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Functional Reach Test / Modified Functional Reach Test

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Purpose

The FRT assesses a patient's stability by measuring the maximum distance an individual can reach forward while standing in a fixed position. The modified version of the FRT, requires the individual to sit in a fixed position.

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Instrument Details

Acronym FRT / MFRT

Area of Assessment

Balance – Vestibular
Balance – Non-vestibular
Functional Mobility
Vestibular

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

CDE Status

NINDS CDE Notice of Copyright
Functional Reach Test (FRT)

Classification

Supplemental: Cerebral Palsy (CP)

Diagnosis/Conditions

  • Parkinson's Disease & Movement Disorders
  • Spinal Cord Injury
  • Stroke Recovery
  • Vestibular Disorders

Populations

Vestibular Disorders
Stroke
Spinal Injuries
Parkinson's Disease
Older Adults and Geriatric Care

Key Descriptions

  • The Functional Reach Test: Standing instructions (Weiner, D. K., Duncan, P. W., et al. (1992). "Functional reach: a marker of physical frailty." J Am Geriatr Soc 40(3): 203-207.)
  • The patient is instructed to stand close to, but not touching, a wall and position the arm that is closer to the wall at 90 degrees of shoulder flexion with?a closed?fist.
  • The assessor records the starting position at the 3rd metacarpal head on the yardstick.
  • Instruct the patient to “Reach as far as you can forward without taking a step.”
  • The location of the 3rd metacarpal is recorded.
  • The difference between the start and end position is the reach distance, usually measured in inches.
  • The test allows for five total trials: two practice trials, followed by three "test" trials. The distances of the last three trials are averaged to obtain the patient's score.
  • The Modified?Functional Reach Test: Adapted for individuals who are unable to stand (Katz-Leurer, M., Fisher, I., et al. (2009). "Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke." Disabil Rehabil 31(3): 243-248.
  • Performed with a leveled yardstick that has been mounted on the wall at the height of the patient’s acromion level in the non-affected arm while sitting in a chair.
  • Hips, knees and ankles are positioned at 90 degree of flexion, with feet positioned flat on the floor.
  • The initial reach is measured with the patient sitting against the back of the chair with the?upper-extremity flexed to 90 degrees,?measure was taken from the distal end of the third metacarpal along the yardstick.
  • Consists of three conditions over three trials
    1) Sitting with the unaffected side near the wall and leaning forward
    2) Sitting with the back to the wall and leaning right
    3) Sitting with the back to the wall leaning left
  • Instructions should include leaning as far as possible in each direction without rotation and without touching the wall.
  • Once the individual leans, mark the position of the fifth finger along the yardstick.
  • SCI population - ulnar styloid process was used as landmark since tetraplegic population may not be able to make a fist.
  • Record the distance in centimeters covered in each direction.
  • If the patient?is unable to raise the affected arm, the distance covered by the acromion during leaning is recorded.
  • First trial in each direction is a practice trial and should not included in the final result.
  • A?15-second rest break should?be allowed?between trials.

Number of Items

1 or 3

Equipment Required

  • Yardstick
  • Duct tape (to tape the yardstick to the wall)

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by the Rehabilitation Measures Team in 2010; Updated with references from the PD and geriatric populations by Jill Proffitt, SPT and Kaitlyn Pasquinelli, SPT in 2011; Updated with references from the SCI population by Christopher Newman, PT, MPT, NCS, and Rachel Tappan, PT, NCS, Phyllis Palma, PT, DPT, and the SCI EDGE task force of the Neurology Section of the APTA in 2012; Updated with references from the vestibular population by Kelsey Flanders, SPT, Rima Gala, SPT, and Alexandra Grimaud, SPT in 11/2012. Updated with references for individuals with vestibular disorders by Linda B. Horn, PT DScPT, MHS NCS, Karen H. Lambert PT, MPT, NCS, and the Vestibular EDGE task force of the Neurology Section of the APTA (2013). Updated for the PD population by Rosemary Gallagher, PT, DPT, GCS and the PD Edge Taskforce of the Neurology Section of the APTA in 2013.

