Wolf Motor Function Test (WMFT)

What is the Wolf Motor Function Test (WMFT)?

is a type of physical therapy assessment mostly used on patients suffering from stroke or have noticeable deficits in the motor functions of their upper extremities (UE). This is common in those who have had a stroke. The test assesses the motor abilities of a person’s UE by having them partake in a series of timed exercises involving both their arms. Do note that upper extremity deficits do not include those who are amputees or those with severe upper limb spasticity.

The test has a total of seventeen exercises. Six of these exercises are for observing the patient's functional ability (exercises 1 to 6), and eight of these are for observing the patient's strength (exercises 7 to 14). Nine of these exercises (exercises 9 to 17) are for observing the quality of movement when performing certain tasks.

The patient taking the test is allotted 120 seconds per exercise. The less affected side will be evaluated first, followed by the side that is mostly affected.

Materials Required for the WMFT

This test also requires certain materials for it to be administered. Here are all the things you will need to prepare:

• A table that is 28cm long
• Sturdy chair
• Bedside table
• Box (25.4cm tall)
• Wrist weights (1-20 pounds)
• Beverage can (12 oz)
• 7” pencil with six flat sides
• 2” paperclip
• 3 checkers
• 3 note cards (must be 3” x 5”)
• Keylock and key
• Towel
• Basket
• Dynamometer (to measure the patient’s hand grip strength)
• Stopwatch (to time each exercise)
• Video camera (optional if you want to take video recordings)

How to Administer the Wolf Motor Function Test

Once you have prepared all the materials above, it’s time for you to conduct the series of exercises.

Remember that you must allot 120 seconds for each exercise. Say “GO” to signal the start of each exercise. You should also activate your stopwatch as soon as you say “GO,” and turn it off as soon as the patient accomplishes the exercise or if you say “STOP” after 120 seconds.

You also have to start with the less affected limb, and then the more affected limb to compare results later on.

Wolf Motor Function Test Sequence

Now, here are the exercises that they must accomplish. Make sure to demonstrate each one and have them do each of them in the sequence arranged below:

1. Forearm to table (side): client attempts to place their forearm on a table by abducting at the shoulder
   

2. Forearm to box (side): client attempts to place their 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 the outer wrist joint across the table by extending the elbow
   

5. Hand to table (front): client attempts to place the involved hand on a table
   

6. Hand to the box (front): client attempts to place their hand on the box placed on the tabletop
   

7. Weight to the 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 a 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, the client attempts to flip each card over
    

14. Grip strength: use the dynamometer to measure this
    

15. Turning the key in the lock (front): using a pincer grasp, while maintaining contact, the client turns the key 180 degrees to the left and right
    

16. Fold towel (front): client grasps the 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 then have them place it on a bedside table

How to score the Wolf Motor Function Test (WMFT)

Scoring each exercise is simple since each score has a set scoring system and set designations. Here are the possible scores you can give for each exercise:

• 0 = The patient does not attempt with the UE being tested
• 1 = The UE being tested does not participate functionally; however, an attempt is made by the patient to use the UE. In unilateral tasks, the UE not being tested may be used to move the UE being tested.
• 2 = The patient does attempt, but requires the 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 = The patient does attempt, but the movement is influenced to some degree by synergy or is performed slowly or with effort.
• 4 = The patient does attempt; movement is similar to the non-affected side but slightly slower; may lack precision, fine coordination, or fluidity.
• 5 = The patient does attempt, and movement appears to be normal.
  

Exercises 7 and 14 are not scored this way. Instead, you must indicate the pounds (for Exercise 7) and the grip strength in kgs for (Exercise 14).

Given this, the maximum score is 75 for each limb, so make sure to assess both.

There are no specific score ranges and designations to consider, but lower scores indicate lower functional levels for their upper extremities.

Don’t forget to indicate the time it took the patient to complete each exercise as well.

If they are scoring low and it’s evident they are having trouble with their upper extremities, then you should determine what goes into your care plan based on your observations. It’s also best that you conduct other assessments to cover more ground.

When is it best to administer the Wolf Motor Function Test (WMFT)?

The Wolf Motor Function Test (WMFT) is often included in the rehabilitation plans created for people impacted by stroke and other similar afflictions. This is used to gauge where patients currently are physically so that physical therapists handling them can create care plans that take into account whatever deficits they have with their upper extremities.

Do note that the Wolf Motor Function Test (WMFT) is limited to assessing a person’s upper extremities. There may be more to the patient’s physical condition, especially after dealing with something like a stroke, so it’s always best to conduct other examinations that focus on other body parts to get a more comprehensive look at the patient’s physical condition.

The WMFT can also be administered during routine examinations to check up on the patient. Subsequent tests are done to monitor the progress of patients when it comes to their upper extremity functions. Are they getting better? Are they still the same as they were after the initial test? Or are they getting worse? These are the questions you can answer whenever you re-administer this test. It’s highly recommended that you use this every now and then instead of it being a one-time, big-time test.

Who can administer the Wolf Motor Function Test (WMFT) and for whom is it?

Since the Wolf Motor Function Test (WMFT) focuses on the upper extremities of a patient, specifically those who are dealing with the effects of stroke (and similar brain issues) as well as those who have noticeable deficits with their upper extremities, the healthcare professionals that can administer this test are orthopedists and physical therapists.

The healthcare professional must be able to make careful observations and, as much as possible, accurate inferences regarding a patient’s upper extremity functions. Given that, not just anyone can use this. Only those highly trained and experienced in assessing and treating patients with upper extremity problems should administer this test, whether for an initial assessment or as part of a routine examination.

Do note that the Wolf Motor Function Test (WMFT) should not be the sole test to administer to a patient, nor should it be the sole catalyst for developing a treatment plan. Remember to integrate other assessments as part of your comprehensive patient examination so you can tackle their physical condition from various angles. This is so you can make better-informed decisions when treating and rehabilitating your patient and developing care plans for them.

What are the benefits of using the Wolf Motor Function Test (WMFT)?

It gives a clear picture of the state of a person’s upper extremities.

The Wolf Motor Function Test (WMFT) may take a lot out of a patient given they have to do seventeen exercises to complete it, but the number of exercises they do and how fast they accomplish them will provide physical therapists and orthopedists a clear picture of what a patient’s current capabilities are when it comes to their upper extremities.

It can help determine what goes into a care plan for the patient.

By having a comprehensive look at a patient’s upper extremities, physical therapists and orthopedists will be able to determine what they should consider when developing a care plan. Will the patient benefit from doing certain things independently despite their condition? Given their current condition, should the patient’s loved ones or caregivers assist with certain actions or Activities of Daily Living (ADLs)? What kind of exercises should they practice, and will these exercises even improve their condition in the first place? These are just some questions that can be answered after the patient completes this test.

It can be used to monitor a patient.

Now, let’s say that you have developed a care plan, implemented it, and it’s being followed by your patient and their loved ones/caregivers. You will want to know if your patient is getting better or worse, so you can re-administer this test to see if there are any improvements in their upper extremity functions. How they are doing should also help you determine if your plan is working and should be maintained, or if aspects of it should be adjusted or if you must overhaul it.