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Wolf Motor Function Test

Last Updated

Purpose

The Wolf Motor Function Test (WMFT) is a quantitative measure for upper extremity motor ability using timed functional tasks and strength tasks completed with some common household objects. 

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Instrument Details

Acronym WMFT

Area of Assessment

Bodily Functions

Assessment Type

Performance Measure

Administration Mode

Computer

Cost

Free

Cost Description

Cost of equipment

CDE Status

Not a CDE--last searched on 1/27/2026

Diagnosis/Conditions

  • Brain Injury Recovery
  • Stroke Recovery
  • Parkinson's Disease & Movement Disorders

Populations

Brain Injury
Stroke
Neurologic Conditions
Mixed Conditions

Key Descriptions

  • The original version consisted of 21 items; the widely used version of the WMFT consists of 17 items.
  • Composed of 3 parts:
    1) Time
    2) Functional ability
    3) Strength
  • Includes 15 function-based tasks and 2 strength based tasks
    1) Performance time is referred to as WMFT-TIME
    2) Functional ability is referred to as WMFT-FAS
  • Items 1-6 involve timed functional tasks, items 7-14 are measures of strength, and the remaining 9 items consist of analyzing movement quality when completing various tasks. Each task should be described and demonstrated twice by the examiner before examinee's completion.
  • Examiner should test the less affected upper extremity followed by the most affected side.
  • Uses a 6-point ordinal scale:
    -"0" = “does not attempt with the involved arm” to
    -"5" = “arm does participate; movement appears to be normal.”
  • Maximum score is 75
  • Lower scores are indicative of lower levels of functioning
  • WMFT-TIME allows 120 seconds per task
  • Other versions of the WFMT exist such as the streamlined, graded, and orthopedic versions

Number of Items

21

Equipment Required

  • Standardized table (54 inches long, 30 inches wide, and 29 inches high)
  • Straight back chair without armrests
  • Standardized test item template
  • Height-adjustable bedside table
  • Box (one that does not require patient to flex or abduct shoulder more than 90 degrees)
  • Individual wrist weights, 1-20 pounds
  • 12-oz beverage can, unopened
  • 7” pencil with 6 flat sides
  • 2” paper clip
  • 3 checkers
  • Three 3” x 5” note cards
  • Standardized lock and key board at 45 degree angle
  • Standardized face towel
  • Standardized basket
  • Dynamometer
  • Talcum powder to reduce friction as needed
  • Stopwatch
  • Video camera (optional)

Time to Administer

30-45 minutes

gWMFT and WMFT-O takes about 40 minutes to administer (Turtle et al., 2020; Oberle et al., 2018)

Required Training

Reading an Article/Manual

Required Training Description

Should be performed by a trained clinician

Age Ranges

Adult

18 - 64

years

Older Adult

65 +

years

Instrument Reviewers

Initially reviewed by Jason Raad MS and the Rehabilitation Measures Team; Updated by Irene Ward, PT, DPT, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 2012; Updated by Heather Anderson and Rie Yoshida of the StrokEdge II task force in 2016; Updated in January 2026 by Carolyn Bourgeault, OTS, Brekkon Godbold, OTS, Tenley Regal, OTS, Isabella Vandeloecht, OTS, & Tianyu Xu, OTS, and reviewed by Jessica Schmidt, OTD, MS-OTR/L, Concordia University Wisconsin.

Body Structure

Upper Extremity

ICF Domain

Activity

Measurement Domain

Motor

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  ANPT Outcome Measures Recommendations (EDGE)

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

HR

HR

HR

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

NR

R

UR

R

UR

TBI EDGE

NR

LS

LS

LS

NR

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

N/A

N/A

N/A

N/A

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

StrokEDGE

No

Yes

Yes

Not reported

TBI EDGE

No

No

Yes

Not reported

Considerations

Observer plots were a less stable method of scoring the WMFT, suggesting relatively higher measurement error for the WMFT than for the ARAT (Nijland et al., 2010).

Streamlined 4-item (WMFT-4) or 6-item (SWMFT-C) versions, a graded version with 13 items (gWMFT), and an orthopedic adapted version with 18 items (WMFT-O) are available.

Stroke

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Standard Error of Measurement (SEM)

Chronic Stroke: (Fritz et al. 2009; n = 96; mean age = 62.3 (range, 19–90) years)

  • Standard error of measurement (SEM) in stroke: 0.2 seconds

Reliability Indices for WMFT:

 

 

Item No.

