The L Test of Functional Mobility

What negatively impacts functional mobility?

Functional mobility refers to the ability to move freely and efficiently to perform everyday activities. Various factors can negatively impact functional mobility, leading to significant challenges in daily life. Physical limitations such as muscle weakness, joint stiffness, and balance disorders are common contributors. Conditions like arthritis, osteoporosis, and neurological disorders, including Parkinson’s disease and stroke, can severely restrict an individual’s ability to move. Injuries such as fractures, sprains, and surgeries also play a significant role in diminishing functional mobility.

Age-related changes further exacerbate these issues. As people age, they naturally experience a decline in muscle mass and strength, reduced flexibility, and slower reaction times. Additionally, chronic conditions like diabetes and cardiovascular disease can impair circulation and nerve function, leading to mobility problems. Environmental factors, such as inadequate home safety measures, can also hinder mobility by increasing the risk of falls and accidents.

Problems associated with impaired functional mobility

Impaired functional mobility can lead to numerous issues that significantly impact an individual's quality of life:

• Increased risk of falls and injuries
• Reduced independence in daily activities
• Social isolation and reduced participation in community activities
• Decreased physical fitness and muscle strength
• Higher likelihood of developing secondary health problems such as pressure sores, infections, and deep vein thrombosis

What is the L Test of Functional Mobility?

The L Test of Functional Mobility (L test) is a performance-based measure to assess physical function, including dynamic balance ability.

The L test is a modification of the Timed Up and Go (TUG) Test, created to overcome the ceiling effect observed in higher-functioning patients using the TUG test. Assessing the concurrent validity of the L Test against other established mobility tests is crucial for ensuring its reliability and effectiveness.

The test involves the participant standing up from a chair, walking a specific path marked by lines on the floor, turning at designated points, and returning to the chair. The time taken to complete the test is recorded, and the gait quality is observed after participants complete it. This test can be conducted with or without assistive devices, allowing flexibility based on the patient’s needs. The importance of concurrent validity lies in how well the L test correlates with other tests like the Timed Up and Go (TUG) test, ensuring it is a reliable measure of functional mobility.

Interpreting the results of walk tests involves comparing the test time with normative data for various populations. A shorter time indicates better functional mobility. Clinicians can use this information to plan appropriate interventions if the test results show significant impairment. This might include physical therapy, adjustments to prosthetic devices, or other treatments to improve mobility (Deathe & Miller, 2005).

Test validity

With regard to the reliability and validity of the L test, Deathe and Miller (2005) recruited individuals with unilateral amputations from an outpatient clinic to complete all tests over two visits, with some subjects returning for a third retest. The L test proved strong and met the home's functional mobility requirements.

Meanwhile, to assess concurrent validity of the L test in participants with mild to moderate Parkinson's disease, researchers correlated it with the TUG test. It revealed a strong correlation between the L Test and TUG, confirming that the L test is a reliable and valid measure of walking ability in this population (Haas et al., 2019).

The L test is also beneficial for evaluating individuals with lower-limb amputations, Parkinson’s disease, and other conditions that affect mobility. In terms of L test's effectiveness, its ability in identifying important clinical change in individuals with lower limb amputations using the global rating change scale was assessed in a prospective follow-up study. However, its accuracy is limited, indicating further research needs (Rushton et al., 2015).

How to use our L Test of Functional Mobility template

Using our L Test of Functional Mobility template ensures a standardized and efficient assessment process for clinicians. Here's how to use it effectively:

Step 1: Download the template

Start by downloading our L Test of Functional Mobility template, which includes all necessary sections baseline and follow up with instructions.

Step 2: Prepare the testing area

Set up the chair and mark the floor with lines at the 3-meter and 7-meter points, as shown in the diagram. Ensure the area is clear of obstacles.

Step 3: Instruct the patient

Explain the test procedure to the patient, demonstrating the required movements and scoring criteria. Ensure the patient understands the instructions and feels comfortable.

Step 4: Conduct the test

Have the patient perform one practice trial to familiarize themselves with the procedure. Then, the test will be conducted by timing the patient as they complete the required movements and recording the time taken for the walk test and any errors observed.

Step 5: Record and analyze the results

Use the provided scorecard to record the results once the participants completed the test. The L test change scores are crucial for evaluating functional improvement in individuals with lower limb amputation. Compare the patient’s performance with normative data to assess their functional mobility, including L test scores and their correlation with other measurement properties. Based on the results, plan the next steps for intervention or further evaluation.

Benefits of using our template

Our L Test of Functional Mobility template offers several advantages for clinicians and patients. Here are three key benefits:

Standardized assessment

Our template provides a standardized method for assessing functional mobility, ensuring consistency and accuracy in test administration. This helps clinicians to reliably measure patient progress over time and make informed decisions regarding treatment plans.

Time-efficient

The template streamlines the testing process, making it quick and easy to administer. With clear instructions and a straightforward setup, the L test can be completed in approximately 10 minutes, allowing for efficient use of clinical time.

Comprehensive evaluation

In addition to measuring the time taken to complete the test, our template includes sections for recording observational data on gait quality. This provides a more comprehensive evaluation of the patient’s functional mobility, helping to identify specific areas that may need targeted intervention.

Reference

Deathe, A. B., & Miller, W. C. (2005). The L test of functional mobility: Measurement properties of a modified version of the timed “up & go” test designed for people with lower-limb amputations. Physical Therapy, 85(7), 626–635. https://pubmed.ncbi.nlm.nih.gov/15982169/

Haas, B., Clarke, E., Elver, L., Gowman, E., Mortimer, E., & Byrd, E. (2019). The reliability and validity of the L-test in people with Parkinson’s disease. Physiotherapy, 105(1), 84–89. https://doi.org/10.1016/j.physio.2017.11.218

Rushton, P. W., Miller, W. C., & Deathe, A. B. (2015). Minimal clinically important difference of the L test for individuals with lower limb amputation. Prosthetics & Orthotics International, 39(6), 470–476. https://doi.org/10.1177/0309364614545418