Wolf Motor Function Test (WMFT)

Purpose

The Wolf Motor Function Test (WMFT) quantifies upper extremity (UE) motor ability through timed and functional tasks (Wolf, Catlin, Ellis, Archer, Morgan & Piacentino, 1995).

In-Depth Review

Purpose of the measure

The Wolf Motor Function Test (WMFT) quantifies upper extremity (UE) motor ability through timed and functional tasks (Wolf, Catlin, Ellis, Archer, Morgan & Piacentino, 1995).

Available versions

The original version of the WMFT was developed by Wolf, Lecraw, Barton, and Jann in 1989 to examine the effects of constraint-induced movement therapy in clients with mild to moderate strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. and traumatic brain injury. In 1999, a graded WMFT was developed by Uswatte and Taub to assess the motor abilities of patients who were functioning at a lower level (Morris, Uswatte, Crago, Cook & Taub, 2001).

Features of the measure

Items:

The original version of the WMFT consisted of 21 items. The widely used version of the WMFT consists of 17 items. The first 6 items involve timed functional tasks, items 7 and 14 are measures of strength, and the remaining 9 items consist of analyzing movement quality when completing various tasks (Wolf et al., 1995; Whitall, Savin, Harris-Love, & Waller, 2006).

The examiner should test the less affected upper extremity followed by the most affected side. The following items should be performed as quickly as possible, truncated at 120 seconds (Wolf, Thompson, Morris, Rose, Winstein, Taub, et al., 2005):

1. Forearm to table (side): client attempts to place forearm on a table by abducting at the shoulder
2. Forearm to box (side): client attempts to place forearm on a box, 25.4cm tall, by abduction at the shoulder
3. Extended elbow (side): client attempts to reach across a table, 28cm long, by extending the elbow (to the side)
4. Extended elbow (to the side) with 1lb weight: client attempts to push the weight against outer wrist joint across the table by extending the elbow
5. Hand to table (front): client attempts to place involved hand on a table
6. Hand to box (front): client attempts to place hand on the box placed on the tabletop
7. Weight to box: client attempts to place the heaviest possible weight on the box placed on the tabletop
8. Reach and retrieve (front): client attempts to pull 1lb weight across the table by using elbow flexion and cupped wrist
9. Lift can (front): client attempts to lift a can and bring it close to his/her lips with a cylindrical grasp
10. Lift pencil (front): client attempts to pick up a pencil by using 3-jaw chuck grasp.
11. Pick-up paper clip (front): client attempts to pick up a paper clip by using a pincer grasp
12. Stack checkers (front): client attempts to stack checkers onto the center checker
13. Flip 3 cards (front): using the pincer grasp, client attempts to flip each card over
14. Grip strength
15. Turning the key in lock (front): using pincer grasp, while maintaining contact, client turns key 180 degrees to the left and right
16. Fold towel (front): client grasps towel, folds it lengthwise, and then uses the tested hand to fold the towel in half again
17. Lift basket (standing): client picks up a 3lb basket from a chair, by grasping the handles, and placing it on a bedside table

Scoring:

The items are rated on a 6-point scale as outlined below (Wolf et al., 2005):

0. “Does not attempt with UE being tested”
1. “UE being tested does not participate functionally; however, an attempt is made to use the UE. In unilateral tasks, the UE not being tested may be used to move the UE being tested”.
2. “Does attempt, but requires assistance of the UE not being tested for minor readjustments or change of position, or requires more than 2 attempts to complete, or accomplishes very slowly. In bilateral tasks, the UE being tested may serve only as a helper”.
3. “Does attempt, but movement is influenced to some degree by synergy or is performed slowly or with effort”.
4. “Does attempt; movement is similar to the non-affected side but slightly slower; may lack precision, fine coordination or fluidity”.
5. “Does attempt, movement appears to be normal”.

Lower scores are indicative of lower functioning levels.

