Functional Performance and Balance Assessment Tests in Patient Care

Cutoff scores for Chair Stand: 5T -STS

≥12 seconds identifies the need to further assess for falls; >15 seconds= risk of fall

Chair stand >15 s

risk of fall

Chair stand 5TSTS ≥12S

identifies the need to further assess for fall

Chair Stand: 5T -STS Assesses

Functional lower extremity strength, transitional movement

Populations for Chair Stand: 5T -STS

Cerebral palsy, PD and movement disorders, stroke recovery, vestibular disorders, arthritis, MS, Pulmonary diseases, neurologic conditions

Time to Administer for Chair Stand: 5T -STS

Less than 5 mins

Setting for Chair Stand: 5T -STS

Outpt, inpt, SNF

Testing Procedure for Chair Stand: 5T -STS

Start on go, stand up fully 5 times

Norm for Chair Stand: 5T -STS

8 secs is norm

Chair Stand: 5T -STS interpretation

Longer it takes, more likely to fall

Chair Stand: 30s STS assesses

Functional lower extremity strength and endurance in older adults.

Time to Administer for Chair Stand: 30s STS

30 s

Setting for Chair Stand: 30s STS

Outpt, inpt, SNF, Home

Equipment for Chair Stand: 30s STS

Chair, stopwatch, wall space

Performance Levels for Chair Stand: 30s STS

Below average <14; Average=14-19; Above average=>19

Chair Stand: 30s STS interpretation

Scores below average for age/gender may indicate reduced functional capacity and potential for increased fall risk

Gait Speed: 10m Assesses

walking speed in meters per second over a short duration.

Populations for Gait Speed: 10m

MS, STROKE, Neuromuscular conditions, SCI, Mixed conditions, brain injury, arthritis

Time to Administer for Gait Speed: 10m

5 mins

Setting for Gait Speed: 10m

Outpatient, inpatient, SNF

Equipment for Gait Speed: 10m

Stopwatch and a clear pathway

Normal walking speed for Gait Speed: 10m

1.2-1.4 m/s

MDC for Gait Speed: 10m

0.05 change in performance

Meaningful change for Gait Speed: 10m

Increase by 0.1 m/sec in patients with gait impairments

Gait speed interpretation

Shorter times (higher walking speeds) indicate increased ambulatory capacity.

Gait Speed: 6m asseeses

Aerobic capacity and endurance, oxygen saturation, overall functional exercise

Populations for Gait Speed: 6m

COPD, COVID-19, STROKE, OA, AMPUTEE, OLDER Adults

MDC for Gait Speed: 6m

58.21

6M walk test interpretation

Increased distance walked indicates improvement in basic mobility and functional capacity

TUG

Assesses mobility, balance, walking ability, and fall risk in older adults.

Populations for TUG

MS, STROKE, Neuromuscular conditions, SCI, Mixed conditions, brain injury, arthritis, vestibular

Time to Administer for TUG

Less than 3 mins

Setting for TUG

Neuro rehab, SNF, acute care

Equipment for TUG

Standard armchair, stopwatch

Average time for older adults for TUG

8s

Cutoff for TUG

13.5s

Cutoff Scores for Stroke in TUG

<0.4 m/s household ambulators; 0.4-0.8 m/s limited community ambulators; >0.8 m/s community ambulators

Cutoff Scores for Healthy older adults in TUG

< 0.7 m/s is indicative of increased risk of adverse events (fall, hospitalization, need for caregiver, fracture, etc.)

TUG >12 seconds

Risk for falling (general older adult

TUG >30 seconds

Walking and balance problems, cannot walk outside alone, requires walking aid.

Tug interpretation

A longer time to complete the test indicates poorer functional mobility and increased fall risk.

Stair Climb

Patients with OA of hip or knee (pre/post surgery), individuals after TKA (Total Knee Arthroplasty), patients with advanced hip and knee OA awaiting TJA (Total Joint Arthroplasty).

Norm for Stair Climb

0.5s/stair

Two Minute Step Test

Assess an individual's aerobic capacity and evaluate their level of functional fitness.

Time to Administer for Two Minute Step Test

2 mins

Setting for Two Minute Step Test

All

Equipment for Two Minute Step Test

Stopwatch, tape measure, tape

Two minute step test cut off

<65

Performance Indicator for Two Minute Step Test

A higher number of steps indicates better aerobic endurance and functional capacity.

Romberg assesses

Assesses static standing balance and the proprioceptive/vestibular systems

Romberg Time

2 mins

Romberg setting

All, any setting with a firm flat surface

Romberg Norms

30 seconds

Romberg cutoff

person falls or reaches, opens eye

Romberg High risk

<5s

Romberg moderate risk

5-20s

Romberg low risk

>20s

Positive Romberg test

loss of balance that occurs when closing the eyes.

SLS Test purpose

assess static postural and balance control in

Setting for SLS test

Outpt, inpt, SNF

Norm for SLS test

30 s

Cutoff for SLS test

10s

SLS test populations

parkinsons, neurologic pts and older pts

65-74 sls test norm

10s

76+ sls test norm

5s

CTSIB purpose

a means to quantify postural control under various sensory conditions.

CTSIB Population

TBI, MS, Parkinsons ans movement diorders, stroke, vestibular disorders

CTSIB settings

Outpatient, inpatient, SNF, home

CTSIB timeframe

20 mins

CTSIB Norm

30 seconds with minimal sway is norm

CTSIB cutoff

2+ falls or 15s

<15s CTSIB

86% sensitivity (positive fall risk is score of greater) 88% specificity for no fall risk

<12S CTSIB

80% sensitivity and 90% specificity

Functional reach test reason

measuring the maximum distance an individual can reach forward while standing in a fixed position. Dynamic balance in limit of stability

FRT populations

older adults, Stroke, PD, SCI, Vestibular

FRT Timeframe

less than 5

FRT Setting

ALL

FRT MDC

3.7

unable to reach

28x more likely to fall

1-6 inches reach

4x more likely to fall

6-10 reach

2x more likely to fall

>10 reach

not likely to fall

FRT interpretation

Shorter reach distances indicate reduced limits of stability and increased fall risk

Berg Balance Scale purpose

assess static and dynamic balance and fall risk

Berg timeframe

15-20 mins

BBS settingss

Outpt, inpt, SNF

BBS cutoff

45

Score of 40 on the BERG

100% fall risk and did fall within 6 months

berg less than 51 with history of falls and <42 with no history of falls

91% sensitive, 82% specific

41-56 (Berg)

low fall risk

21-40 (Berg)

medium fall risk

0-20 (Berg)

high fall risk

Berg MDC older adults

8.5-10

berg 45-56 initial score mdc

3.3

berg 35-44 initial score mdc

4.9

berg 24-34 initial score mdc

6.3

berg 0-24 initial score mdc

4.6

Berg MCID

4

FGA assesses

postural stability during walking and assesses an individual's ability to perform multiple motor tasks while walking.

FGA populations

Stroke, neurologic, PD, Older adults, vestibular