Functional Reach Test

What is a Functional Reach Test (FRT)?

The Functional Reach Test or functional reach assessment is a widely used, new clinical measure to measure dynamic balance and fall risk in older adults. Healthcare practitioners, specifically therapists, mainly implement it for their geriatric patients and younger clients experiencing mobility issues. It measures the maximum distance an individual can reach forward while in a fixed standing position while maintaining their balance.

The Functional Reach Test is an essential tool in physical and rehabilitation medicine, helping healthcare professionals identify physical frailty, which is a significant factor in fall risk among the elderly, so they may develop targeted interventions to prevent falls. Assessing an elderly's risk of falling is crucial and should be assessed as soon as possible, as the result of a fall could have physical, mental, and emotional consequences.

Aside from that, the Functional Reach Test is also helpful when gauging mobility and checking improvements or worsened conditions. The results obtained should help you make the necessary adjustments to the care plan and ensure your client's condition is appropriately treated.

By assessing dynamic balance, the Functional Reach Test performance results provide valuable insights into an individual's stability and help predict fall risk, making it a valuable component in caring for older adults and those with balance impairment.

How to conduct the Functional Reach Test?

The Functional Reach Test is easy to conduct or administer. You simply have to follow the steps below.

Step 1: Prepare equipment and tools beforehand

To conduct the test effectively, you must prepare the following: wall space (at least 3 feet of wall space should suffice), a yardstick to measure reach distance, tape or velcro to secure the yardstick and mark the patient's standing point of your patient, someone to stand near the patient in case they show signs of falling and the Functional Reach Test template you can download in the guide. In case you forget, there's also a list of what you must prepare on the template.

Step 2: Have your patient stand behind the standing baseline

After all the necessary tools are ready, the first thing you need to do is have your patient stand behind the standing baseline. They should be standing alongside the wall, with their arm close to the wall at 90 shoulder flexion and their fist closed. This setup allows you to measure balance stability as the patient reaches forward accurately.

Step 2: Conduct the test

The Functional Test has three trials, the first being a demonstration. Here’s how it’s supposed to go:

• You’ll first measure the starting position of your client, specifically the starting position of the third metacarpal head on the yardstick.
• Once you measure that, instruct your patient to reach as far as they can without moving their feet.
• Record their reach, a.k.a the third metacarpal head on the yardstick. When recording the reach, keep in mind that you’re recording in inches.
• Have your patient rest. At least 15 seconds should be good, but of course, take into consideration how they’re feeling and extend the break if necessary.

Keep in mind that you'll be calculating the reach and it'll be based on the difference between the starting position and end position.

Step 3: Repeat the trial two more times

The first test is mainly for demonstration purposes. You'll record the second and third tests, but you may also include the first test result in your final score if you wish.

Do remember to give your client breaks in between each trial and to stop the test if the patient falls forward or if their feet are lifted up from the floor.

Step 4: Calculate the averages

Once you have the results of the second and third trials (again, you can count the first one if you wish), calculate the average.

Just to give you an idea, here are the average reaches for both men and women of specific age groups:

• 20-40 years old: 16.73 inches (42.49 cm) for men, 14.64 inches (37.9 cm) for women
• 41-69 years old: 14.98 inches (38.05 cm) for men, 13.81 inches (35.08 cm) for women
• 70-87 years old: 13.16 inches (33.43 cm) for men, 10.47 inches (26.59 cm) for women

Do note that the normative Functional Reach Test values may vary depending on the population being tested.

Step 5: Interpret the scores

Refer to the information below when you're interpreting the average Functional Reach Test score:

• Extremely high risk (8x the risk): Patient is unwilling to reach
• High risk of falling (4x the risk): Average score of 6 or below inches
• Moderate risk of falling (2x the risk ): 7-10 inches
• Low risk of falling: Score an average above 10

Once you’ve calculated the average of the Functional Reach Test results, you can use that to help determine parts of the developed care plan for your patient to address specific balance deficits and improve overall stability.  Do note that in some settings, a computerized Functional Reach Test is used to enhance accuracy and provide a detailed analysis of the results.

Benefits of using the Functional Reach Test

There are numerous benefits of using the functional reach assessment and taking advantage of the template available in this guide. Here are some of them:

It's quick to do

The Functional Reach Test doesn't take too long to do. You can finish all three trials in just five minutes and calculate your results as soon as the trials are over.

Immediately determine what you need for your care plan

Since you will be gauging the patient and calculating your results immediately after the trials, you should be able to talk to your patient about their fall risk. You can then determine what to add to your care plan to prevent them from getting into an accident.

It's an excellent way to check if your client is doing better or worse

You may reissue this test to your client to check for any improvements or if their mobility is deteriorating. It's also an excellent way to see if you need to adjust your care plan.

Be aware of a patient's limits

Aside from being helpful to physical therapists, your patient might find this beneficial because they can know their limits based on the current state of their mobility. They will know what to avoid and what needs work to get better, what can't be changed, and how to adjust based on what can't be changed.