Time:

Not reported, but since a maximum of 120 seconds is allocated to each item, it should take approximately 30 minutes with additional time for measuring grip strength (item 14).

Subscales:

None officially documented. However, many studies use the Performance Time (WMFT-PT) and Functional Capacity (WMFT-FA) scales as subtests of the WFMT.

Equipment:

• Table 28 cm long (height not reported)
• Chair (dimensions not reported)
• Bedside table (dimensions not reported)
• Box (25.4 cm tall)
• Free-weights
• Can
• Pencil
• Paperclip
• Checkers
• Cards
• Key lock with the key
• Towel
• Basket
• Dynamometer for measuring hand grip strength

Training:

Not reported.

Alternative form of the WMFT

• The original version (21 items)
• The modified version (17 items): The modified version is most widely used and allows assessment of clients with severe, moderate and mild strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Client suitability

Can be used with:

• Clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.
• Clients with upper limb functional deficits/li>

Should not be used with:

• Severe cases of upper limb spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
  , and upper limb amputees

In what languages is the measure available?

French and English.

Summary

Wolf Motor Function Test (WMFT) Evaluation Summary

What does the tool measure?	The WMFT quantifies upper extremity motor ability through timed and functional tasks.
What types of clients can the tool be used for?	The WMFT can be used with, but is not limited to clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Is this a screeningTesting for disease in people without symptoms. or assessment tool?	Assessment
Time to administer	The WMFT takes approximately 30 minutes to administer.
Versions	The original version (21 items), and the modified version (17 items)
Other Languages	English
Measurement Properties
ReliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest .	Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.: Two studies examined the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the WMFT and reported excellent internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. using Cronbach’s alpha. Test-retest: Two studies examined the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). of the WMFT and reported excellent reliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest . using Pearson and Intraclass correlations coefficients (ICC). Inter-rater: Four studies examined the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept. of the WMFT and reported excellent reliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest . using the ICC.
ValidityThe degree to which an assessment measures what it is supposed to measure.	Content: No studies have reported the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension. of the WMFT. Criterion: Concurrent: – Two studies examined the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.” of the WMFT and reported moderate to excellent correlations with the Fugl-Meyer Assessment, as the gold standardA measurement that is widely accepted as being the best available to measure a construct. measure. – One study examined the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.” of the WMFT and reported excellent correlations with the Action Research Arm Test. Construct: Known Groups: One study examined the known groups validityKnown groups validity is a form of construct validation in which the validity is determined by the degree to which an instrument can demonstate different scores for groups know to vary on the variables being measured. of the WMFT using Wilcoxon TestThe Wilcoxon test is a nonparametric test that compares two paired groups. This test calculates and then analyzes the differences between the pairs. The Wilcoxon Rank Sum test is used to determine whether two scores have the same continuous distribution. The Wilcoxon Signed Rank test is suitable to use as an alternative to the paired t-test when the scores are not normally distributed. and reported that the WMFT is able to discriminate between healthy individuals and those with upper extremity impairments.
Floor/Ceiling Effects	No studies have examined floor/ceiling effects of the WMFT in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Does the tool detect change in patients?	No studies have examined the responsivenessThe ability of an instrument to detect clinically important change over time. of the WMFT in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Acceptability	The WMFT is the widely used as an outcome measure for constraint-induced movement therapy.
Feasibility	The administration of the WMFT is quick and simple.
How to obtain the tool?	The WMFT can be found at: Wolf, S., Thompson, P., Morris, D., Rose, D., Winstein, C., Taub, E., Giuliani, C., & Pearson, S. (2005). The EXCITE Trial: Atrributes of the Wolf Motor Function test in patients with Subacute StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Neurorehabil Neural Repair, 19, 194-205.

Psychometric Properties

Overview

We conducted a literature search to identify all relevant publications on the psychometric properties of the Wolf Motor Function Test (WMFT) in individuals with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. We identified 3 studies.

