Minimal detectable change scores for the Wolf Motor Function Test.
BACKGROUND
The Wolf Motor Function Test (WMFT) is an impairment-based test whose psychometrics have been examined by previous reliability and validity studies. Standards for evaluating whether a given change is meaningful, however, have not yet been addressed.


OBJECTIVE
To determine the standard error of measurement (SEM) and minimal detectable change (MDC) for the WMFT.


METHODS
Data were collected from 6 university laboratories that participated in the EXCITE national clinical trial and included 96 individuals with sub-acute stroke (3-9 months). Measurements were made by blinded evaluators who were trained and standardized to administer the WMFT, which was completed on 2 occasions 2 weeks apart. No intervention was given between testing sessions.


RESULTS
The WMFT Performance Time score has a SEM of 0.2 seconds and a MDC95 of 0.7 seconds. The individual task timed items MDC95 ranged from 1.0 second (turn key in lock) to 3.4 seconds (reach and retrieve) with individual task items demonstrating notably higher variability than the average WMFT Performance Time. The average WMFT Functional Ability Scale SEM and MDC95 is 0.1 points.


CONCLUSIONS
When assessing the effect of a therapeutic intervention, if an individual experiences an amount of change equal to or greater than the MDC, then one may be 95% confident that this margin of change is truly larger than measurement error and not a chance result. Thus, the determination of SEM and MDC in outcome assessments allows researchers and clinicians to distinguish which results are actual differences versus which results are simply changes resulting from error or chance.
Fritz
Stacy L
SL
Arnold School of Public Health, Department of Exercise Science, Physical Therapy Program, University of South Carolina, Columbia, South Carolina 29208, USA. sfritz@mailbox.sc.edu
Blanton
Sarah
S
Uswatte
Gitendra
G
Taub
Edward
E
Wolf
Steven L
SL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009069:Movement Disorders / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis; D013997:Time Factors; D055815:Young Adult