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Functional Reach Test (FRT)
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Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
Construct measured: Functional Standing Balance.
Generic vs. disease specific: Generic with disease specific modifications.
Means of administration: Examiner administered.
Intended respondent: Administrator.
Background: The Functional Reach Test (FRT) was originally designed for measuring a balance impairment or change in balance over time in the elderly. It has since been validated and modified to be used in children and adults with neurologic impairments. The subject must be able to stand unsupported. This has been validated for use in children with Cerebral Palsy (CP) between 5 and 15 years and Gross Motor Function Classification Scale (GMFCS) I-III with ability to discriminate between children of differing GMFCS levels.
Comments/Special Instructions
Functional reach is defined as the maximum distance one can reach forward beyond arm's length while maintaining a fixed base of support in the standing position. A leveled yardstick is secured to the wall with tape at the height of the subject's acromion process of the dominant arm. If the subject touches the wall or the examiner or left the designated area, the test does not count. The subject makes a fist and positions the shoulders at 90 degrees of flexion against the yardstick. Then the subject is instructed to "reach as far as possible."
Specific Modifications for CP: Prior to the test, the examiner demonstrates forward arm reaching twice, and the subject practices the task once. A parent or caregiver stands in front of the child and encourages him or her to reach as far forward as possible.
Scoring: Three trials should be done. The difference between the starting position and the final position of the third metacarpal is recorded. Resting intervals up to 5 seconds between each of the 3 trials should be allotted. The 3 test results are averaged for data analysis. The FRT is measured in centimeters, with longer distances indicating better gross motor functional abilities.
Adminstration: 15 minutes or less
Strengths/Weaknesses: It has good discriminate validity to discriminate between GMFCS Levels I-III. However, it can only be administered if the child is able to stand independently.
Psychometric Properties: FRT has been shown to have high intrarater reliability (intrarater reliability - ICC 0.89-0.98), high test-retest reliability (ICC 0.94-0.98) and high interrater reliability (ICC 0.97-0.99) in children with CP. It has good discriminate validity to distigiush among the GMFCS levels I-III. It has lower correlation with GMFM-88 section D (standing dimension) and walking speed.
Key References:
Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):M192-M197.
Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of functional balance assessment in children with cerebral palsy. Neurorehabil Neural Repair. 2008;22(6):745-753.
Niznik TM, Turner D, Worrell TW. Functional reach as a measurement of balance for children with lower extremity spasticity. Phys Occup Ther Pediatr. 1995;15(suppl 3):1-15.
Additional References:
Weiner DK, Duncan PW, Chandler J, Studenski SA. Functional reach: a marker of physical frailty. J Am Geriatr Soc. 1992;40(3):203-207.
Katz-Leurer M, Fisher I, Neeb M, Schwartz I, Carmeli E. Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke. Disabil Rehabil. 2009;31(3):243-248.
Lynch SM, Leahy P, Barker SP. Reliability of measurements obtained with a modified functional reach test in subjects with spinal cord injury. Phys Ther. 1998 Feb;78(2):128-33.
Document last updated April 2022