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Is the functional reach test useful for identifying falls risk among individuals with Parkinson's disease?
Andrea L Behrman1, Kathye E Light, Sheryl M Flynn
1Department of Physical Therapy, University of Florida, Box 100154, Gainesville, FL 32510-0154, USA. abehrman@hp.ufl.edu
Objective:
To evaluate the effectiveness and validity of the Functional Reach Test (FRT) as a screening tool to identify fallers (persons at risk for falls) among subjects with Parkinson's disease (PD) and control subjects.
Design:
A case-comparison design with a consecutive sample. Subjects performed 3 consecutive functional reach trials.
Setting:
Motor behavior laboratory in a university setting.
Participants:
Fifty-eight adults (43 subjects with PD, 15 control subjects). Controls were recruited from a Florida hospital and the local community.
Interventions:
Not applicable.
Main Outcome Measures:
A falls history was recorded, a mean FRT score attained, and FRT scores were categorized as less than 25.4 cm, the criterion for falls risk, or > or =25.4 cm.
Results:
Mean FRT scores differentiated subjects with PD and a known history of falls from subjects with PD and no history of falls and from control subjects (P <.001). Tests of validity for the FRT as a screening tool indicated sensitivity as 30%, specificity as 92%, positive predictive value as 90%, and negative predictive value as 36%.
Conclusions:
The FRT, using a reach less than 25.4 cm as a criterion for falls risk, is not a sensitive instrument for identifying individuals with PD at risk. However, the percentage of those persons identified as at risk by the FRT are highly likely at risk, and they should be referred for falls risk intervention. Because the FRT does not identify every person at risk, using a test battery addressing other factors contributing to falls risk may increase the sensitivity of a clinician's assessment to identify persons with PD at risk for falls.