Floor/Ceiling Effects

Nijland et al. (2010) investigated the psychometric properties of the WMFT and the Action Research Arm Test in 40 patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. with mild to moderate hemiparesis. The WMFT showed adequate floor and ceiling effects with only 5 to 17% of patients scoring the lowest or highest score

Reliability

Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.:
Morris, Uswatte, Crago, Cook, and Taub (2001) evaluated the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the WMFT in 24 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. The internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the WMFT, as calculated using Cronbach’s Coefficient Alpha, was excellent (α = 0.92).

Nijland et al. (2010) investigated the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the WMFT in 40 patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. with mild to moderate hemiparesis. Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the WMFT, as calculated using Cronbach’s Coefficient Alpha was excellent (α = 0.98).

Test-retest:
Morris et al. (2001) analyzed the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the WMFT in 24 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Participants were re-assessed within a 2-week interval. The test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
, as calculated using Pearson CorrelationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases - for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases - for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
Coefficient, was excellent for both functional ability and performance tests (r = 0.95; 0.90, respectively).

Whitall, Savin, Harris-Love, and Waller (2006) examined the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the WMFT in 66 clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. Participants were re-assessed within a 2 week interval by the same rater and under the same conditions. Test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
, as calculated using Intraclass Correlation Coefficient (ICC)Intraclass correlation (ICC) is used to measure inter-rater reliability for two or more raters. It may also be used to assess test-retest reliability. ICC may be conceptualized as the ratio of between-groups variance to total variance., was found to be excellent (ICC = 0.97).

Inter-rater:
Morris et al. (2001) evaluated the Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
of the WMFT in 24 clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. Evaluations were conducted by a physiotherapist and were videotaped. The recordings were then rated by two physiotherapists and one occupational therapistIn charge of the "assessment of personal and domestic care activities; evaluation and treatment of functional impairments related to change in sensorimotor, cognitive and perceptual abilities; prescription of wheelchairs and bathroom appliances; home visits; patient and family education."(Suggested by Philips et al, 2002)
. Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
, as calculated using ICC, was excellent for both functional ability and performance tests (ICC = 0.93; 0.99, respectively).

Wolf et al. (2001) verified the Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
of the WMFT in 19 clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. and in 19 healthy individuals. All participants were evaluated by 2 raters, independently. Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
, as calculated using ICC, was excellent (ICC = 0.97)

Whitall et al. (2006) estimated the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
of the WMFT in 10 clients with stroke. The assessment of functional ability was videotaped and rated by three different raters. Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
was excellent (ICC = 0.99).

Nijland et al. (2010) investigated the psychometric properties of the WMFT and Action Research Arm Test in 40 patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. with mild to moderate hemiparesis. 18 patients participated in the reproducibility testing of the WMFT and were assessed twice by the same observer approximately 10 days apart. Intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater's subsequent ratings are contaminated by knowledge of earlier ratings.
, as analyzed using the ICC was found to be excellent (ICC = 0.94).

Validity

Content:
No studies have reported the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension.
of the WMFT.

Criterion:
Concurrent:
Wolf et al. (2001) examined the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the WMFT by comparing it to the Upper Extremity Fugl-Meyer Assessment (UE-FMA – Fugl-Meyer, Jääskö, Leyman, Olsson, & Steglind, 1975) as the gold standardA measurement that is widely accepted as being the best available to measure a construct.
in 19 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Adequate correlations were found between the WMFT and the UE-FMA (r = -0.57).

Whitall et al. (2006) assessed the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the WMFT by comparing it to the UE-FMA as the gold standardA measurement that is widely accepted as being the best available to measure a construct.
in 66 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Correlations between the functional ability test of the WMFT and the UE-FMA were excellent (r = -0.88).

