Psychometric Properties of a Modified Wolf Motor Function Test for People With Mild and Moderate Upper-Extremity Hemiparesis
Abstract
Whitall J, Savin DN, Harris-Love M, McCombe Waller S. Psychometric properties of a modified Wolf Motor Function Test for people with mild and moderate upper-extremity hemiparesis.
Objective
To test the necessity of videotaping, test-retest reliability, and item stability and validity of a modified Wolf Motor Function Test (WMFT) for people with mild and moderate chronic upper-extremity (UE) hemiparesis caused by stroke.
Design
Raters of videotape versus direct observation; test-retest reliability over 3 observations, item stability, and criterion validity with upper-extremity Fugl-Meyer Assessment (FMA) in the mildly and moderately impaired groups.
Setting
Academic research center.
Participants
Sixty-six subjects with chronic UE hemiparesis who participated in a large intervention study. Subjects were classified into mild and moderate groups for additional analyses.
Interventions
Not applicable.
Main Outcome Measures
Mean and median times of task completion, functional ability, and strength (weight to box) measures of the WMFT. FMA scores for validity assessment.
Results
In a subgroup of 10 subjects, the intraclass correlation coefficient (ICC) for videotape versus direct observation ranged from .96 to .99. For the whole group, test-retest reliability using ICC2,1 ranged from .97 to .99; stability of the test showed that administration 1 differed from administrations 2 and 3 but administrations 2 and 3 did not differ; item analysis showed that 4 of 17 items changed across time, and validity, using a correlation with UE FMA, ranged from .86 to .89. Separate mild- and moderate-group analyses were similar to whole-group results.
Conclusions
Videotaping the modified WMFT was not necessary for accurate scoring. The modified WMFT is reliable and valid as an outcome measure for people with chronic moderate and mild UE hemiparesis and is stable, but 1 repeat testing is recommended when practical.
aDepartment of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD
bNational Institutes of Health, National Institute of Neurological Disorders and Stroke, Human Cortical Physiology Section, Bethesda, MD
Reprint requests to Jill Whitall, PhD, Dept of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn St, Baltimore, MD 21201
Supported by the National Institute of Disability and Rehabilitation Research (grant no. H133G010111) and the Claude Pepper Older Americans Independence Center, National Institute on Aging (grant no. P6012583).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT