Stroke, Vol. 32, No. 7. (1 July 2001), pp. 1635-1639.
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. Results--The WMFT and FMA demonstrated agreement (P<0.0001) between raters at each session. WMFT scores for the dominant and nondominant extremities of individuals without impairment were different (P[<=]0.05) 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 (P[<=]0.05) from the dominant and nondominant extremities. However, the FMA score for the less affected upper extremity of individuals after stroke was not different (P>0.05) from the dominant and nondominant extremities of individuals without impairment. The WMFT and FMA scores were related (P<0.02) 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.
Steven Wolf, Pamela Catlin, Michael Ellis, Audrey Archer, Bryn Morgan, Aimee Piacentino
Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke
Stroke, Syndicated
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Feb 222008
Stroke, Vol. 32, No. 7. (1 July 2001), pp. 1635-1639.Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care: Executive summary
Stroke, Syndicated
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Feb 152008
Stroke, Vol. 36, No. 9. (2005), pp. 2049-2056.
Background - A panel of experts developed stroke rehabilitation guidelines for the Veterans Health Administration and Department of Defense Medical Systems. Methods - Starting from previously established guidelines, the panel evaluated published literature through 2002, using criteria developed by the US Preventive Services Task Force. Recommendations were based on evidence from randomized clinical trials, uncontrolled studies, or consensus expert opinion if definitive data were lacking. Results - Recommendations with Level I evidence include the delivery of poststroke care in a multidisciplinary rehabilitation setting or stroke unit, early patient assessment via the NIH Stroke Scale, early initiation of rehabilitation therapies, swallow screening testing for dysphagia, an active secondary stroke prevention program, and proactive prevention of venous thrombi. Standardized assessment tools should be used to develop a comprehensive treatment plan appropriate to each patient's deficits and needs. Medical therapy for depression or emotional lability is strongly recommended. A speech and language pathologist should evaluate communication and related cognitive disorders and provide treatment when indicated. The patient, caregiver, and family are essential members of the rehabilitation team and should be involved in all phases of the rehabilitation process. These recommendations are available in their entirety at http://stroke.ahajournals. org/cgi/content/full/36/9/e100. Evidence tables for each of the recommendations are also in the full document. Conclusions - These recommendations should be equally applicable to stroke patients receiving rehabilitation in all medical system settings and are not based on clinical problems or resources unique to the Federal Medical System. © 2005 American Heart Association, Inc.
B Bates, JY Choi, PW Duncan, JJ Glasberg, GD Graham, RC Katz, K Lamberty, D Reker, R Zorowitz
Background - A panel of experts developed stroke rehabilitation guidelines for the Veterans Health Administration and Department of Defense Medical Systems. Methods - Starting from previously established guidelines, the panel evaluated published literature through 2002, using criteria developed by the US Preventive Services Task Force. Recommendations were based on evidence from randomized clinical trials, uncontrolled studies, or consensus expert opinion if definitive data were lacking. Results - Recommendations with Level I evidence include the delivery of poststroke care in a multidisciplinary rehabilitation setting or stroke unit, early patient assessment via the NIH Stroke Scale, early initiation of rehabilitation therapies, swallow screening testing for dysphagia, an active secondary stroke prevention program, and proactive prevention of venous thrombi. Standardized assessment tools should be used to develop a comprehensive treatment plan appropriate to each patient's deficits and needs. Medical therapy for depression or emotional lability is strongly recommended. A speech and language pathologist should evaluate communication and related cognitive disorders and provide treatment when indicated. The patient, caregiver, and family are essential members of the rehabilitation team and should be involved in all phases of the rehabilitation process. These recommendations are available in their entirety at http://stroke.ahajournals. org/cgi/content/full/36/9/e100. Evidence tables for each of the recommendations are also in the full document. Conclusions - These recommendations should be equally applicable to stroke patients receiving rehabilitation in all medical system settings and are not based on clinical problems or resources unique to the Federal Medical System. © 2005 American Heart Association, Inc.
B Bates, JY Choi, PW Duncan, JJ Glasberg, GD Graham, RC Katz, K Lamberty, D Reker, R Zorowitz
Feb 142008
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The federal budget President Bush proposes for 2009 begins a program of cutting 196 billion dollars from Medicare health care benefits for the elderly and extremely impoverished Americans. Some of the money the Republicans will save by cutting Medicare benefits for senior citizens will go to pay for a new generation of nuclear bombs. |
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