Modifying a functional obstacle course to test balance and mobility in the community

A previously reported functional obstacle course (FOC) developed to assess elderly persons with and without balance and mobility impairment was used in a hospital-based study of 237 participants. A new modified version of the FOC was developed for use in a community-based study, by placing some obstacles next to walls instead of between parallel bars. These modifications eliminate the need for parallel bars or for extra personnel to interchange the obstacles. We were concerned that the modifications could affect performance scores, because touching or holding onto the now eliminated parallel bars could influence FOC scores under the original scoring system. To determine the effect of these modifications on FOC performance, we tested 36 volunteers, (18 fallers [falls within last year] and 18 non-fallers), on the modified parts of the old and new versions of the FOC. Random testing order and inter-trial rests were used. For both the old and new FOC versions, we summed quality and task completion time scores from the six modified obstacles (artificial turf, carpet, pine bark, sand, up ramp and down ramp) to create scores for quality and time. Our hypothesis was that there would be no performance difference between the original and modified obstacle course. Using a two-factor repeated-measures analysis of variance, we found no difference in quality scores between the two FOC versions and no effect of an interaction between faller status and the course versions. We did find that the time was approximately 2 seconds longer for the new version; however, the time increase was the same for fallers and non-fallers. These data show that fallers and non-fallers have comparable performance on both versions of the FOC; however, to compare the two obstacle courses we recommend an adjustment of 2 seconds in time scores. The obstacle course modifications will facilitate more extensive and efficient use of the obstacle course as a research tool to assess balance and mobility.