Item Description

SEM

Average WMFT time score

 

0.2

1

Forearm to table

0.8

2

Forearm to box

0.6

3

Extend elbow

0.6

4

Extend elbow with weight

0.8

5

Hand to table (front)

0.5

6

Hand to box (front)

0.7

7

Weight to box (lbs)

1.9

8

Reach and retrieve

1.2

9

Lift can

1.2

10

Lift pencil

1.1

11

Lift paper clip

0.8

12

Stack checkers

1.1

13

Flip cards

0.4

14

Grip strength (lbs)

0.0

15

Turn key in lock

0.4

16

Fold towel

0.4

17

Lift basket

0.7

Average WMFT FAS

 

0.1

 

Sub-acute Stroke: (Turtle et al., 2020; n = 28; Mean Age = 71.3 (9.6) years; Mean Time Post Stroke = 14.73 (8.36) days; graded Wolf Motor Function Test)

  • SEM for performance time inter-rater (n = 28): 6.49 seconds
  • SEM for functional ability scale (FAS) inter-rater (n = 28): 0.33 points
  • SEM for performance time intra-rater (n = 21): 3.64 seconds 
  • SEM for FAS intra-rater (n = 21): 0.19 points

 

Chronic Stroke: (Hla Tun et al., 2025; n = 20; Mean Age = 59.55 (7.62) years; Mean Time Post CVA = 50.25 (29.67) months; Malaysian sample; Streamlined Wolf Motor Function Test for Chronic Stroke (SWMFT-C)) 

  • SEM for performance time test-retest: 0.15 seconds
  • SEM for FAS test-retest: 0.12 points
  • SEM for performance time inter-rater: 1.15 seconds
  • SEM for FAS inter-rater: 0.18 points

 

Minimal Detectable Change (MDC)

Chronic Stroke: (Fritz et al, 2009)

  • Average for timed items: 0.7 seconds
  • Average for WMFT Functional Ability Scale: 0.1 points

Reliability Indices for WMFT:

 

 

Item No.

Item Description

95% MDC

Average WMFT time score

 

0.7

1

Forearm to table

2.1

2

Forearm to box

1.6

3

Extend elbow

1.7

4

Extend elbow with weight

2.4

5

Hand to table (front)

1.5

6

Hand to box (front)

1.9

7

Weight to box (lbs)

5.2

8

Reach and retrieve

3.4

9

Lift can

2.0

10

Lift pencil

3.0

11

Lift paper clip

2.2

12

Stack checkers

3.2

13

Flip cards

1.2

14

Grip strength (lbs)

0.1

15

Turn key in lock

1.0

16

Fold towel

1.2

17

Lift basket

2.0

Average WMFT FAS

 

0.1

 

Sub-acute Stroke: (Turtle et al., 2020; gWMFT; MDC calculated)

  • MDC for performance time inter-rater (n = 28): 17.99 seconds
  • MDC for FAS inter-rater (n = 28): 0.91 points
  • MDC for performance time intra-rater (n = 21): 10.09 seconds
  • MDC for FAS intra-rater (n = 21): 0.53 points

 

Chronic Stroke: (Hla Tun et al., 2025; SWMFT-C) 

  • MDC95 for performance time: 2.26 seconds
  • MDC95 for FAS: 0.34 points

 

Minimally Clinically Important Difference (MCID)

Acute Stroke: (Lang et al, 2008; n = 52; mean age = 64 (14) years; < 28 days post-stroke)

  • MCID (Functional Ability):
    • 1.0 points (Dominant Side Affected)
    • 1.2 points (Non-dominant Side Affected)
    • 17% change (Dominant Side Affected)
    • 20% change (Non-dominant Side Affected)
  • MCID (time):
    • -19.0 seconds (Dominant Side Affected)
    • 16% change (Dominant Side Affected)

Chronic Stroke: (Kim et al., 2026; n = 543; WMFT-4)

  • MCID for anchor-based WMFT-4 rate score (n = 396): 9.90 reps/min.
  • MCID for anchor-based WMFT-15 rate score (n = 396): 6.88 reps/min.
  • MCID for distribution-based WMFT-4 rate score (n = 396): 13.27 reps/min.
  • MCID for distribution-based WMFT-15 rate score (n = 396): 8.17 reps/min.

