THE WOLF MOTOR FUNCTION TEST

Abstract

Purpose/Hypothesis: The purpose of this study was to establish a normative database for the Wolf Motor Function Test (WMFT) and to determine trends between and within specific age groups, gender, sequence of testing, and specific WMFT tasks. We hypothesized that movement times would increase and strength would decrease among older participants. We further hypothesized that women would not be as strong as men for the two strength tasks. Number of Subjects: A convenience sample of 52 healthy able-bodied adult individuals, both male and female, between the ages of 40 and 80 participated. The sample was then grouped by decades. All participants met pre-established inclusion/exclusion criteria including no past medical history of stroke or other brain injury and no previous upper extremity (UE) impairments or limitations. All but one person were right handed by statement of hand preference for writing. Prior to testing, all participants read and signed an informed consent and a HIPAA form. Materials/Methods: Administration of the WMFT required standardized positions for table and seat height, the correct position of a standardized template, standard items for testing, and specific verbal instructions. WMFT tasks remained constant throughout (tasks 1–17, sequentially) and progressed from proximal single joint movements to more complex multi-seg-mental UE motions. Both UE for each participant were tested. Limb sequencing was determined randomly by a coin flip. Two co-investigators were responsible for administering the WMFT throughout the study. Each co-investigator established intra-rater reliability prior to administration of the WMFT (ICC3, 1 = 0.99). Inter-rater reliability was established prior to and throughout testing (ICC2, 1 = 0.91–1.00). Results: An age effect for timed tasks was observed between the forty–sixty, forty–seventy, and fifty–seventy year age groups for the right hand and between the forty–sixty and forty–seventy year age groups for the left hand (p = 0.0027). An interaction was also seen within hand by sequencing in timed tasks (p < 0.0001). No gender differences existed for the timed tasks; however, differences between genders were found for both strength tasks (p < 0.0001). Conclusions: This study presents a normative database of healthy able-bodied adult individuals for the WMFT. On timed tasks, older adults were slower than younger adults and the first hand tested was slower. Men were consistently stronger than women on strength tasks. Clinical Relevance: Currently the WMFT is administered to the less affected UE first; therefore the more impaired UE may yield better scores because of a sequence effect. Consequently, randomizing the limb sequence for testing may combat a potential testing effect. Having this normative data set will help clinicians and third party payers to understand relative improvement in patients with mild to moderate stroke following interventions. Periodic assessment of change scores among individual tasks will also assist clinicians in modifying treatment programs to target those joint movements requiring additional attention.