Document Type

Dissertation

Degree Name

Doctor of Physical Therapy (DPT)

Department

College of Health Care Sciences - Physical Therapy Department

First Advisor

Jennifer Canbek

Second Advisor

Shari Rone-Adams

Third Advisor

Steven B. Chesbro

Publication Date / Copyright Date

2018

Abstract

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center in Alabama. Inclusion criteria required: ability to stand for two minutes, walk independently with or without an assistive device for 20’, no restrictive neurological/orthopedic injury or vital signs. Participants were classified into height groups; short < 65”, medium 65” to 69”, or tall > 69” and as fall risk (1) or non-fall risk (0) based on health/fall history, Activities-Specific Balance Confidence Scale (ABC), Timed Up and Go (TUG), and handgrip strength; summative as fall risk composite score (FRCS). Distance using the FFRT for unilateral forward functional reach (UFFR) and bilateral forward functional reach (BFFR) was found then unilateral reach to height ratio (URHR) and bilateral reach to height ratio (BRHF) were calculated.

Research Analysis/Discussion: A Pearson Correlation showed UFFR, BFFR, URHR, and BRHR negatively correlated to FRCS (-0.51 to -0.54) however height correlated greater with UFFR (0.59) and BFFR (0.63) than URHR (0.42) and BRHR (0.47). An ANOVA between height group comparison showed statistical differences; UFFR (p=3.03x10-6), BFFR (p=7.8x10-7), URHR (p=0.00123), BRHR (p=0.00052); greater difference for BFFR than UFFR. A multilinear regression showed both BFFR and BRHR more influential to FRCS. Using a scatterplot between UFFR and BFFR, BFFR cut point values specific to height groups reduced false negatives by >60% in all height groups.

Conclusion: Height is a factor in FFRT. The extra calculation for reach to height ratio does not add improve fall risk identification. BFFR with cut points by height group, 10” for short, 11” for medium and 12” for tall, improves fall risk identification.

Disciplines

Health and Medical Administration | Medicine and Health Sciences | Physical Therapy | Rehabilitation and Therapy

Keywords

balance, falls, functional reach

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