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:  

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)

(Vestibular > 6 weeks post)

SCI EDGE

LS

LS

LS

StrokEDGE

HR

HR

HR

Vestibular EDGE

LS

 

LS

Recommendations Based on Parkinson Disease Hoehn and Yahr stage: 

 

I

II

III

IV

V

PD EDGE

NR

R

R

LS / UR

NR

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

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

MS EDGE

R

R

UR

R

R

StrokEDGE

HR

HR

HR

HR

HR

TBI EDGE

LS

LS

LS

LS

LS

Recommendations based on SCI AIS Classification: 

 

AIS A/B

AIS C/D

SCI EDGE

LS

LS

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

LS

LS

LS

NR

Recommendations based on EDSS Classification:

 

EDSS 0.0 – 3.5

EDSS 4.0 – 5.5

EDSS 6.0 – 7.5

EDSS 8.0 – 9.5

MS EDGE

R

R

NR

NR

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

Vestibular EDGE

LS

LS

LS

LS

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)

MS EDGE

Yes

Yes

Yes

No

PD EDGE

No

No

Yes

Not reported

SCI EDGE

No

No

No

Not reported

StrokEDGE

Yes

Yes

Yes

Not reported

TBI EDGE

Yes

Yes

Yes

Not reported

Vestibular EDGE

Yes

Yes

No

Yes

Considerations

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Older Adults and Geriatric Care

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Cut-Off Scores

Functional Reach Test:

 

Community Dwelling Elderly:

(Weiner et al, 1992; n = 45, mean age = 78(8.4) years, Community Dwelling Elderly) 

  • FRT < 7 inches: 
    • Unable to leave neighborhood without help 
    • Limited in mobility skills 
    • Most restricted in ADLs 

 

Frail Elderly Patients:

(Thomas et al, 2005; n = 30, fallers mean age = 79.7 (6.7) non-faller mean age = 81.4 (6.7) years, Frail Elderly Patients)

  • < 18.5 cm indicates fall risk (75% Sensitivity, 67% Specificity)

Test/Retest Reliability

Functional Reach Test:

 

Community Dwelling Elderly:

(Weiner et al, 1992, Community Dwelling Elderly)

  • Excellent test-retest reliability (ICC = 0.89) 

(Duncan et al, 1990, Community Dwelling Elderly)

  • Excellent test-retest reliability (ICC = 0.92)

Interrater/Intrarater Reliability

Functional Reach Test:

 

Asymptomatic Adults:

(Bennie et al, 2003; n = 20, mean age = 68(14.5) years, Asymptomatic Adults)

  • Excellent interrater reliability (ICC = 0.99)
  • Excellent intrarater reliability (ICC = 0.90)

 

Community Dwelling Elderly:

(Duncan et al, 1990; 2 clinicians blinded to other's assessment recorded reach on 17 of 128 participants, Community Dwelling Elderly) 

  • Excellent inter observer "yardstick" reach reliability (ICC = 0.98) 

 

Frail Elderly Patients:

(Thomas et al, 2005; n = 30, fallers mean age = 79.7 (6.7) non-faller mean age = 81.4 (6.7) years, Frail Elderly Patients)

  • Excellent intrarater reliability (ICC = 0.87)
  • Excellent Intrarater reliability (ICC = 0.92)
  • Excellent interrater reliability (ICC = 0.97)

Criterion Validity (Predictive/Concurrent)

Functional Reach Test: 

 

Asymptomatic Adults:

(Bennie et al, 2003, Asymptomatic Adults)

  • Adequate correlation with BBS (r = 0.42) 
  • Adequate correlation with (TUG and FRT) and BBS (r = 0.56) 

 

Community Dwelling Elderly

(Weiner et al, 1992, Community Dwelling Elderly) 

