The ability to maintain static and dynamic balance is a prerequisite for safe walking and for obtaining functional mobility. For this reason, a reliable and valid means of screening for risk of falls is needed. The functional reach test (FRT) is one of the most common clinical tests used to determine balance in patients who are at risk of falling.
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. The typical populations tested include; community dwelling elderly, patients with Parkinson’s disease, peripheral vestibular disorders, spinal cord injury, stroke or vestibular disorders.
The FRT is most commonly used to aid diagnosis and to serve as baseline data for future intervention reviews or reassessments. Most of the patients tested using the FRT have systemic or global balance issues such as Parkinson’s or vestibular disorders and do not necessarily present with the risk of falling due to muscle tightness.
Nevertheless, since the test involves bending forward at the hip with an outstretched hand while standing or sitting, muscle tightness may not be a major limiting factor except it significantly affects forward trunk flexion or bilateral shoulder flexion and elbow extension etc. It is therefore safe to conclude that a patient may not be a good candidate (ab initio or from the very beginning) for balance testing using the FRT where these muscle limitations are present.
For objectivity and reliability, the PT may consider applying alternative clinical tests for balance such as the CTSIB (Clinical Testing for Sensory Integration and Balance) or any other appropriate balance test that accommodates the presence of muscle tightness in the patient rather than rely on an inaccurate FRT test result that has been compromised by the presence of muscle tightness.
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