 

Normative Data

Chronic Stroke: (Wing et al, 2006; n = 35; mean age = 60.2 (14.1) years; rehab = 3–6 hours/day, 4–5 days/week, ≥ 2 weeks; mean time since stroke = 40.9 (29.1) months)

Outcome measure:

 

 

 

Measure

n

Pretest mean

Posttest mean

Wolf Motor Function Test (mean)

29

55.6 s

45.2 s

TUG

30

31.0 s

20.2 s

Berg Balance

32

46.5

47.2

Fugl-Meyer (m)

34

31.8

37.0

Box and Block

11

11.2

18.0

s = seconds; all means were significant; TUG = Timed Up & Go Test; Fugl-Meyer (m) = 66-point Fugl-Meyer motor assessment

Test/Retest Reliability

Chronic Stroke: (Morris et al, 2001; n = 24; mean age 61; mean time since one set = 6 years; Whithall et al, 2006; n = 66; mean age = 58 (14) years; >6 months post-stroke)

  • Excellent test-retest reliability, Functional ability and performance tests (r= 0.95; 0.90, respectively)
  • Excellent overall total score (n = 66; ICC = 0.97)

Chronic Stroke: (Hla Tun et al., 2025) 

  • Excellent test-retest reliability (ICC = 0.943; 0.945) for performance time and FAS, respectively

 

Interrater/Intrarater Reliability

Chronic Stroke: (Morris et al, 2001; Whithall, 2006; Wolf et al, 2001; n = 19, mean age = 61.4 (9.5) years; mean time since stroke = 4.9 (6.4) years)

  • Excellent inter-rater reliability:
    • Study1: n = 24: ICC = 0.93; 0.99, functional ability and performance test, respectively.
    • Study 2: n = 10; ICC = 0.99
    • Study 3: n = 19: ICC = 0.97

Sub-acute Stroke: (Turtle et al., 2020; gWMFT; n = 28)

  • Excellent interrater reliability (ICC = 0.979; 0.986) for functional ability and performance time respectively at two weeks post-stroke
  • Excellent intra-rater reliability (ICC = 0.993; 0.996) for functional ability and performance time respectively at 3 months post-stroke

 

Chronic Stroke: (Hla Tun et al., 2025; SWMFT-C)

  • Excellent inter-rater reliability for performance time and FAS, respectively (ICC = 0.999; 0.973)

 

Internal Consistency

Chronic Stroke: (Morris et al, 2001)

  • Excellent Internal Consistency (Cronbach's alpha = 0.92)

Sub-acute Stroke: (Turtle et al., 2020; gWMFT)

  • Excellent internal consistency at 2 weeks post-stroke (n = 28) for functional ability and performance time respectively (Cronbach’s alpha = 0.99; 0.98) 
  • Excellent internal consistency at 3 months post-stroke (n = 19) for functional ability and performance time respectively (Cronbach’s alpha = 0.99; 0.98) 

 

Chronic Stroke: (Hla Tun et al., 2025)

  • Adequate to excellent internal consistency for performance time and FAS, respectively (Cronbach’s alpha = 0.793; 0.905)

 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Chronic Stroke: (Wolf et al, 2001; Whithall et al, 2006)

  • Adequate concurrent validity with:
    • Upper Extremity Fugl-Meyer Assessment
      • Study 1: n = 19 (r = - 0.57)
      • Study 2: n = 66 (r = - 0.88)

Chronic Stroke: (Kim et al., 2026; WMFT-4)

  • Adequate correlation with the Fugl-Meyer Assessment of Upper Extremity (FMA-UE) (r = 0.452)

Construct Validity

Convergent validity:

Chronic Stroke: (Hla Tun et al., 2025; SWMFT-C; n = 20)

  • Excellent correlations between SWMFT-C performance times baseline scores and FMA-UE and SIS-hand function scores (r = -0.71 and r = -0.86, respectively)
  • Excellent correlations between SWMFT-C FAS baseline assessment scores and FMA-UE and SIS-hand function (r = 0.80 and r = 0.69, respectively)
  • Adequate to excellent  correlations between performance time at 2 weeks for FMA-UE and SIS-hand function (r = -0.52 and r = -0.74, respectively)
  • Excellent correlations between functional ability scale at 2 weeks for FMA-UE and SIS-hand function (r = 0.71 and r = 0.65, respectively)

Chronic Stroke: (Kim et al., 2026; WMFT-4; n = 432)

  • Excellent correlation between the WMFT-4 and WMFT-15 (r = 0.981)

Discriminant validity:

  • Wolf et al (2001) evaluated whether the WMFT was able to distinguish between individuals with impairment secondary to stroke (n = 19) from those without impairment (n = 19).
  • Known group's validity, as calculated using Wilcoxon test, showed that the WMFT scores for the dominant and the non-dominant hand of individuals without impairment were significant higher when compared to the most and to the least affected upper extremities of clients with stroke.