  • Excellent correlation with: 
    • Walking speed (r = 0.71) 
    • Life space (r = 0.71) 
    • iADL (r = 0.66) 
    • Tandem walk (r = 0.67) 
    • Mobility skills (r = 0.65) 
    • 1 footed stand (r = 0.64) 
  • Adequate correlation with: 
    • Physical Activities of Daily Living (PADL) (r = 0.48) 

 

Frail Elderly Patients:

(Thomas et al, 2005, Frail Elderly Patients) 

  • < 18.5 cm indicates fall risk (75% Sensitivity, 67% Specificity)

Responsiveness

Functional Reach Test

 

Frail Elderly Patients:

(Thomas et al, 2005; n = 30, fallers mean age = 79.7 (6.7) non-faller mean age = 81.4 (6.7) years, Frail Elderly Patients) 

  • 18.5 cm cutoff for fall risk demonstrated % Sensitivity (95% C.I.) of 75 (0.46 - 0.91) 
  • 18.5 cm cutoff for fall risk demonstrated % Specificity (95% C.I.) of 67 (0.44 - 0.84)

Stroke

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Standard Error of Measurement (SEM)

Modified Functional Reach Test:

 

Stroke:

(calculated from values given in Outermans et al, 2010; n = 21, mean age = 56.3 (8.6) years, Subacute Stroke) 

  • Forward Functional Reach Test = 2.45 cm 

 

(calculated from statistics in Katz-Leurer et al, 2009; n = 10 stroke and 10 healthy controls; mean stroke sample age 63 (6) years; first ischemic stroke was 14 to 21 days prior; Israeli sample, Acute Stroke)

  • Forward Modified Functional Reach Test = 2.65 cm 
  • Paretic side Modified Functional Reach Test = 1.62 cm
  • Non-paretic side Modified Functional Reach Test = 2.67 cm

Minimal Detectable Change (MDC)

Functional Reach Test:

 

Stroke:

(calculated from statistics in Katz-Leurer et al, 2009, Acute Stroke)

  • Forward Modified Functional Reach Test = 3.7 cm
  • Paretic side Modified Functional Reach Test = 2.3 cm
  • Non-paretic side Modified Functional Reach Test = 2.67 cm 

 

(calculated from values given in Outermans et al, 2010, Subacute Stroke) 

  • Forward Functional Reach Test = 6.79 cm

Normative Data

Functional Reach Test: 

 

Stroke: 

(Acar & Karatas, 2010, Hemiplegic Patients Post-Stroke) 

  • With Arm Sling:
    • Functional Reach test mean (SD) = 16.8 (9) cm 
  • Without Arm Sling:
    • Functional Reach test mean (SD) = 15.2 (8.5) cm 

(Outermans et al, 2010; n = 21; mean age = 56.3 (8.6) years, Subacute Stroke)

  • Functional Reach Test mean (SD): 25.6 (7.4) cm 

(Erel et al, 2011; n = 14; mean age = 50.64 (9.22) years, Chronic Hemiplegic Patients Post-Stroke)

  • Functional Reach Test mean (SD)
    • initial assessment = 27.11 (5.41) cm
    • after 3 months = 28.46 (4.40) cm 

(Erel et al, 2011; n = 14; mean age = 42.50 (14.89) years, Chronic Hemiplegic Paients Post-stroke with In-sole Dynamic AFO)

  • Functional Reach Test mean (SD)
    • initial assessment = 28.50 (8.49) cm
    • after 3 months = 33.43 (9.59) cm

 

Modified Functional Reach Test:

 

Acute Stroke:

(Katz-Leurer et al, 2009, Acute Stroke)

Stroke Norms at 3 & 6 Weeks Post Stroke:

 

 

 

 

 

@ 3 Weeks

 

@ 6 Weeks

 

Measures Mean

Mean (SD)

ICC (95% CI)

Mean (SD)

ICC (95% CI)

Forward MFRT

31.7 (7.8)

0.94 (0.92 – 0.96)

37.6 (5.2)

0.97 (0.93 – 0.99)

Paretic side MFRT/Non-dominant

13.8 (3.7)

