Inter-rater and intra-rater reliability of an adapted Wolf motor function test for older patients with shoulder injuries

Oberle, Corinna; Becker, Clemens; Schölch, Sabine; Lenz, Joerg-Uwe; Studier-Fischer, Stefan; Augat, Peter; Schwickert, Lars

doi:10.1007/s00391-017-1226-2

Cited by 4 publications

(10 citation statements)

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“…For testing inter-rater reliability of the videotaped WMFT-O two patient populations were assessed. The first sample was a group of sixteen patients with an age range from 75 to 90 years with surgical treatment after PHF [12]. Due to the funding guidelines of the sponsor of the study (“Deutsche Gesetzliche Unfallversicherung (DGUV)”) only persons up to 69 could be included into the intervention study.…”

Section: Methodsmentioning

confidence: 99%

“…They were assessed before randomisation (baseline) and after completing an intervention period of 3 weeks (reassessment). At baseline, cognition was assessed by the Short Orientation-Memory-Concentration Test [20] as well as visual acuity, gait speed (10-m walk [21]), level of pain in the affected arm, ability to work, disability of the arm, shoulder and hand (DASH [22]), range of motion of the affected arm (goniometer measurement [23]), and motor function of the affected arm and shoulder (WMFT-O; [12]). Clinical reassessment directly after the intervention assessed disability of the arm, shoulder and hand (DASH) as well as range of motion and functional capacity (WMFT-O).…”

Section: Methodsmentioning

confidence: 99%

“…The WMFT-O is an adapted version of the basic WMFT [24] with good clinical inter- and intra-rater reliability. The modified version for shoulder injuries was developed by our group [12]. The WMFT was developed to measure functional improvement between the beginning and the end of therapy.…”

Section: Methodsmentioning

confidence: 99%

“…The Disability of the Arm, Shoulder and Hand (DASH) questionnaire is the most commonly used questionnaire for assessing activities of daily living after shoulder and arm injuries [10]. A clinically administered assessment of the functional capacity including the quality of movement of PHF patients is the Wolf-Motor-Function-Test-Orthopaedic (WMFT-O) which has previously been assessed regarding re-test reliability, inter-rater reliability, and internal consistency [12]. One further property required of an outcome measurement is the sensitivity to change.…”

Section: Introductionmentioning

confidence: 99%

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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

Nerz

Schwickert

Schölch

et al. 2019

BMC Musculoskelet Disord

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Background The incidence of proximal humeral fractures (PHF) increased by more than 30% over the last decade, which is accompanied by an increased number of operations. However, the evidence on operative vs. non-operative treatment and post-operative treatments is limited and mostly based on expert opinion. It is mandatory to objectively assess functional capacity to compare different treatments. Clinical tools should be valid, reliable and sensitive to change assessing functional capacity after PHFs. This study aimed to analyse inter-rater reliability of the videotaped Wolf-Motor-Function-Test-Orthopaedic (WMFT-O) and the association between the clinical WMFT-O and the Disability of the Arm, Shoulder and Hand (DASH) and to determine the sensitivity to change of the WMFT-O and the DASH to measure functional capacity before and after rehabilitation in PHF patients. Methods Fifty-six patients (61.7 ± 14.7 years) after surgical treatment of PHF were assessed using the WMFT-O at two different time points. To determine inter-rater reliability, the videotaped WMFT-O was evaluated through three blinded raters. Inter-rater agreement was determined by Fleiss’ Kappa statistics. Pearson correlation coefficients were calculated to assess the association between the clinical WMFT-O and the video rating as well as the DASH. Sensitivity to change and responsiveness were analysed for the WMFT-O and the DASH in a subsample of forty patients (53.8 ± 1.4 years) who were assessed before and after a three week robotic-assisted training intervention. Results Inter-rater agreement was indicated by Fleiss’ Kappa values ranging from 0.33–0.66 for functional capacity and from 0.27–0.54 for quality of movement. The correlation between the clinical WMFT-O and the video rating was higher than 0.77. The correlation between the clinical WMFT-O and the DASH was weak. Sensitivity to change was high for the WMFT-O and the DASH and responsiveness was given. In comparison to the DASH, the sensitivity to change of the WMFT-O was higher. Conclusion The overall results indicate that the WMFT-O is a reliable, sensitive and responsive instrument to measure more objectively functional change over time in rehabilitation after PHF. Furthermore, it has been shown that video assessment is eligible for studies to ensure a full blinding of raters. Trial registration Clinicaltrials.gov, NCT03100201 . Registered on 28 March 2017. The trial was retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s12891-019-2691-0) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Nerz

