Julie Chandler

Dworkin, Robert H.a,*; Turk, Dennis C.b; Farrar, John T.c; Haythornthwaite, Jennifer A.d; Jensen, Mark P.b; Katz, Nathaniel P.e; Kerns, Robert D.f; Stucki, Geroldg; Allen, Robert R.h; Bellamy, Nicholasi; Carr, Daniel B.j; Chandler, Juliek; Cowan, Penneyl; Dionne, Raymondm; Galer, Bradley S.n; Hertz, Sharono; Jadad, Alejandro R.p; Kramer, Lynn D.q; Manning, Donald C.r; Martin, Susans; McCormick, Cynthia G.t; McDermott, Michael P.u; McGrath, Patrickv; Quessy, Stevew; Rappaport, Bob A.o; Robbins, Wendyex; Robinson, James P.b; Rothman, Margarety; Royal, Mike A.z; Simon, Leeo; Stauffer, Joseph W.aa; Stein, Wendyab; Tollett, Janeac; Wernicke, Joachimad; Witter, Jameso Author Information

A new clinically accessible measure of balance, functional reach (FR), is the difference between arm's length and maximal forward reach, using a fixed base of support. The purposes of this study were to (a) establish FR as a measure of the margin of stability versus the laboratory measure, center of pressure excursion (COPE); (b) test reliability and precision, and (c) determine factors that influence FR, including age and anthropometrics. We evaluated FR in 128 volunteers (age 21-87 years). FR was determined with a precise electronic device and a simple clinical apparatus (yardstick). FR correlates with COPE (Pearson r = .71) and is precise (coefficient of variation = 2.5%) and stable (intraclass correlation coefficient across days = .81). Age and height influence FR. FR is portable, inexpensive, reliable, precise, and a reasonable clinical approximator of the margin of stability. FR may be useful for detecting balance impairment, change in balance performance over time, and in the design of modified environments for impaired older persons.

A new measure of balance, functional reach, has been recently developed. Functional reach is the maximal distance one can reach forward beyond arm's length while maintaining a fixed base of support in the standing position. Reliability, criterion, and concurrent construct validity of functional reach have been established. The purpose of this study was to assess the predictive validity of functional reach in identifying elderly subjects at risk for recurrent falls. Two hundred and seventeen elderly, community-dwelling male veterans (aged 70-104) underwent baseline screening and were followed for 6 months to monitor falls. Subjects with two or more falls during the 6-month follow-up were classified as recurrent fallers. Logistic regression reveals that if individuals were unable to reach, the adjusted odds ratio (OR) of having two falls was 8.07 (2.8-23.71); if their reach was less than or equal to 6 inches the OR was 4.02 (1.84-8.77); and if reach was greater than 6 inches but less than 10 inches the OR was 2.00 (1.35-2.98). The association between functional reach and recurrent falls was not confounded by age, depression, or cognition. We conclude that functional reach is a simple and easy-to-use clinical measure that has predictive validity in identifying recurrent falls.