The EXCITE Trial: Attributes of the Wolf Motor Function Test in Patients with Subacute Stroke

The Wolf Motor Function Test (WMFT) has been used in rehabilitation studies of chronic stroke patients, but until now its psychometric properties have not been evaluated in patients with subacute stroke. Two hundred twenty-nine participants with subacute stroke (3-9 months postinjury) at 7 research sites met inclusion criteria for the EXCITE Trial and were randomized into immediate or delayed (by 1 year) constraint-induced movement therapy treatment. All evaluations were undertaken by assessors standardized in the administration of the WMFT and masked to treatment designation. Participants were also assessed using the Fugl Meyer Motor Assessment (FMA). Delayed group members had measurements repeated 2 weeks following baseline assessment to determine learning or exposure effects. The results demonstrate that the WMFT differentiated higher from lower functioning participants across sites; scores were uninfluenced by hand dominance or affected side. Women exhibited slower performance times than men. The Functional Ability scale (FAS) portion of the WMFT also revealed lower scores among lower functioning participants and women. Minimal changes were observed after repeating the WMFT among delayed group participants 2 weeks later. The FMA revealed similar results when the total group was divided into higher and lower functional levels at its midpoint score of 33. The WMFT discriminates higher from lower functioning participants tested across research sites. Comparable findings using the FMA support the criterion validity of the WMFT.

[1]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[2]  Michael W. Morrison,et al.  Reliability of the Finger Tapping Test and a Note on Sex Differences , 1979, Perceptual and motor skills.

[3]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[4]  Steven L. Wolf,et al.  Changes in Lower Extremity Neuromuscular and Functional Status , 1983 .

[5]  S. G. Nelson,et al.  Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. , 1983, Physical therapy.

[6]  S L Wolf,et al.  Electromyographic biofeedback applications to the hemiplegic patient. Changes in upper extremity neuromuscular and functional status. , 1983, Physical therapy.

[7]  Richard W. Bohannon Relationship between static strength and various other measures in hemiparetic stroke patients. , 1987, International rehabilitation medicine.

[8]  J. Poole,et al.  Motor assessment scale for stroke patients: concurrent validity and interrater reliability. , 1988, Archives of physical medicine and rehabilitation.

[9]  S. Wolf,et al.  Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients , 1989, Experimental Neurology.

[10]  G. Kraft,et al.  Laterality of performance in fingertapping rate and grip strength by hemisphere of stroke and gender. , 1990, Archives of physical medicine and rehabilitation.

[11]  N. Miller,et al.  Technique to improve chronic motor deficit after stroke. , 1993, Archives of physical medicine and rehabilitation.

[12]  F. Malouin,et al.  Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer Assessment and the Motor Assessment Scale. , 1994, Archives of physical medicine and rehabilitation.

[13]  Linda P. Fried,et al.  The Women's Health and Aging Study: Health and Social Characteristics of Older Women with Disability , 1995 .

[14]  H. Vanharanta,et al.  Influences of Aging, Gender, and Handedness on Motor Performance of Upper and Lower Extremities , 1996, Perceptual and motor skills.

[15]  C. Winstein,et al.  Sensory-motor control in the ipsilesional upper extremity after stroke. , 1997, NeuroRehabilitation.

[16]  J R Carey,et al.  Tracking control in the nonparetic hand of subjects with stroke. , 1998, Archives of physical medicine and rehabilitation.

[17]  A Villringer,et al.  Constraint-induced movement therapy for motor recovery in chronic stroke patients. , 1999, Archives of physical medicine and rehabilitation.

[18]  C H Chen,et al.  Please Scroll down for Article Journal of Motor Behavior Effect of Age and Gender in the Control of Elbow Flexion Movements , 2022 .

[19]  J. Whitall,et al.  Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke , 2000, Stroke.

[20]  E. Taub,et al.  The reliability of the wolf motor function test for assessing upper extremity function after stroke. , 2001, Archives of physical medicine and rehabilitation.

[21]  S. Wolf,et al.  Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke , 2001, Stroke.

[22]  S. Page,et al.  Modified constraint induced therapy: a randomized feasibility and efficacy study. , 2001, Journal of rehabilitation research and development.

[23]  B. Rosen,et al.  Motor Recovery and Cortical Reorganization after Constraint-Induced Movement Therapy in Stroke Patients: A Preliminary Study , 2002, Neurorehabilitation and neural repair.

[24]  P. Lapuerta,et al.  Change in physical performance over time in older women: the Women's Health and Aging Study. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[25]  Thomas Elbert,et al.  Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: an exploratory study. , 2002, Archives of physical medicine and rehabilitation.

[26]  J. P. Miller,et al.  Methods for a Multisite Randomized Trial to Investigate the Effect of Constraint-Induced Movement Therapy in Improving Upper Extremity Function among Adults Recovering from a Cerebrovascular Stroke , 2003, Neurorehabilitation and neural repair.

[27]  Lori Shutter,et al.  Home Forced Use in an Outpatient Rehabilitation Program for Adults with Hemiplegia: A Pilot Study , 2003, Neurorehabilitation and neural repair.

[28]  John Chae,et al.  Upper Limb Motor Function in Hemiparesis: Concurrent Validity of the Arm Motor Ability Test , 2003, American journal of physical medicine & rehabilitation.

[29]  K. M. Anderson,et al.  Application of constraint-induced movement therapy for an individual with severe chronic upper-extremity hemiplegia. , 2003, Physical therapy.

[30]  Mark Hallett,et al.  Constraint-Induced Therapy in Stroke: Magnetic-Stimulation Motor Maps and Cerebral Activation , 2003, Neurorehabilitation and neural repair.

[31]  H. Vet,et al.  Clinimetric Properties of the Motor Activity Log for the Assessment of Arm Use in Hemiparetic Patients , 2004, Stroke.

[32]  P. Jongbloet "Conception origin" versus "fetal origins" hypothesis and stroke. , 2003, Stroke.