Chronic Stroke: (Kim et al., 2026; WMFT-4; n = 432)

  • Significant ability of WMFT-4 scores to discriminate between known groups on the FMA-UE: severe (mean rate of 22.65 reps/min on WMFT-4), moderate (43.81), and mild (58.75) (F(2,432) = 56.69, p < 0.001
  • Significant ability of WMFT-15 scores to discriminate between known groups on the FMA-UE: severe (mean rate of 17.15 reps/min on WMFT-15), moderate (31.33), and mild (41.05) (F(2,432) = 56.60, p < 0.001

 

 

Floor/Ceiling Effects

Sub-acute Stroke: (Turtle et al., 2020; gWMFT) 

At two weeks: n = 28

  • Poor floor effects of 35.7% found for performance time
  • Poor floor effects of 21.4% found for functional ability 

At three months: n = 21

  • Poor floor effects of 33.7% found for performance time 
  • Adequate floor effects of 19% found for functional ability

 

Responsiveness

Acute Stroke: (Hsieh et al, 2009; n = 57; mean age = 54.56 (11.52) years; Taiwanese sample)

Responsiveness of 3 Outcome Measures:

 

 

Scale Name

SRM (95% CI)

Wilcoxon Test Z-Value

WMFT-TIME

0.38 (0.22, 0.59)

5.97*

WMFT-FAS

1.30 (1.03, 1.67)

5.59*

FIM-total

0.36 (0.17, 0.59)

3.39*

FIM-motor

0.37 (0.17, 0.58)

3.18*

FMA

1.42 (1.19, 1.80)

6.33*

ARAT

0.95 (0.75, 1.20)

4.64*

*p < 0.001; WMFT-TIME = performance time of the Wolf Motor Function Test; WMFT-FAS = functional ability scale of the Wolf Motor Function Test; FIM = Functional Independence Measure; FMA = Fugl-Meyer Assessment; ARAT = Action Research Arm Test; SRM = standardized response mean; CI = confidence interval

Brain Injury

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Test/Retest Reliability

Chronic Traumatic Brain Injury: (Shaw et al., 2005; n = 22; Mean age = 39.3 (14.4) years, onset at least 1 year prior to assessment; relative hemiparesis)

  • Excellent ICC = 0.97 (range = 0.89 - 0.97); agreement between the self-report and objective measures

Neurologic Conditions

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Test/Retest Reliability

Parkinson’s Disease: (de Britto et al., 2025; n = 50; Mean Age = 64.84 (9.57) years; Male = 27 (54%); Mean Disease Duration = 6.3 (4.1) years; Hoehn & Yahr Stage range = 2 – 4)

  • Poor to excellent test-retest reliability for execution time (ICC = 0.06-0.96)
  • Poor to adequate test-rest reliability for functional ability scale (FAS) (Cohen's kappa range = 0.33-0.74)

 

Interrater/Intrarater Reliability

Parkinson’s Disease: (de Britto et al., 2025)

  • Poor to excellent intra-rater reliability for execution time in both upper extremities for evaluation 1 (ICC = 0.10-0.98)
  • Adequate to excellent  intra-rater reliability for execution time in both upper extremities for evaluation 2 (ICC = 0.42-0.98)
  • Adequate to excellent intra-rater reliability for FAS for evaluation 1 (Cohen’s kappa range = 0.57-0.94) 
  • Adequate to excellent intra-rater reliability for functional ability scale (FAS) for evaluation 2 (Cohen’s kappa range = 0.50-0.94)
  • Poor to excellent interrater reliability for FAS (Cohen’s kappa range = 0.18-0.78)

 

Mixed Conditions

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Interrater/Intrarater Reliability

Shoulder Injuries: (Oberle et al., 2018; n = 20; Median Age (range) = 80.5 (64-94) years; female = 16 (80%); after surgical or conservative treatment; German sample; orthopedic Wolf Motor Function Test (WMFT-O))

  • Excellent inter-rater reliability (weighted Cohen’s kappa range = 0.84-1.00; 0.79-1.00) for functional capacity (FC) and quality of movement (QoM) respectively 
  • Adequate to excellent  intra-rater reliability for both FC and QoM (weighted Cohen’s kappa range = 0.71-1.00)

 

Internal Consistency

Shoulder Injuries: (Oberle et al., 2018; WMFT-O)

  • Excellent internal consistency for FC and QoM (Cronbach’s alpha range = 0.94-1.00; 0.96-1.00, respectively)

 

