A Reaching Performance Scale for 2 Wolf Motor Function Test Items

Objective: To adapt the Reaching Performance Scale for Stroke (RPSS) for the Wolf Motor Function Test (WMFT) "Lift Can" (Can) and "Hand to Box" (Box) items. Design: Retrospective analysis of video-recorded WMFT assessment performed by 3 raters on 2 occasions. Setting: Not applicable. Participants: Participants (N=29) with mild to moderate upper extremity impairment less than 3 months after stroke. Interventions: Not applicable. Main Outcome Measures: Inter- and intra-rater agreement, concurrent validity of WMFT-RPSS. Results: Mean +/- SD inter-rater Gwet's agreement coefficient (AC(2)) was 0.61 +/- 0.05 for Can WMFT-RPSS and 0.56 (0.03) for Box. Mean +/- SD intra-rater AC(2) for Can was 0.63 +/- 0.05 and 0.70 +/- 0.04 for Box. WMFT-RPSS Can and Box scores correlated with log mean WMFT time (C, -0.73; B, -0.48), Functional Ability Scale (C, 0.87; B, 0.62), Upper Extremity Fugl-Meyer Motor Score (C, 0.69; B, 0.51), and item movement rate (C, 0.74; B, 0.71) (P<.05 for all). Mean +/- SD WMFT-RPSS score across the 29 participants was 12.7 +/- 3.5 for Can (max score, 19) and 11.4 +/- 3.0 for Box (max score, 16). Conclusions: WMFT-RPSS demonstrated moderate intra-rater and weak-to-moderate inter-rater agreement for individuals with mild-moderate impairment. For construct validity, Can and Box WMFT-RPSS were significantly correlated with 4 standardized measures. Average WMFT-RPSS scores revealed that some participants may have relied on compensatory movements to complete the task, a revelation not discernable from movement rate alone. The WMFT-RPSS is potentially useful as a valid and reliable tool to examine longitudinal changes in movement quality after stroke. (C) 2020 by the American Congress of Rehabilitation Medicine