Postural Control/Balance

Question 1

Functional Reach Test

Answer 1

• Quick screen to detect balance problems on elders; also used with CVA, TBI and other neurologic dysfunction
• Tests anticipatory postural control anteriorly only
• Patient reaches as far forward as he/she can without changing BOS or moving feet or losing balance.
• Distance reached is measured and compared to norms

Question 2

Functional Reach Test Cut-off Scores

Answer 2

• Unable to reach, 8X more likely to fall
• Reaches 10 inches, unlikely to fall
• <6 predictive of falls

Question 3

Modified Functional Reach Test (MFRT)

Answer 3

• Perform test unsupported reaching in forward and lateral direction in a seating position
• Responsive to improve motor performance on paretic side in acute post-stroke patients

Question 4

Pediatric Reach Test (PRT)

Answer 4

• Measure forward and lateral reach in both seated and standing positions
• Good in developing children and those with CP

Question 5

Multi-directional reach test (MDRT)

Answer 5

• Examines limits of stability in forward, backward, medial, and lateral populations - test both arms
• Correlated with BERG and inversely related to TUG
• Not yet studied in neuro populations

Question 6

BERG

Answer 6

• Comprehensive functional balance assessment used with any pt with balance problems –> anticipatory control
• 14 items, rated 0-4
• No norms yet
• Cut off score = 45 (mod risk of falls); max score = 54
• < 36, 100% risk of fall

Question 7

Dynamic Gait Index (DGI)

Answer 7

• Developed for individuals with higher level balance problems –> anticipatory control
• 8 items that tests gait under different environment
• Score 0-4, lower = more impaired
• Good reliability with brain injury, geriatric, MS, Parkinson’s, stroke, vestibular disorders
• Max score = 24; cut off = 19 (mod risk for fall)

Question 8

Tinetti (POMA)

Answer 8

• Tests reactive and anticipatory balance
• Balance subscore = 16 (< 9, high fall risk)
• Total score = 28 (< 19 = high risk for fall; 19-24 = mod risk)

Question 9

Falls Efficacy Scale (FES)

Answer 9

• 10 ADL items and asked individual’s fear of falling with the items
• Score 1-10, higher score = greater confidence

Question 10

Activity Specific Balance Confidence Scale (ABC Scale)

Answer 10

• 16 items rating confidence
• Scored 0-100 for each item, higher = more confident
• Comm dwelling elders < 67% = fall risk (87% of time)
• Parkinson’s - < 69 = fall risk (93% of time)
• Stroke 81.1 = certainty that individual does not have history of multiple falls
• Tested in elderly, MS, Parkinson’s, Stroke, Unilateral transtibial amputation, vestibular disorder