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Lateral Reach Tests

FORWARD REACH:

The functional reach test has been designed to test how well a seating system assists in leaning or reaching forward with the ability to return to the upright position.

Setup subject in wheelchair:

Place subject in the middle of clinic with plenty of space to reach/lean forward.

Secure the wheel locks of the wheelchair.

Setup tripod behind wheelchair:

Secure a specialized tripod to the rear wheels of the subject’s wheelchair so that the vertical tube is positioned directly behind the subject’s reaching shoulder (right first).

A flexible tape measure is fixed to the tripod vertical tube.

Overview of Reach instructions:

The acromion process will be used as the anatomical marker.

Set the flexible tape measure on the tripod vertical tube at the height of the acromion process.

The tester will hold the 2nd and 3rd fingers on the subject’s shoulder with the acromion between the two fingers.

The tape measure should be held lightly and allowed to glide as the subject reaches forward.

The forward reach will be explained and demonstrated by one of the investigators.

No weight bearing or holding will be allowed by either upper extremity.

The non-reaching upper extremities will be placed either: (1) Over the navel, (2) Against the chest, (3) Free/Non-weight bearing (record the position of the upper extremities) or (4) Other (note position and if weight bearing or not).

The subject reaches out for a ball that the second tester is holding out of reach.

The subject must be able to independently return to the upright position or the trial needs to be repeated.

The subject has one practice trial to ensure that they understand the task.

Reposition the subject in the upright position and record the baseline measurement.

The baseline measurement is the distance from the tripod vertical tube to the acromion process.

The subject is asked to lean forward as far as possible and the lean measurement is recorded.

The lean measurement is the distance from the tripod vertical tube to the acromion process at the extreme lean point.

The subject will be guarded for safety as they reach forward.

The difference between the starting distance and the extreme lean point will be calculated and recorded as the lean distance.

Three functional reach/leans will be performed and recorded for each side.

The subject will be repositioned between each lean.

If a subject is unable to return to upright or moves the non-reaching upper extremity from position, then the trial will be repeated.

Relocate the tripod behind the left shoulder for the left forward reach/lean.

LATERAL REACH- DOWNWARD

Reaching straight down laterally to the side from sitting in the wheelchair with the ability to return to the upright position.

Setup subject in wheelchair:

Place subject in the middle of the clinic with plenty of space to reach lateral and down.

Secure the wheel locks of the wheelchair.

Setup measuring tool:

Setup the specialized measuring tool for the lateral reach downward (steel ruler mounted to aluminum base plate) by the left side of the wheelchair positioned as adjacent as possible to the trajectory of the subject’s downward reach. Overview of Reach instructions:

The most distal part of the fingers will be used as the end measuring point, unless the subject is unable to keep his/her hand in a straight open position or unless the subject is able to touch the floor with the fingers. If subject is unable to keep the hand open, record an alternate reaching body part. If subject is able to touch the floor with the fingers, then use the distal part of the elbow as the reaching body part with the reaching side hand touching the reaching side shoulder. Record these alternate positions on the evaluation form.

The tester will lie down on the floor and align himself/herself to have a good view of the most distal reaching body part adjacent to the measuring device for accurate measurement.

One of the investigators should explain and demonstrate the lateral reach downward.

No weight bearing or holding shall be allowed by either upper extremity.

The non-reaching upper extremity shall be placed over but not touching the non-reaching side push-rim in case the subject needs to grab on to prevent complete loss of balance. If the subject is unable to hold the non-reaching arm in this position, the alternate position will be recorded.

The subject shall reach laterally straight down to the side towards the floor as far as possible.

The non-reaching arm shall not be extended as a counter balance.

The subject must be able to independently return to the upright position and shall not touch any part of the wheelchair with the non-reaching arm or the trial must be repeated. The trial shall also be repeated if the non-reaching arm deviates more than 6 inches away from the push-rim during the reach.

The subject has one practice trial to ensure that they understand the task.

The subject is asked to reach laterally downward, reaching for the floor as far as possible and the reach measurement is recorded.

Three lateral downward leans are to be performed to the left and to the right with the subject repositioning in the upright position between each downward lateral reach.

The lean measurement is the difference between the start and end distance in centimeters from the floor.

The subject shall be spotted for safety as they reach laterally downward.

If the subject is unable to return to an upright position or moves the non-reaching upper extremity more then 6 inches from the push-rim (or alternate start position), then the trial shall be repeated.

LATERAL REACH IN THE HORIZONTAL PLANE:

Reaching laterally, parallel to the floor, in the horizontal plane level with the shoulders, with the ability to return to the upright position.

Setup subject in wheelchair:

Place subject in the middle of the clinic with plenty of space to reach laterally.

Secure the wheel locks of the wheelchair.

Setup tripod by the side of the wheelchair:

Position a vertical pole directly behind the subject’s reaching shoulder (left first).

A flexible tape measure is fixed to the vertical pole.

Overview of Reach instructions:

The acromion process shall be used as the anatomical marker.

Set the flexible tape measure on the vertical pole at the height of the acromion process.

The tester shall hold the 2nd and 3rd fingers on the subject’s shoulder with the acromion between the two fingers.

The tape measure should be held lightly and allowed to glide as the subject reaches laterally.

The lateral reach shall be explained and demonstrated by one of the testers.

No weight bearing or holding shall be allowed by either upper extremity.

The non-reaching upper extremity shall be extended laterally in the opposite direction. If the subject is unable to extend the arm laterally, an alternate position shall be recorded.

The subject shall reach laterally straight out on the horizontal and sagittal plane as far as possible.

The subject must be able to independently return to the upright position or the trial shall be repeated.

The subject shall practice the lateral reach to ensure that they understand the task.

Three lateral reaches shall be performed on each side with the subject repositioning in an upright posture between each reach.

The baseline measurement shall be the distance from the vertical pole to the acromion process. This measurement shall be recorded at the beginning of each trial.

The subject shall reach laterally as far as possible. The maximum lateral reach shall be recorded at the acromion process.

The amount of lateral reach is the difference between the acromion process measured at maximum reach and the baseline position of the acromion process.

The subject shall be spotted for safety as they reach laterally.

If the subject is unable to return to an upright position or moves the other extremity out of position more than 6 inches, then the trial shall be repeated.

Relocate the vertical pole from the left side of the wheelchair to the right side and repeat the process.