Minimal Detectable Change and Clinically Important Difference of the Wolf Motor Function Test in Stroke Patients
- 16 March 2009
- journal article
- research article
- Published by SAGE Publications in Neurorehabilitation and Neural Repair
- Vol. 23 (5), 429-434
- https://doi.org/10.1177/1545968308331144
Abstract
Objectives. This study aimed to establish the minimal detectable change (MDC) and clinically important differences (CID) of the Wolf Motor Function Test (WMFT) in patients with stroke, and to assess the proportions of patients' change scores exceeding the MDC and CID after stroke rehabilitation. Methods. A total of 57 patients received 1 of the 3 treatments for 3 weeks and underwent clinical assessments before and after treatment. The MDC, at 90% confidence (MDC 90), was calculated from the standard error of measurement to indicate a real change for individual patients. Anchor-based and distribution-based approaches were used to triangulate the values of minimal CID. The percentages of patients exceeding the MDC and minimal CID were also examined. Results. The MDC90 of the WMFT was 4.36 for the performance time (WMFT time) and 0.37 for the functional ability scale (WMFT FAS). The minimal CID ranged from 1.5 to 2 seconds on the WMFT time and from 0.2 to 0.4 points on the WMFT FAS. The MDC and CID proportions ranged from 14% to 30% on the WMFT time and from 39% to 65% on the WMFT FAS, respectively. Conclusions. The change score of an individual patient has to reach 4.36 and 0.37 on the WMFT time and WMFT FAS to indicate a real change. The mean change scores of a stroke group on the WMFT time and WMFT FAS should achieve 1.5 to 2 seconds and 0.2 to 0.4 points to be regarded as clinically important changes. Furthermore, the WMFT FAS may be more responsive than the WMFT time based on the results of proportions exceeding the threshold criteria.This publication has 40 references indexed in Scilit:
- The EXCITE Trial: Predicting a Clinically Meaningful Motor Activity Log OutcomeNeurorehabilitation and Neural Repair, 2008
- Using Kinematic Analysis to Evaluate Constraint-Induced Movement Therapy in Chronic Stroke PatientsNeurorehabilitation and Neural Repair, 2007
- Effect of Constraint-Induced Movement Therapy on Upper Extremity Function 3 to 9 Months After StrokeJama-Journal Of The American Medical Association, 2006
- Psychometric Properties of a Modified Wolf Motor Function Test for People With Mild and Moderate Upper-Extremity HemiparesisArchives Of Physical Medicine and Rehabilitation, 2006
- The EXCITE Trial: Attributes of the Wolf Motor Function Test in Patients with Subacute StrokeNeurorehabilitation and Neural Repair, 2005
- What change in isokinetic knee muscle strength can be detected in men and women with hemiparesis after stroke?Clinical Rehabilitation, 2005
- Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteriaJournal of Clinical Epidemiology, 2004
- Clinimetrics and psychometrics: two sides of the same coinJournal of Clinical Epidemiology, 2003
- The reliability of the Wolf Motor Function Test for assessing upper extremity function after strokeArchives of Physical Medicine and Rehabilitation, 2001
- Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patientsExperimental Neurology, 1989