Bibliography

Chen, H. F., Lin KC, Wu CY, Chen CL. Rasch validation and predictive validity of the action research arm test in patients receiving stroke rehabilitation. Arch Phys Med Rehabil. 2012;93(6):1039-1045. Find it on PubMed

de Britto, V. L. S., da Silva, T. V., de Andrade, C. D. C. G., Domingos, L. F., da Silva, R. V., Silva, A. E. L., Vasconcellos, L. F., Fontana, A. P., & Correa, C. L. (2025). Reliability of the Wolf Motor Function Test for Parkinson’s disease. Geriatric Nursing, 63, 422–427. https://doi.org/10.1016/j.gerinurse.2025.03.056

Edwards, D. F., Lang, C. E., Wagner, J. M., Birkenmeier, R., Dromerick, A. W. An evaluation of the Wolf Motor Function Test in motor trials early after stroke. Arch Phys Med Rehabil. 2012 93(4): 660-668. Find it on PubMed

Fritz, S. L., Blanton, S., et al. (2009). "Minimal detectable change scores for the Wolf Motor Function Test." Neurorehabil Neural Repair 23: 662-667. Find it on PubMed

Hla Tun, S. S., Wanpen, S., Nualnetr, N., Chatchawan, U., Puntumetakul, R., & Khin, M. (2025). Reliability and validity of the streamlined Wolf Motor Function Test for chronic stroke. The Malaysian Journal of Medical Sciences, 32(1), 110–120. https://doi.org/10.21315/mjms-09-2024-736

Kim, B., Schweighofer, N., Wolf, S. L., & Winstein, C. (2026). A streamlined 4-item Wolf Motor Function Test for efficient assessment of upper extremity motor function in chronic stroke survivors. Neurorehabilitation and Neural Repair, 40(3), 214–225. https://doi.org/10.1177/15459683251412278

Lang, C. E., Edwards, D. F., et al. (2008). "Estimating minimal clinically important differences of upper-extremity measures early after stroke." Arch Phys Med Rehabil 89(9): 1693-1700. Find it on PubMed

Lin, K.-C., Hsieh, Y.-W., et al., (2009). “Minimum detectable change and clinically important difference of the Wolf Motor Function Test in stroke patients.” Neurohabilitation and Neural Repair 23(5): 429-434. Find it on PubMed

Morris, D. M., Uswatte, G., et al. (2001). "The reliability of the wolf motor function test for assessing upper extremity function after stroke." Arch Phys Med Rehabil 82: 750-755. Find it on PubMed

Nijland, R., van Wegen, E., et al. (2010). "A comparison of two validated tests for upper limb function after stroke: The Wolf Motor Function Test and the Action Research Arm Test." J Rehabil Med 42(7): 694-696. Find it on PubMed

Oberle, C., Becker, C., Schölch, S., Lenz, J., Studier-Fischer, S., Augat, P., & Schwickert, L. (2018). Inter-rater and intra-rater reliability of an adapted Wolf Motor Function Test for older patients with shoulder injuries. Zeitschrift für Gerontologie und Geriatrie, 51, 293–300. https://doi.org/10.1007/s00391-017-1226-2

O’Dell, M. W., Grace, K., et al., (2013). “A psychometric evaluation of the Arm Motor Ability Test.” J Rehabil Med 45(6): 519–527. Find it on PubMed

Shaw, S. E., Morris, D. M., et al. (2005). "Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury." J Rehabil Res Dev 42(6): 769-778. Find it on PubMed

Turtle, B., Porter-Armstrong, A., & Stinson, M. (2020) The reliability of the graded Wolf Motor Function Test for stroke. British Journal of Occupational Therapy, 83(9), 585–594. https://doi-org.cuw.idm.oclc.org/10.1177/0308022620902697

Whitall, J., Savin, D. N., Jr., et al. (2006). "Psychometric properties of a modified Wolf Motor Function test for people with mild and moderate upper-extremity hemiparesis." Arch Phys Med Rehabil 87(5): 656-660. Find it on PubMed

Wing, K., Lynskey, J. V., et al. (2008). "Whole-body intensive rehabilitation is feasible and effective in chronic stroke survivors: a retrospective data analysis." Top Stroke Rehabil 15(3): 247-255. Find it on PubMed

Wolf, S. L., Catlin, P. A., et al. (2001). "Assessing Wolf motor function test as outcome measure for research in patients after stroke." Stroke 32: 1635-1639. Find it on PubMed

Woodbury, M., Velozo C. A., et al., (2010). “Measurement structure of the Wolf Motor Function Test: Implications for motor control theory.” Neurorehabil Neural Repair 24(9):  791–801. Find it on PubMed

 

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