Schwickert

Schölch

et al. 2019

BMC Musculoskelet Disord

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“…For objective proof of a functional improvement between the beginning and the end of the intervention, the Wolf Motor Function Test–Orthopaedic version (WMFT-O) [ 18 ] was conducted. The WMFT-O is an adapted version of the basic WMFT [ 19 ] with good inter- and intra-rater reliability.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of robot-assisted training added to conventional rehabilitation in patients with humeral fracture early after surgical treatment: protocol of a randomised, controlled, multicentre trial

Nerz

Schwickert

Becker

et al. 2017

Trials

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BackgroundThe incidence of proximal humeral fractures increases with age. The functional recovery of the upper arm after such fractures is slow, and results are often disappointing. Treatment is associated with long immobilisation periods. Evidence-based exercise guidelines are missing. Loss of muscle mass as well as reduced range of motion and motor performance are common consequences. These losses could be partly counteracted by training interventions using robot-assisted arm support of the affected arm derived from neurorehabilitation. Thus, shorter immobilisation could be reached. Thus far, this approach has been tested in only a few small studies. The aim of the present study is to examine whether assistive robotic training augmenting conventional occupational and physical therapy can improve functional shoulder outcomes.Methods/designPatients aged between 35 and 66 years with proximal humeral fracture and surgical treatment will be recruited at three different clinics in Germany and randomised into an intervention group and a control group. Participants will be assessed before randomisation and followed after completing an intervention period of 3 weeks and additionally after 3, 6 and 12 months. The baseline assessment will include cognition (Short Orientation-Memory-Concentration Test); level of pain in the affected arm; ability to work; gait speed (10-m walk); disability of the arm, shoulder and hand (Disabilities of the Arm, Shoulder and Hand Outcome Measure [DASH]); range of motion of the affected arm (goniometer measurement); visual acuity; and motor function of orthopaedic patients (Wolf Motor Function Test–Orthopaedic version [WMFT-O]). Clinical follow-up directly after the intervention will include assessment of disability of the arm, shoulder and hand (DASH) as well as range of motion and motor function (WMFT-O). The primary outcome parameter will be the DASH, and the secondary outcome parameter will be the WMFT-O. The long-term results will be assessed prospectively by postal follow-up. All patients will receive conventional occupational and physical therapy. The intervention group will receive additional robot-assisted training using the Armeo®Spring robot for 3 weeks.DiscussionThis study protocol describes a phase II, randomised, controlled, single-blind, multicentre intervention study. The results will guide and possibly improve methods of rehabilitation after proximal humeral fracture.Trial registrationClinicaltrials.gov, NCT03100201. Registered on 28 March 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2274-z) contains supplementary material, which is available to authorized users.

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Robot-assisted training after proximal humeral fracture: A randomised controlled multicentre intervention trial

et al. 2020

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Objective: To examine whether robotic-assisted training as a supplement to usual therapy is safe, acceptable and improves function and patient reported outcome after proximal humeral fractures (PHF). Design: Multicentre, assessor-blinded, randomised controlled prospective trial. Setting: Three different rehabilitation hospitals in Germany. Subjects: In total 928 PHF patients between 35 and 70 years were screened. Forty-eight participants were included in the study (intervention group n = 23; control group n = 25). Intervention: The control group received usual occupational and physiotherapy over three weeks, and the intervention group received additional 12 robot-assisted training sessions at the ARMEO®-Spring. Main measures: Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), the Wolf Motor Function Test-Orthopaedic, active range of motion and grip strength were determined before and after intervention period. The DASH was additionally obtained postal 6 and 13 months following surgery. Results: The mean age of participants was 55 ± 10 years and was similar in both groups ( p > 0.05). The change in DASH as the primary endpoint in the intervention group after intervention was −15 (CI = 8–22), at follow-up six month −7 (CI = −2 to 16) at follow up 13 month −9 (CI = 1–16); in control group −14 (CI = 11–18), at follow-up six month −13 (CI = 7–19) at follow up 13 month −6 (CI = −3 to 14). No difference in the change was found between groups ( p > 0.05). None of the follow-up time points demonstrated an additional benefit of the robotic therapy. Conclusion: The additional robot-assisted therapy was safe, acceptable but showed no improvement in functional shoulder outcome compared to usual therapy only.

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Inter-rater and intra-rater reliability of an adapted Wolf motor function test for older patients with shoulder injuries

Abstract: The adapted version of the WMFT shows high intra-rater and inter-rater reliability for patients with shoulder injuries.

Cited by 4 publications

References 27 publications

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

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

Effectiveness of robot-assisted training added to conventional rehabilitation in patients with humeral fracture early after surgical treatment: protocol of a randomised, controlled, multicentre trial

Robot-assisted training after proximal humeral fracture: A randomised controlled multicentre intervention trial

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