Can the Wolf Motor Function Test be Streamlined?

Abstract

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.

Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial

“…We used an abbreviated version of WMFT that included six tasks (hand to table, hand to box, reach and retrieve, lift can, lift pencil, and fold towel), 25 and added grip strength and flip a card tasks. Secondary endpoints at the end of the 2 week interventions were: gross manual dexterity assessed using the Box and Block Test (BBT); quality of life after stroke and hand function, both measured by the Stroke Impact Scale (SIS); score on the functional independence measure (FIM); independence for activities of daily living as measured by the Barthel Index; score on the Modified Rankin Scale; and grip strength measured using a dynamometer.…”

Home-based telerehabilitation shows improved upper limb function in adults with chronic stroke: A pilot study

“…Six of the participants also completed laboratory-based pre-, post- and one-month follow-up testing consisting of the Streamlined Wolf Motor Function Test (WMFT), a clinical assessment of upper limb function (7), kinematic assessments of unilateral reaching movements from a waist to shoulder height target using an electro-magnetic 3D motion monitor (Ascension Technology Corporation, Burlington, VT), computerized cognitive assessments using CogState software (New Haven, CT) and position sense. Using output data from the 3D motion monitor movement smoothness was calculated using a normalized jerk score (8).…”

Effect of Trunk Support on Upper Extremity Function in People With Chronic Stroke and People Who Are Healthy

“…The UE motor function was measured with the Streamlined Wolf Motor Function Test (SWMFT) 25 . The six SWMFT tasks appropriate for people with chronic stroke were lifting hand from the table to a box, lifting a can to mouth, lifting a pencil with 3-jaw chuck grasp, folding towel, turning key in lock, and extending elbow against a one-pound weight 26 …”