Wolf Motor Function Test for characterizing moderate to severe hemiparesis in stroke patients

Abstract

Objective: To extend the applicability of the Wolf Motor Function Test (WMFT) to describe the residual functional abilities of moderate to severely affected stroke patients.

Design: Data were collected as part of 2 double-blind, sham-controlled, randomized interventional studies: the Transcranial Direct Current Stimulation (tDCS) in Chronic Stroke Recovery and the tDCS Enhanced Stroke Recovery and Cortical Reorganization. Stroke patients were evaluated with the upper extremity Fugl-Meyer (UFM) and the WMFT in the same setting before treatment.

Setting: University inpatient rehabilitation and outpatient clinic.

Participants: Stroke patients (N=32) with moderate to severe hemiparesis enrolled in the tDCS in Chronic Stroke Recovery and the tDCS Enhanced Stroke Recovery and Cortical Reorganization studies.

Interventions: Not applicable.

Main outcome measures: WMFT scores were calculated using (1) median performance times and (2) a new calculation using the mean rate of performance. We compared the distribution of values from the 2 methods and examined the WMFT-UFM correlation for the traditional and the new calculation.

Results: WMFT rate values were more evenly distributed across their range than median WMFT time scores. The association between the WMFT rate and UFM was as good as the association between the median WMFT time scores and UFM (Spearman ρ, .84 vs -.79).

Conclusions: The new WMFT mean rate of performance is valid and a more sensitive measure in describing the functional activities of the moderate to severely affected upper extremity of stroke subjects and avoids the pitfalls of the median WMFT time calculations.

Trial registration: ClinicalTrials.gov NCT00085657 NCT01014897.

Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1. Scatter Charts Demonstrate Consistent Relationship between the WMFT Mean Rate of Performance and UFM

Scatter plots of median task times (on the left) and mean rates of performance (on the right) from the WMFT vs. UE-FM scores from the acute (first row), chronic study (second row), and the combined dataset (third row). Each graph contains a LOWESS line superimposed on the data points. Please note that shorter task completion times indicate better performance for the median time data, therefore the sign of correlation is reversed.