Overview
The segment explains the Modified (Seated) Functional Reach Test: purpose, setup, procedure, scoring considerations, interpretation, and intervention ideas to improve dynamic sitting balance.
Purpose and Indications
- Assesses dynamic sitting balance in patients with impaired seated stability.
- Use when patients need support to sit, lean on chair back, or struggle maintaining sitting.
- Not necessary if interview and observation show normal sitting balance.
Test Setup and Positioning
- Patient seated with hips, knees, ankles at 90 degrees; feet flat on floor.
- Yardstick mounted on wall at the patient’s acromion height.
- Patient starts with back against chair for all test conditions.
Procedure and Measurement
- Arm position: shoulder flexed to 90 degrees, elbow extended when possible.
- Primary measure point: distal end of the fifth finger (pinky) on the yardstick.
- If unable to lift arm: measure using the acromion as the landmark.
- Movement instructions: lean as far as possible without trunk rotation or touching wall/yardstick.
- Units recorded in centimeters; first trial is practice and not scored.
- Provide approximately 15-second rest between measured trials.
Test Conditions and Options
- Forward reach with unaffected side closest to the wall/yardstick.
- Lateral reach to the right with back against the wall.
- Lateral reach to the left with back against the wall.
- Forward reach is most common; all three are optional based on goals.
Example Measurements (Demonstration)
- Forward reach: start at 5 inches, end at 22 inches; reach distance = 17 inches.
- Lateral reach example: start at 10 inches, end at 19 inches; reach distance = 9 inches.
Measurement and Trial Structure
- Practice trial first, excluded from results.
- Subsequent trials measured; allow rest between attempts.
- Document start and end positions to compute reach distance.
Norms and Clinical Use
- No published normative values for this test.
- Emphasize quality of movement and ability to return to upright.
- Track change over time to demonstrate progress (e.g., 5 cm to 10 cm after interventions).
Interpretation and Clinical Reasoning
- Poor performance: limited reach or inability to return to upright suggests impaired dynamic sitting balance.
- Observations to note: trunk rotation, loss of balance, reliance on backrest, and symmetry across directions.
Interventions Based on Findings
- Seated reaching beyond base of support in multiple directions.
- Seated object movement tasks to encourage controlled weight shift.
- Progress surface challenge: firm surface → foam → BOSU → therapy ball.
- Maintain feet supported; cue target-directed reaching to challenge safely.
Structured Details Summary
| Aspect | Details |
|---|
| Purpose | Assess dynamic sitting balance |
| Indications | Difficulty maintaining seated balance, reliance on backrest |
| Position | Hips/knees/ankles 90°, feet flat, back against chair |
| Equipment | Yardstick at acromion height on wall |
| Landmarks | Primary: distal fifth finger; Alternative: acromion if arm cannot lift |
| Conditions | Forward; Right lateral; Left lateral (forward most common) |
| Instructions | Lean as far as possible without trunk rotation or touching wall/yardstick |
| Units | Centimeters; compute change from start to end |
| Trials | First is practice; ~15 s rest between measured trials |
| Norms | None published; use qualitative analysis and repeated measures |
| Interventions | Seated reaching, object moving, uneven surfaces (foam, BOSU, therapy ball) |
Key Terms & Definitions
- Dynamic sitting balance: ability to maintain seated stability while moving the trunk and reaching.
- Base of support: area under and between points of contact (buttocks and feet in sitting).
- Acromion: bony prominence at the top of the shoulder; alternative measurement landmark.
Action Items / Next Steps
- Use the test for patients with suspected seated balance impairments.
- Record start/end positions and reach distance; note movement quality.
- Reassess periodically to document progress and adjust intervention difficulty.
- Implement progressive seated balance training aligned with test deficits.