Inter-rater and intra-rater reliability of an adapted Wolf motor function test for older patients with shoulder injuries

Testgütekriterien des modifizierten Wolf-Motor-Funktionstests für ältere Patienten nach Schulterverletzung


Background and objective

The Wolf motor function test (WMFT) evaluates the upper extremity performance of patients with neurological disorders and traumatic brain injuries by assessing time and functional capacity. It was later modified to also measure the quality of the performed movements. This study aimed to adapt the WMFT for patients with shoulder injuries and to evaluate the inter-rater and intra-rater reliability of this adapted version.

Subjects and methods

A total of 20 individuals with a median age of 80.5 years were assessed using a test-retest design after surgical or conservative treatment of shoulder injuries. Two raters rated performance to determine inter-rater reliability. One rater rated the performance again to determine intra-rater reliability. Both inter-rater and intra-rater agreement were determined by weighted Cohen’s kappa statistics with corresponding confidence intervals. Cronbach’s alpha was calculated to determine internal consistency.


The inter-rater Cohen’s kappa values ranged from 0.84–1.00 for functional capacity and from 0.79–1.00 for quality of movement. For intra-rater reliability the Cohen’s kappa ranged from 0.71–1.00. Cronbach’s alpha was >0.94 for functional capacity and >0.96 for quality of movement.


The adapted version of the WMFT shows high intra-rater and inter-rater reliability for patients with shoulder injuries.


Hintergrund und Zielsetzung

Der Wolf-Motor-Funktionstest (WNFT) bewertet objektiv die Leistungsfähigkeit der oberen Extremitäten von Patienten mit neurologischen Störungen und Schädel-Hirn-Verletzungen anhand der benötigten Zeit zur Ausführung bestimmter Aufgaben und der funktionellen Fähigkeit. Nach einer durchgeführten Modifikation wird die Bewegungsqualität ebenfalls bewertet. Ziel dieser Studie ist es, den WMFT auf Patienten nach Schulterverletzungen anzupassen und die Inter- und Intrarater-Reliabilität dieser angepassten Version zu überprüfen.

Patienten und Methodik

Bei 20 älteren Patienten (Median: 80,5 Jahre) mit chirurgisch oder konservativ behandelter Schulterverletzung wurde die Leistungsfähigkeit der Schulter in einem Test-Retest-Design erhoben. Um die Interrater-Reliabilität zu bestimmen bewerteten zwei unabhängige Rater die Leistung. Einer der Rater bewertete die Leistung erneut, um die Intrarater-Reliabilität zu erheben. Inter- und Intrarater-Reliabilität wurden durch gewichtete Cohens-Kappa-Statistiken mit entsprechenden Konfidenzintervallen überprüft. Zur Bestimmung der internen Konsistenz wurde Cronbachs Alpha berechnet.


Für die Interrater-Reliabilität reichen die Cohens-Kappa-Werte für die funktionelle Fähigkeit von 0,84–1,00 und für die Bewegungsqualität von 0,79–1,00. Für die Intrarater-Reliabilität liegen die Werte bei 0,71–1,00. Die Cronbachs-Alpha-Werte lagen für die funktionelle Fähigkeit über 0,94 und für die Bewegungsqualität über 0,96.


Die angepasste Version des WMFT zeigt eine gute Intra- und Interrater-Reliabilität für Patienten nach Schulterverletzungen.

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The study was funded and supported by the German Statutory Insurance (Deutsche Gesetzliche Unfallversicherung, DGUV). The DGUV had no influence on data assessment or writing of the manuscript.

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Corresponding author

Correspondence to Corinna Oberle.

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Conflict of interest

C. Oberle, C. Becker, S. Schölch, J.-U. Lenz, S. Studier-Fischer, P. Augat and L. Schwickert declare that they have no competing interests.

All procedures performed in studies involving human participants were approved by the ethical committee of the University of Tübingen and are in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Oberle, C., Becker, C., Schölch, S. et al. Inter-rater and intra-rater reliability of an adapted Wolf motor function test for older patients with shoulder injuries. Z Gerontol Geriat 51, 293–300 (2018).

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  • Wolf motor function test
  • Reliability
  • Orthopedic assessment
  • Shoulder function
  • Proximal humeral fracture


  • Wolf Motor Function Test
  • Reliabilität
  • Orthopädische Assessments
  • Schulterfunktion
  • Proximale Humerusfraktur