0.95 (0.93 – 0.97)

17.7 (4.9)

0.95 (0.93 – 0.97)

Non-paretic side MFRT/dominant

15.5 (6.8)

0.90 (0.86 – 0.94)

18.1 (5.0)

0.96 (0.94 – 0.98)

Test/Retest Reliability

Modified Functional Reach Test:

 

Stroke:

(Katz-Leurer et al, 2009, Acute Stroke) 

  • Excellent test-retest reliability (ICC = 0.90 to 0.95)
    • Forward Modified Functional Reach Test (ICC = 0.94)
    • Paretic side Modified Functional Reach Test/Non-dominant (ICC = 0.95) 
    • Non Paretic side Modified Functional Reach Test Dominant (ICC = 0.90)

Interrater/Intrarater Reliability

Functional Reach Test:

 

Stroke:

(Outermans et al, 2010, Subacute Stroke) 

  • Excellent intrarater reliability (ICC = 0.89)

Criterion Validity (Predictive/Concurrent)

Modified Functional Reach Test:

Stroke:

(Katz-Leurer et al, 2009, Acute Stroke) 

Correlations Between Measures :

 

 

 

 

 

 

 

 

 


First Evaluation

 

 

 

Second Evaluation

 

 

 

 

Rating

BM#

FIM~

SAS~

Rating

BM#

FIM~

SAS ~

Forward MFRT

Adequate

0.55*

0.49*

0.30

Adequate

0.50*

0.45*

0.21

Paretic side MFRT

Adequate

0.48*

0.51*

0.50*

Adequate

0.48*

0.40

0.20

Non-paretic side MFRT

Adequate

0.56**

0.37

0.35

Adequate

0.52*

0.30

0.37

*p < 0.05, **p < 0.01

 

# = Pearson correlations
~ = Spearman correlations
BM = Balance Master
FIM = Functional Independence Measure
SAS = Stroke Activity Scale
MFRT = Modified Functional Reach Test 

Face Validity

Functional Reach Test: 

Stroke:

(Outermans et al, 2010, Subacute Stroke) 

  • High validity of the functional reach test in patients with stroke (r = 0.71)

Responsiveness

Modified Functional Reach Test

 

Stroke:

(Katz-Leurer et al, 2009; n = 35 measured 2-3 weeks post stroke and again 6 weeks later, Acute Stroke) 

  • Mean change score of the MFRT forward = 6 cm (d = 0.60, moderate change) 
  • Mean change score of the MFRT to nonparetic side = 4 cm (d = 0.57, moderate change)
  • Mean change score of the MFRT to the paretic side = 4 cm (d = 0.80, large change)

Parkinson's Disease

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Standard Error of Measurement (SEM)

Modified Functional Reach Test:

 

Parkinson’s Disease: 

(calculated from values given in Smithson et al, 1998; n = 30 total, n = 10 with PD and a history of falling age, mean age = 70.6 (6.4), mean Hoehn and Yahr Disability Scale score = 3.0, disease duration 11.6 (4.3) years; n= 10 with PD and no history of falling, mean age = 70.8 (5.7), mean Hoehn and Yahr Disability Scale Score = 2.5, disease duration = 6.9(5.6) years; n = 10 with no neurological issues, mean age = 70.6 (6.2), Parkinson’s Disease)

  • Forward Functional Reach Test for PD patients with a history of falling = 1.56 cm
  • Forward Functional Reach Test for PD patients with no history of falling = 2.91 cm 

 

(calculated from values given in Schenkman et al, 1997; n = 15, mean age = 74.5 (5.7); disease duration = 6.2 (5.92); Hoehn and Yahr Disability Scale Score = 2.7 (0.32), Parkinson’s Disease)

  • Forward Functional Reach Test= 2.64 cm 

 

 

Minimal Detectable Change (MDC)

Functional Reach Test: 

 

Parkinson's Disease:

