinical measurement studies were eligible for inclusion. Data quality was assessed using the adapted Critical Appraisal Skills Programme questions and the Consensus-based Standards for the Selection of Health Measurement Instruments Risk of Bias checklist. Results Twelve studies, of mostly low quality, were included. Studies included one randomised controlled trial, 10 pre- and post-studies and one clinical measurement study. All studies involved participants following stroke. Reliability was the only measurement property assessed in two studies, which were of a ‘doubtful’ and ‘poor’ quality. Conclusion Low quality studies impede the ability of clinicians and researchers to best determine the applicability of the graded Wolf Motor Function Test to patient groups and research contexts. Further exploration of the psychometric properties of the graded Wolf Motor Function Test is recommended across stroke populations using rigorous design methods.

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Can the Wolf Motor Function Test be Streamlined?

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308331141 ◽

2009 ◽

Vol 23 (5) ◽

pp. 422-428 ◽

Cited By ~ 31

Author(s):

Kimberly Bogard ◽

Steven Wolf ◽

Qin Zhang ◽

Paul Thompson ◽

David Morris ◽

...

Keyword(s):

Upper Extremity ◽

Motor Function ◽

Movement Therapy ◽

Change Score ◽

Functional Level ◽

Regression Methods ◽

Constraint Induced Movement Therapy ◽

Gender Concordance ◽

Function Test ◽

Wolf Motor Function Test

Background. To assess upper extremity (UE) capabilities following stroke, the Wolf Motor Function Test (WMFT) measures time to complete 15 UE tasks and 2 strength tasks, but takes 30 to 45 minutes for the clinician to complete. Objective. In an effort to streamline the WMFT, this study evaluated the association between the magnitude of improvement on any timed task of the WMFT and the change score on all other tasks among participants in the Extremity Constraint Induced Therapy Evaluation (EXCITE) trial. Methods. This association was evaluated using regression methods according to chronicity and controlling for key covariates (functional level, gender, concordance) for log mean WMFT scores. Results. After controlling for covariates, 6 tasks (hand to table [front], hand to box [front], reach and retrieve, lift can, lift pencil, and fold towel) influenced the overall WMFT score for survivors meeting EXCITE criteria and treated within 3 to 9 months poststroke. Six different tasks (extend elbow weight, hand to box [front], lift can, lift pencil, turn key in lock, and fold towel) influenced the overall WMFT score for those receiving constraint-induced movement therapy (CIMT) 1 year later. The importance of certain tasks relative to others may best represent overall UE function, but this streamlining enables the clinician to prioritize these tasks in the evaluation. Conclusions. The delineation of those tasks depends on the time poststroke from enrollment to CIMT. This study demonstrates that the WMFT can be streamlined from 17 to 6 tasks.

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