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Functional Reach Arm Test(FRT)

1. Test name
2. Main subjects & wide applying subjects
3. Purpose
4. Standardization
5. Reliability
6. Validity
7. Require training
8. Test Time
9. Contents
10. Method
11. Recoding
12. Interpretation.

1.

Test name

Functional reach arm test

2.

Main subjects & wide applying subjects

Balance Vestibular; Balance Non-Vestibular; Functional Mobility; Vestibular


1. Community Dwelling Elderly(Geriatrics)
2. Parkinson's Disease
3. Spinal Cord Injury
4. Stroke
5. Vestibular Disorders
Domain
ICF Domain
Assessment Type

3.

Activity
Motor
Performance Measure

Purpose

The purpose of this study was to investigate which reach distance was more
highly correlated with Balance.
1) to document change over time in patients with balance problems,
2) to assess likelihood that patient will fall ,
3) to complete a balance assessment.

4.

Standardization
Results in the literature have been reported in inches and centimeters. The
functional reach score equals the difference (in inches or centimeters)
between the end and the start hand positions. (2.54 cm = 1 inch)

5.

Test Time
This test takes a few minutes and is very reliable
Subject must be able to stand 5 Minutes or Less without support in order to
have this test administered

6.

Method

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): 203207.)
The patient is instructed to stands 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 and
without rotation
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

7.

Reliability

Community Dwelling Elderly:


(Weiner et al, 1992, Community Dwelling Elderly)

Excellent test-retest reliability (ICC = 0.89)

Parkinsons Disease:
(Schenkman et al, 1997, Parkinsons Disease)

Excellent test-retest reliability (ICC = 0.84)

Stroke:
(Outermans et al, 2010, Subacute Stroke)

Excellent intrarater reliability (ICC = 0.89)

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

Excellent Intrarater reliability (ICC = 0.89)

8.

Validity

Community Dwelling Elderly


(Weiner et al, 1992, Community Dwelling Elderly)

Excellent correlation with:


o

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:


o

Physical Activities of Daily Living (PADL) (r = 0.48)

Parkinsons Disease
(Jenkens et al. 2010, Parkinsons Disease)

Good predictive validity of Functional Reach Test at predicting maximum top,


middle and bottom reaches for Parkinsons Disease Patients (r = 0.72, 0.76,
and 0.73 respectively)

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

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

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

9.

Contents
Yardstick and/or large paper, tape. Mackenzie(1999)
Suggests a modified form of the measuring device using a self-recording tape
measure connected to a handle.

10.

Recoding

Terms

Definitions

Healthy individual score


>10 inches
Limited functional balance score <6 or 7
2 practice trials.
# of trials
3 trials recorded & averaged.
Arm ext. fully, shoulder flex. to 90, hand in a fist.
Starting position
Instructions to pt.
When must a trial be discarded
& repeated

Take note of start by marking number where MCP


jts line up on ruler.
Reach as far fwd. as you can w/o taking a step.
If feet move.

11.

Require training

12.

Interpretation

No Training

The result indicates your patient's fall-risk category:

very high risk: unable to reach

high risk: reach of less than 6" (15.2 cm)

moderate risk: reach of 6" to 10" (15.2 to 25.4 cm)

low risk: reach greater than 10" in (25.4 cm).

As reach decreases, the chance of falling increases (Duncan, et al,1992)

FRT < 7 inches:

Unable to leave neighborhood without help

Limited in mobility skills

Most restricted in ADLs

It measures a subjects forward limit of stability, which is considered one part of


postural control (or balance) assessment.Duncan (1990) concludes that FR is a good
clinical measure of the margin of stability and is conceptually related to the
excursion of the center of pressure. Others are suggesting that FR is a weak
measure of stability limits (low correlation with FR and displacement of center of
pressure). Movement of the trunk seems to influence the test more than
displacement of center of pressure.
When the Functional Reach test and platform measures of postural sway were used
with clients with hemiparesis, they appeared to be evaluating comparable standingbalance abilities. In a kinematic study of 34 young subjects(20-36) and 33 older
subjects (60-76 years), spinal motion during forward FR was characterized by
forward and lateral trunk flexion, thoracolumbar and lower body rotation. Young
subjects displaced their center of pressure further forward (45.2 cm) and through a
greater percentage of their initial base of support than older subjects (37.1 cm). The
younger group had more forward trunk flexion and thoracolumbar rotation. OBrien,
et al (1997) found a weak correlation between inclination of the upper thoracic
spine and functional reach.106W e r n i ck-Robinson (1999) found FR does not
measure dynamic balance because people with vestibular hypofunction did as well.

Daubney and Culham (1999) found that ankle plantar-flexion force accounted for
13% of the score on the FR. Correlations were found between FR and hip extensor
strength and hip flexor strength. Eight hundred thirty three community dwelling
elderly 64-79 years old (457 were Mexican American) participated in a home
assessment. For each degree increase in shoulder ROM,
the likelihood of having a short reach was reduced by 3% and for each degree
increase in elbow ROM, the likelihood of having a short reach was reduced by 2%.