  • Smallest Detectable Difference (SDD) = 11.5 (Lim et al, 2005; n = 26; mean age = 62.5 (range 44–80) years; mean duration of symptoms = 6.5 years; Hoehn and Yahr ranged from 1 to 3)
  • Forward functional reach test, MDC = 9
  • Backward functional reach test, MDC = 5 (Steffen & Seney, 2008, n = 37; mean age = 71 (12) years, Hoehn and Yahr score = 2, range = 1 to 4) 

 

 (calculated from values given in Smithson et al, 1998, Parkinson’s Disease)

  • MDC for PD patients with a history of falls = 4.32 cm
  • MDC for PD patients with no history of falls = 8.07 cm

 

(calculated from values given in Schenkman et al, 1997, Parkinson’s Disease)

  • MDC for Forward Functional Reach Test = 7.32 cm

Cut-Off Scores

Functional Reach Test:

 

Parkinson's Disease:

(Behrman, A.L. et al, 2002; n = 58; mean age = 64.3 (9.3) years) 

  • Cut-off of 25.4 cm indicates fall risk (sensitivity of 30%), but a cut-off of 30.1 increases sensitivity to 56% 
  • Cut-off of 25.4 cm indicates fall risk (specificity of 92%), and a cut-off of 30.1cm decreases specificity to 77% 

(Dibble & Lange, 2006; n = 45; mean age = 69.94 (11.28) years, mean Hoehn and Yahr score = 2.60 (0.66) points)

  • < 31.75 cm indicates fall risk (sensitivity of 0.86, specificity of 0.52 for risk of falling)

Normative Data

Functional Reach Test: 

 

Parkinson's Disease:

(Lim et al, 2005; n = 26; mean age = 62.5 (8.2) years, Parkinson’s Disease)

  • Functional Reach Test = 33.54 (7.36) cm
  • Range = 22 - 50 cm 

(Shenkman et al., 2011; N = 339, 238 males, mean age (y) 66.1 (9.34) range 37-92, time since onset (y): mean 6.0 (5.12) range 0-32, H&Y stages 1-3, UPDRS total: mean 39.2(9.56), UPDRS motor: mean 25.2(9.56). Subset of n = 152 performed FR.)

 

H&Y Stage

1-1.5

2

2.5

3

Linear trend

Cohen f

Mean

16.07

14.28

12.13

10.79

F value, 46.00

0.30

SD

1.6

2.58

2.88

2.95

p < 0.0001

 

Min

13.33

6.70

6.00

3.50

 

 

Q1

15.50

12.70

10.30

9.20

 

 

Median

16.33

14.40

12.20

11.00

 

 

Q3

16.80

15.80

14.00

12.50

 

 

Max

18.20

19.20

17.30

16.70

 

 

 

(Steffen & Seney, 2008, Parkinson’s Disease)

  • Forward mean = 21 (6); 95% CI = 18 - 23 
  • Backward mean = 14 (5); 95% CI = 13 - 16

Test/Retest Reliability

Functional Reach Test:

 

Parkinson’s Disease: 

(Schenkman et al, 1997, Parkinson’s Disease)

  • Excellent test-retest reliability (ICC = 0.84) 

(Smithson et al, 1998, Parkinson’s Disease)

  • Poor test-retest reliability for PD with no history of falls Pearson Product Moment Correlation = 0.47, ICC = 0.42
  • Excellent test-retest reliability for PD with a history of falls Pearson Product Moment Correlation = 0.92, ICC = 0.93

Interrater/Intrarater Reliability

Functional Reach Test:

 

Parkinson's Disease:

(Lim et al, 2005, Parkinson’s Disease) 

  • Adequate inter observer reliability (ICC = 0.64) 
  • Adequate intra observer reliability (ICC = 0.74)

Criterion Validity (Predictive/Concurrent)

Functional Reach Test:

 

Parkinson’s Disease

(Behrman, A.L. et al, 2002; n = 58; mean age = 64.3(9.3) years) 