Nijland et al. (2010) investigated the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the WMFT by comparing it to the Action Research Arm Test (ARAT – Lyle, 1981) in 40 patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. with mild to moderate hemiparesis. For the purpose of their investigation, the WMFT score was split into 4 variables: Functional Ability Score (FAS), median time score (s), item 7 and item 14 (strength). Correlations were calculated between the ARAT total score and the four variables. Excellent correlations between the ARAT total score and the WMFT FAS (r= 0.86), median time score (r=-0.89) and strength tasks (items 7 and 14) (r=0.70) were found.

Predictive:
No studies have reported the predictive validityA form of criterion validity that examines a measure’s ability to predict some subsequent event. Example: can the Berg Balance Scale predict falls over the following 6 weeks? The criterion standard in this example would be whether the patient fell over the next 6 weeks.
of the WMFT.

Construct:
Known groups:
Wolf et al. (2001) evaluated whether the WMFT was able to distinguish between individuals with impairment secondary to strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. (n=19) from those without impairment (n=19). Known group’s validityThe degree to which an assessment measures what it is supposed to measure.
, as calculated using Wilcoxon testThe Wilcoxon test is a nonparametric test that compares two paired groups. This test calculates and then analyzes the differences between the pairs. The Wilcoxon Rank Sum test is used to determine whether two scores have the same continuous distribution. The Wilcoxon Signed Rank test is suitable to use as an alternative to the paired t-test when the scores are not normally distributed.
, showed that the WMFT scores for the dominant and the non-dominant hand of individuals without impairment were significantly higher when compared to the most and to the least affected upper extremity of clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Responsiveness

No studies have reported the responsivenessThe ability of an instrument to detect clinically important change over time.
of the WMFT.

References

• Barreca, S.R., Gowland, C.K., Stratford, P.W., et al. (2004). Development of the Chedoke Arm and Hand Activity Inventory: Theoretical constructs, item generation, and selection. Topics in Stroke Rehabilitation, 11(4), 31- 42.
• Fugl-Meyer, A.R., Jääskö, L., Leyman, I., Olsson, S., & Steglind, S. (1975). The post-stroke hemiplegic patient 1. A method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine, 7, 13-31
• Lyle, R.C. (1981). A performance test for assessment of upper limb function in physical rehabilitation treatment and research. International Journal of Rehabilitation and Research, 4, 483-492.
• Morris, D., Uswatte, G., Crago, J., Cook, E., Taub, E. (2001). The reliability of the Wolf Motor Function Test for assessing upper extremity function after stroke. Arch Phys Med Rehabil, 82, 750-755.
• Nijland, R., van Wegen, E., Verbunt, J, van Wijk, R., van Kordelaar, J. & Kwakkel, G. (2010) A comparison of two validated tests for upper limb function after stroke: The Wolf Motor Function Test and the Action Research Arm Test. Journal of Rehabilitation Medicine, 42, 694-696.
• Whitall, J., Savin, D., Harris-Love, M., Waller, S. (2006). Psychometric properties of a modified wolf motor function test for people with mild and moderate upper extremity hemiparesis. Arch Phys Med Rehabil, 82, 750-755.
• Wolf, S., Catlin, P., Ellis, M., Archer, A., Morgan, B., Piacentino, A. (2001). Assessing Wolf Motor Function Test as outcome measure for research in patients after stroke. Stroke, 32, 1635-1639.
• Wolf, S., Thompson, P., Morris, D., Rose, D., Winstein, C., Taub, E., Giuliani, C., and Pearson, S. (2005). The EXCITE Trial: Atrributes of the Wolf Motor Function test in patients with Subacute Stroke. Neurorehabil Neural Repair, 19, 194-205.

See the measure

The WMFT can be obtained from the following publication or by clicking here.:

Wolf, S., Thompson, P., Morris, D., Rose, D., Winstein, C., Taub, E., Giuliani, C., & Pearson, S. (2005). The EXCITE Trial: Atrributes of the Wolf Motor Function test in patients with Subacute Stroke. Neurorehabil Neural Repair, 19, 194-205.