Background and Purpose-The Wolf Motor Function Test (WMFT) is a new time-based method to evaluate upper extremity performance while providing insight into joint-specific and total limb movements. This study addresses selected psychometric attributes of the WMFT applied to a chronic stroke population. Methods-Nineteen individuals after stroke and with intact cognition and sitting balance were age-and sex-matched with 19 individuals without impairment. Subjects performed the WMFT and the upper extremity portion of the Fugl-Meyer Motor Assessment (FMA) on 2 occasions (12 to 16 days apart), with scoring performed independently by 2 random raters. WMFT and FMA demonstrated agreement (PϽ0.0001) between raters at each session. WMFT scores for the dominant and nondominant extremities of individuals without impairment were different (PՅ0.05) from the more and less affected extremities of subjects after stroke. The FMA score for the more affected extremity of subjects after stroke was different (PՅ0.05) from the dominant and nondominant extremities. However, the FMA score for the less affected upper extremity of individuals after stroke was not different (PϾ0.05) from the dominant and nondominant extremities of individuals without impairment. The WMFT and FMA scores were related (PϽ0.02) for the more affected extremity in individuals after stroke. Conclusions-The interrater reliability, construct validity, and criterion validity of the WMFT, as used in these subject samples, are supported. Key Words: arm Ⅲ motor activity Ⅲ psychometrics Ⅲ stroke M any upper extremity motor function outcome measures do not produce data that provide obvious links between the basis for planning treatment and the emergent plan for functional restitution. The Wolf Motor Function Test (WMFT) quantifies upper extremity movement ability through timed single-or multiple-joint motions and functional tasks. 1 The tasks are arranged in order of complexity, progress from proximal to distal joint involvement, test total extremity movement and movement speed, and require few tools and minimal training for test execution. Results-TheThe present study establishes the reliability and validity of the WMFT. The scores from the WMFT and the upper extremity portion of the Fugl-Meyer Motor Assessment (FMA) were compared to investigate the criterion validity of the WMFT. The FMA was chosen as the criterion test because it focuses on multijoint upper extremity function in patients after stroke and is reliable 2 and valid. 3,4 Yet the FMA is difficult to use and examines synergy patterns that no longer form the basis for many functionally oriented treatments. Subjects and Methods SubjectsForty-seven subjects were recruited by convenience sampling in this repeated-measures design study. Twenty-one subjects had sustained a stroke. All subjects participating were between the ages of 42 and 76 years. Nineteen subjects after stroke (mean age 61.4Ϯ9.5 years, mean time from stroke 4.9Ϯ6.4 years, range 0.67 to 29 years) and 19 individuals without impairments (mean age 60...

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Background and Purpose. The Emory Functional Ambulation Profile (E-FAP) measures time to walk in different environments and accounts for use of assistive devices. This study assessed the reliability and validity of walking time measurements using these components. Subjects. Twenty-eight subjects who had strokes and 28 subjects without impairment were recruited. Methods. The E-FAP, Berg Balance Test, Functional Reach Test, and Timed 10-Meter Walk Test were administered in random order during a single data collection session. Results. Interrater reliability for the total E-FAP was ≥.997. Subjects without impairment performed better on all 4 tests than did subjects who had strokes. Increased times on the E-FAP correlated with poor performance on the Berg Balance Test and slow gait speeds on the Timed 10-Meter Walk Test in the subjects who had strokes. The E-FAP scores and the Functional Reach Test scores were not correlated. Conclusion and Discussion. The E-FAP can be administered easily and inexpensively. Because the E-FAP scores differentiated subject groups and correlated with known measures of function, the E-FAP may be a clinically useful measure of ambulation.

Anatomical partitioning has been found in the human biceps brachii, extensor carpi radialis longus and flexor carpi radialis muscles. The purpose of this study was to determine if the human extensor carpi ulnaris, flexor carpi ulnaris and flexor digitorum profundus are anatomically partitioned. Evidence for or against anatomical partitioning was obtained by observation of the architectural and innervation characteristics of each of the investigated muscles. Twelve samples (11 were used for extensor carpi ulnaris) of each specific muscle type were harvested from perfused human cadavers. The architectural characteristics of tendinous boundaries, muscle fiber direction, and muscle fiber angle magnitude were observed, measured and documented. Microdissection technique was used to investigate the primary nerve branching pattern throughout each muscle. A primary nerve branch to a specific muscle region indicated possible partitioning by innervation. The extensor carpi ulnaris was found to have a variable number of primary nerve branches. The extensor carpi ulnaris may have four partitions by innervation alone or three congruent partitions by innervation and muscle fiber architecture. The nerve to the flexor carpi ulnaris clearly innervates two architectural partitions within the muscle. The innervation pattern to the flexor carpi ulnaris is congruent with muscle fiber architecture characteristics indicating consistent anatomical partitioning within the flexor carpi ulnaris. Two muscle nerves innervate the flexor digitorum profundus with branches innervating the medial and lateral regions of the muscle. Up to eight architectural partitions were found in a medial-to-lateral direction.

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he effects on the lower kinetic chain of structural abnormalities of the feet include diffuse o r specific lower extremity pain, low back pain, and/ o r other structural abnormalities of the foot (9,10,12,15,19,33,34). However, the frequency of structural deformities of the foot in healthy individuals is not extensively documented. McPoil et al measured the forefoot-to-rearfoot relationship of 58 asymptomatic female subjects. A forefoot valgus was present in 44.8% and a forefoot varus was present in 8.6% of the 116 feet surveyed (2 1). This study addressed the following question: What is the frequency of forefoot varus, valgus, o r neutral in healthy individuals?T w o structural abnormalities of the forefoot-rearfoot relationship are forefoot varus and valgus ( 1 0.33). In forefoot varus, with the subtalar joint in a neutral position, the forefoot is in the fixed position of inversion on the rearfoot in the frontal plane. This static deformity causes the subtalar and midtarsal joints to pronate from midstance to the pushoff phase of the gait cycle. Instead of being a rigid lever for propulsion, the fbrefoot now becomes a mobile structure, causing an increase in the stress and shear forces transmitted to

Results from previous studies on monkeys and human subjects have demonstrated that the biceps brachii spinal stretch reflex (SSR) can be operantly conditioned. The extent to which conditioning paradigms influence contralateral SSRs or longer latency responses in the same limb has not been examined. Nine subjects were given 10 training sessions to either increase or decrease the size of their biceps brachii SSR. Group changes were compared to the mean of six baseline (control) sessions. Both groups showed progressive SSR changes over the training sessions. Up-trained subjects increased their SSR responses by an average of 135.3% above baseline, with the last three sessions showing a 237.5% increase, while down-trained subjects reduced their average SSR responses by 43.4%, with a 52.7% reduction over the last three sessions. ipsilateral longer latency responses showed average changes of 68.9% and -68.7% for up- and down-trainers, respectively. As in the case of SSRs, these responses changed progressively over sessions, with a 131.5% increase seen in the last three up-training sessions and an 82.4% reduction over the same period for down-trainers. Correlation coefficients between SSR and longer latency responses were high (R = 0.90, up-trainers; R = 0.87, down-trainers). Contralateral SSR and longer latency responses, measured in the absence of feedback and at least 10 min after ipsilateral conditioning, showed directional changes that were similar to the trained side, but their magnitudes were not as profound. Collectively, these data suggest that unilateral SSR conditioning affects spinal circuits controlling contralateral SSRs and influences longer latency responses.