  • Sensitivity: A functional reach criterion of less than 25.4 cm for risk of falls identified only 30% of the individuals with PD known to be at risk from their history of falls. Negative predictive value (the probability that a person who tests negative (< 25.4 cm) actually does not have a history of falls = 36%. Positive predictive value (probability that those showing a positive fall risk reach (< 25.4cm) actually do have a positive history for falls) = 90% 
  • An increase in the reach criterion to 30.1 cm for falls risk nearly doubled the test sensitivity of the FRT, although 44% of the persons at risk remained unidentified by the FRT 
  • Specificity (those that truly had no history of falls were identified by the FRT as having a negative fall risk (> 25.4cm) = 92% 

 

(Dibble and Lange, 2006, Parkinson’s Disease)

  • Adequate validity: AUC = 0.80

(Kerr et al. 2010, n = 101, mean age 66.4y (8.20; range 43-84, 67.3% male) 

ROC characteristics: (to predict falls) 

  • Accuracy(&) = 0.52 
  • Area under curve = 0.52 
  • Sensitivity = 0.52 
  • Specificity = 0.53 

 

(Jenkens et al. 2010, Parkinson’s Disease) 

  • Good predictive validity of Functional Reach Test at predicting maximum top, middle and bottom reaches for Parkinson’s Disease Patients (r = 0.72, 0.76, and 0.73 respectively) 

 

(Nocera et al, 2010; n = 44, mean age = 66 (11) years, Modified HY disability score = 2.3 (0.5), Parkinson’s Disease) 

 

Functional Measures (Pearson Correlations)

Functional Reach

Knee Strength

Dynamic Stability

6 Minute Walk Test

Functional Reach

  

0.221

0.367

-0.017

P Value

  

0.177

0.018

0.914

Knee Strength

0.221

  

0.500

0.248

P Value

0.177

  

0.001

0.127

Dynamic Stability

0.367

0.500

  

0.529

P Value

0.018

0.001

  

0.000

6 Minute Walk Test

-0.017

0.248

0.529

  

P Value

0.914

0.127

0.000

  

 

Functional Measures

UPDRS Motor

UPDRS Total

HY

Functional Reach

-0.266

-0.275

-0.248

P Value

0.08

0.07

0.1

 

Construct Validity

Functional Reach Test:

 

Parkinson's Disease:

(Dibble & Lange, 2006, Parkinson’s Disease)

  • FRT scores for fallers and nonfallers were significantly different (p < 0.05)
    • Fallers mean (sd) = 23.11 (8.12) cm
    • Nonfallers mean (sd) = 31.70 (5.61) cm 
    • Fallers & Nonfallers mean (sd) = 27.43 (8.38) cm

 

(Smithson et al, 1998, Parkinson’s Disease) 

  • Successfully able to detect differences between patients with and without a history of falls
    • Between subjects with PD who had a history of falls and the subjects with PD who had no history of falls P < 0.05
    • Between the subjects with PD who had a history of falls and the comparison subjects P < 0.05 

 

(Kerr et al, 2010, Parkinson’s Disease) 

  • Significant difference in Functional Reach Test scores between fallers and nonfallers (p < 0.05)
    • fallers mean: 52.8 (3.4) cm
    • nonfallers mean: 54.2 (1.9)
    • all patients 53.6 (2.8) 
  • Sensitivity and Specificity were found to be 0.52 and 0.53 respectively which are moderate scores and may render this test less significant of an indicator of fall risk than the statistics show

Vestibular Disorders

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Standard Error of Measurement (SEM)

Modified Functional Reach Test:

 

Vestibular Disorder:

(calculated from values given in Mann et al, 1996; mean age = 58.3 (14.0); Time since onset of dizziness symptoms = 20.7 (33.7); group 1: n = 18, Dizziness Handicap Inventory (DHI) less than or equal to 49; group 2: n = 10, Dizziness Handicap Inventory greater than or equal to 50, Vestibular Disorders)

  • Forward Functional Reach Test; group 1 = 2.29 cm 
  • Forward Functional Reach Test; group 2 = 2.45 cm

