Wolf Motor Function Test (WMFT)

Purpose of the measure

The Wolf Motor Function Test (WMFT) quantifies upper extremity (UE) motor ability through timed and functional tasks (Wolf, Catlin, Ellis, Archer, Morgan & Piacentino, 1995).

Available versions
The original version of the WMFT was developed by Wolf, Lecraw, Barton, and Jann in 1989 to examine the effects of constraint-induced movement therapy in clients with mild to moderate stroke and traumatic brain injury. In 1999, a graded WMFT was developed by Uswatte and Taub to assess the motor abilities of patients who were functioning at a lower level (Morris, Uswatte, Crago, Cook & Taub, 2001).

Features of the measure

Items:
The original version of the WMFT consisted of 21 items. The widely used version of the WMFT consists of 17 items. The first 6 items involve timed functional tasks, items 7 and 14 are measures of strength, and the remaining 9 items consist of analyzing movement quality when completing various tasks (Wolf et al., 1995; Whitall, Savin, Harris-Love, & Waller, 2006).

The examiner should test the less affected upper extremity followed by the most affected side. The following items should be performed as quickly as possible, truncated at 120 seconds (Wolf, Thompson, Morris, Rose, Winstein, Taub, et al., 2005):

  1. Forearm to table (side): client attempts to place forearm on a table by abducting at the shoulder
  2. Forearm to box (side): client attempts to place forearm on a box, 25.4cm tall, by abduction at the shoulder
  3. Extended elbow (side): client attempts to reach across a table, 28cm long, by extending the elbow (to the side)
  4. Extended elbow (to the side) with 1lb weight: client attempts to push the weight against outer wrist joint across the table by extending the elbow
  5. Hand to table (front): client attempts to place involved hand on a table
  6. Hand to box (front): client attempts to place hand on the box placed on the tabletop
  7. Weight to box: client attempts to place the heaviest possible weight on the box placed on the tabletop
  8. Reach and retrieve (front): client attempts to pull 1lb weight across the table by using elbow flexion and cupped wrist
  9. Lift can (front): client attempts to lift a can and bring it close to his/her lips with a cylindrical grasp
  10. Lift pencil (front): client attempts to pick up a pencil by using 3-jaw chuck grasp.
  11. Pick-up paper clip (front): client attempts to pick up a paper clip by using a pincer grasp
  12. Stack checkers (front): client attempts to stack checkers onto the center checker
  13. Flip 3 cards (front): using the pincer grasp, client attempts to flip each card over
  14. Grip strength
  15. Turning the key in lock (front): using pincer grasp, while maintaining contact, client turns key 180 degrees to the left and right
  16. Fold towel (front): client grasps towel, folds it lengthwise, and then uses the tested hand to fold the towel in half again
  17. Lift basket (standing): client picks up a 3lb basket from a chair, by grasping the handles, and placing it on a bedside table

Scoring:
The items are rated on a 6-point scale as outlined below (Wolf et al., 2005):

0. “Does not attempt with UE being tested”
1. “UE being tested does not participate functionally; however, an attempt is made to use the UE. In unilateral tasks, the UE not being tested may be used to move the UE being tested”.
2. “Does attempt, but requires assistance of the UE not being tested for minor readjustments or change of position, or requires more than 2 attempts to complete, or accomplishes very slowly. In bilateral tasks, the UE being tested may serve only as a helper”.
3. “Does attempt, but movement is influenced to some degree by synergy or is performed slowly or with effort”.
4. “Does attempt; movement is similar to the non-affected side but slightly slower; may lack precision, fine coordination or fluidity”.
5. “Does attempt, movement appears to be normal”.

Lower scores are indicative of lower functioning levels.

Time:
Not reported, but since a maximum of 120 seconds is allocated to each item, it should take approximately 30 minutes with additional time for measuring grip strength (item 14).

Subscales:
None officially documented. However, many studies use the Performance Time (WMFT-PT) and Functional Capacity (WMFT-FA) scales as subtests of the WFMT.

Equipment:

  • Table 28 cm long (height not reported)
  • Chair (dimensions not reported)
  • Bedside table (dimensions not reported)
  • Box (25.4 cm tall)
  • Free-weights
  • Can
  • Pencil
  • Paperclip
  • Checkers
  • Cards
  • Key lock with the key
  • Towel
  • Basket
  • Dynamometer for measuring hand grip strength

Training:
Not reported.

Alternative form of the WMFT
    • The original version (21 items)
    • The modified version (17 items): The modified version is most widely used and allows assessment of clients with severe, moderate and mild stroke.
Client suitability

Can be used with:

    • Clients with stroke
    • Clients with upper limb functional deficits

Should not be used with:

    • Severe cases of upper limb spasticity, and upper limb amputees
In what languages is the measure available?

English
French