Minimal Detectable Change and Clinically Important Difference of the Wolf Motor Function Test in Stroke Patients

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 MDC90 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.

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Minimal Detectable Change Scores for the Wolf Motor Function Test

Neurorehabilitation and Neural Repair ◽

10.1177/1545968309335975 ◽

2009 ◽

Vol 23 (7) ◽

pp. 662-667 ◽

Cited By ~ 57

Author(s):

Stacy L. Fritz ◽

Sarah Blanton ◽

Gitendra Uswatte ◽

Edward Taub ◽

Steven L. Wolf

Keyword(s):

Motor Function ◽

Reliability And Validity ◽

Minimal Detectable Change ◽

Detectable Change ◽

Performance Time ◽

Function Test ◽

Wolf Motor Function Test ◽

Individual Task ◽

The Individual ◽

Standard Error Of Measurement

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 MDC95 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 MDC95 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.

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Inter-rater reliability, sensitivity to change and responsiveness of the orthopaedic Wolf-Motor-Function-Test as functional capacity measure before and after rehabilitation in patients with proximal humeral fractures

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2691-0 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Corinna Nerz ◽

Lars Schwickert ◽

Sabine Schölch ◽

Katharina Gordt ◽

Philip-Christian Nolte ◽

...

Keyword(s):

Motor Function ◽

Functional Capacity ◽

Proximal Humeral Fractures ◽

Humeral Fractures ◽

Sensitivity To Change ◽

Reliability Sensitivity ◽

Function Test ◽

Before And After ◽

Wolf Motor Function Test ◽

Capacity Measure

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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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Wolf Motor Function Test – Für Klienten nach einem Schlaganfall geeignet

ergopraxis ◽

10.1055/s-0030-1255435 ◽

2010 ◽

Vol 3 (06) ◽

pp. 12-13

Keyword(s):

Motor Function ◽

Function Test ◽

Wolf Motor Function Test

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Efeitos da terapia por contensão induzida nas lesões encefálicas adquiridas

Fisioterapia Brasil ◽

10.33233/fb.v17i1.19 ◽

2016 ◽

Vol 17 (1) ◽

pp. 30

Author(s):

Gabriela Da Silva Matuti ◽

Rafaela Do Nascimento Borges Marques ◽

Amanda Conte Magesto ◽

Rafael Eras Garcia ◽

Clarissa Barros De Oliveira

Keyword(s):

Motor Activity ◽

Motor Function ◽

Function Test ◽

Wolf Motor Function Test

Introdução: A Terapia por Contensão Induzida (TCI) é uma técnica de reabilitação que tem como objetivo melhora da função do membro superior.acometido. Objetivos: Determinar se o protocolo da TCI é adequado para a reabilitação do membro superior em adultos com Lesões Encefálicas Adquiridas (LEA), analisar a manutenção dos resultados e identificar possíveis preditores de eficácia da técnica. Método: Estudo retrospectivo, 40 pacientes. As escalas utilizadas foram Motor Activity Log (MAL), Quantidade (QT) e Qualidade (QL) de movimento do membro superior acometido e Wolf Motor Function Test (WMFT). Resultados e discussão: As médias de QT e QL do membro superior acometido no pré e pós-tratamento tiveram um aumento significativo (p < 0,001), enquanto as do WMFT apresentaram uma redução significativa do tempo (p < 0,001), o que representa uma melhora na habilidade motora e maior uso fora do ambiente terapêutico. Os ganhos foram mantidos após 12 meses do término do protocolo, e não foi evidenciado nenhum preditor de evolução. Conclusão: A TCI demonstrou eficácia na melhora da habilidade motora e reversão do não uso aprendido do membro superior acometido, estes resultados foram mantidos após um ano da intervenção. Não foi evidenciado no estudo nenhum fator preditor de eficácia da técnica.Palavras-chave: lesões encefálicas adquiridas, hemiplegia, terapia por contensão induzida, reabilitação.

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A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke

Clinical Rehabilitation ◽

10.1177/02692155211025131 ◽

2021 ◽

pp. 026921552110251

Author(s):

Marla K Beauchamp ◽

Rudy Niebuhr ◽

Patricia Roche ◽

Renata Kirkwood ◽

Kathryn M Sibley

Keyword(s):

Stroke Rehabilitation ◽

Minimal Clinically Important Difference ◽

Clinical Importance ◽

Minimal Detectable Change ◽

Global Rating ◽

Detectable Change ◽

Clinically Important Difference ◽

Before And After ◽

Small Change ◽

A Prospective Study

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.

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Test–retest reliability and minimal detectable change scores of twelve functional fitness tests in adults with Down syndrome

Research in Developmental Disabilities ◽

10.1016/j.ridd.2015.10.022 ◽

2016 ◽

Vol 48 ◽

pp. 176-185 ◽

Cited By ~ 14

Author(s):

PH Boer ◽

S.J. Moss

Keyword(s):

Down Syndrome ◽

Minimal Detectable Change ◽

Functional Fitness ◽

Detectable Change ◽

Retest Reliability ◽

Change Scores ◽

Fitness Tests ◽

Test Retest Reliability

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Translation, cultural adaptation and reliability of the brazilian version of the Graded Wolf Motor Function Test in adults with severe hemiparesis

Fisioterapia em Movimento ◽

10.1590/0103-5150.028.004.ao03 ◽

2015 ◽

Vol 28 (4) ◽

pp. 667-676 ◽

Cited By ~ 2

Author(s):

Natalia Duarte Pereira ◽

Luciane Vieira ◽

Fernanda Priscila Pompeu ◽

Isabella De Souza Menezes ◽

Sarah Monteiro Dos Anjos ◽

...

Keyword(s):

Motor Function ◽

Cultural Adaptation ◽

Motor Impairment ◽

Correlation Coefficients ◽

Rater Reliability ◽

Brazilian Version ◽

Function Test ◽

Wolf Motor Function Test ◽

Quality Of Movement ◽

Upper Extremity Motor Impairment

Abstract Introduction : The Graded Wolf Motor Function Test (GWMFT) was developed as a modification of the Wolf Motor Function Test (WMFT), designed to address moderate-to-severe upper-extremity motor impairment, consequent to a stroke or brain injury, by combining time and quality of movement measures in both isolated movements and functional tasks. Objectives : To translate and adapt the GWMFT form and instructions manual to Brazilian Portuguese and evaluate the inter-rater reliability. Materials and methods : Ten individuals, mean age 53.2 ± 11.39 (range: 28-72) years and a mean time since stroke onset of 82.5 ± 85.83 (16-288) months participated in the study. After translation and cultural adaptation, two independent evaluators, based on the instructions manual information, administered GWMFT. Video observations were used to rate the time and the compensatory movements in the Functional Ability Scale (FAS). Intra-class Correlation Coefficients (ICCs) and Bland-Altman plots were calculated to examine the inter-rater reliability for performance time and FAS. Results : The translated and adapted version obtained a total ICC inter-rater time 0.99 (0.95-1.00), showing less reliability in the task of lifting a pen, with ICC = 0.71 (- 0.15-0.93). The ICC of the total FAS was 0.98 (0.92-0.99) and the task of elbow extension has shown the lowest ICC rate = 0.83 (0.31-0.96). Conclusion : The GWMFT scale reliability proved to be appropriate to evaluate the paretic upper limb in individuals with chronic hemiparesis post severe stroke.

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