Minimal Detectable Change (MDC)

Functional Reach Test:

 

Vestibular Disorder: 

(calculated from values given in Mann et al, 1996, Vestibular Disorder)

  • MCD group 1 subjects with DHI < 49 = 6.35 cm
  • MCD group 2 subjects with DHI > 50 = 6.79 cm

Normative Data

Functional Reach Test:

 

Vestibular Disorders:

(Mann et al, 1996, Vestibular Disorders)

  • Functional Reach Test mean 31.7 (7.5) cm

Interrater/Intrarater Reliability

Functional Reach Test:

 

Vestibular Disorders:

(Mann et al, 1996; 2 physical therapists, 10 undiagnosed volunteers, Vestibular Disorder) 

  • Excellent Intrarater reliability (ICC = 0.89)

Construct Validity

Functional Reach Test:

 

Peripheral Vestibular Disorders:

(Mann et al, 1996; n = 28; mean age = 58.3 (14) years; mean time since onset dizziness symptoms = 20.7 (33.7) months)

  • FRT and right single leg stance time were adequately correlated (r = 0.59)
  • FRT and DHI (Dizziness Handicap Inventory) were poorly correlated (r = -0.23)
    • Significant difference in FRT when divided into groups based on DHI scored ( t = 2.08, p 0.05)
      • Group 1 DHI < 49: FRT was 33.7 (SD = 6.9) cm
      • Group 2 DHI > 50: FRT was 28.0 (SD = 7.4) cm

Spinal Injuries

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Standard Error of Measurement (SEM)

Modified Functional Reach Test:

 

SCI Population:

(calculated from Lynch et al., 1998; n = 30 males, mean age: 30.8 (7.2) years old; time since onset: ≥ 1 month post-rehab;severity of injury: AIS A or B, SCI)

Group

SD (cm)

SEM (cm)

1; n = 10, C5-C6

7.6

1.86

2; n = 10, T1-4

4.3

1.66

3; n = 10, T10-12

5.6

1.48

 

Minimal Detectable Change (MDC)

Functional Reach Test:

 

SCI:

(calculated from Lynch et al, 1998, SCI)

  • C5-6 SCI = 5.16 cm
  • T1-4 SCI = 4.63 cm
  • T10-12 SCI = 4.10 cm

Test/Retest Reliability

Modified Functional Reach Test: 

 

SCI:

(Lynch, et al 1998, SCI)

  • Excellent test-retest reliability (ICC C5-6 group = 0.94, ICC T1-T4 group = 0.85, ICC T10-12 group = 0.93)
    • Test-retest reliability results are from single rater in study

Interrater/Intrarater Reliability

Modified Functional Reach:

 

SCI Population: (Lynch, et al, 1998) Not Established; single rater used in the study. 

Bibliography

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Dibble, L. E. and Lange, M. (2006). "Predicting falls in individuals with Parkinson disease: a reconsideration of clinical balance measures." J Neurol Phys Ther 30(2): 60-67. 

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Jenkins, M. E., Johnson, A. M., et al. (2010). "Predictive validity of the UPDRS postural stability score and the Functional Reach Test, when compared with ecologically valid reaching tasks." Parkinsonism Relat Disord 16(6): 409-411. 

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Kerr, G., Worringham, C., et al. (2010). "Predictors of future falls in Parkinson disease." Neurology 75(2): 116-124. 

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Lynch, S. M., Leahy, P., et al. (1998). "Reliability of measurements obtained with a modified functional reach test in subjects with spinal cord injury." Phys Ther 78(2): 128-133. 

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Steffen, T. and Seney, M. (2008). "Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism." Physical Therapy 88(6): 733-746. 

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Thomas, J. I. and Lane, J. V. (2005). "A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients." Archives of Physical Medicine and Rehabilitation 86(8): 1636-1640. 

Weiner, D. K., Duncan, P. W., et al. (1992). "Functional reach: a marker of physical frailty." J Am Geriatr Soc 40(3): 203-207. 

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