Alternatif bir postüral kontrol testi: modifiye edilmiş fonksiyonel uzanmanın kararlılık sınırları ile korelasyonu

Year 2023, Volume: 10 Issue: 2, 122 - 131, 30.08.2023

Mustafa Karabulut , Emre Gürses , Songül Aksoy

https://doi.org/10.15437/jetr.992084

Abstract

Amaç: Fonksiyonel Uzanma Testi (FUT) ve modifiye edilmiş versiyonlarının (mFUT) Kararlılık Sınırları (KS) sonuçlarıyla korelasyonunu değerlendirmek ve postüral kontrol değerlendirmesinde kullanılacak en uygun test yöntemini belirlemekti.
Yöntem: Çalışmaya 46 katılımcı dahil edildi. Katılımcılar FUT ve mFUT'ları uyguladılar. Bunlar: Sert zemin dominant kol FUT (SDFUT), Sert zemin çift kol FUT (SÇFUT), yumuşak zemin dominant kol FUT (YDFUT), yumuşak zemin çift kol FUT (YÇFUT) ve sert zemin lateral FUT (sağ-sol). KS testi statik posturografi ile yapıldı. FUT ve mFUT'lerin KS parametreleri ile korelasyonu, ulaşma mesafesi ve hareket süresi parametreleri ile değerlendirildi.
Bulgular: SÇFUT ve KS-I (ileri yön) ulaşılan son nokta ile maksimum son nokta (sırasıyla p<0,001, r=0,690; p<0,001, r=0,649) arasında güçlü bir pozitif korelasyon bulundu. YDFUT'deki hareket süresi ile KS-I'deki hareket hızı arasında negatif orta düzeyde bir korelasyon elde edildi (p=0,011; r=-0,463).
Sonuç: SÇFUT’un postüral kontrol ölçümlerinde kullanılacak en uygun versiyon olduğunu ortaya koyduk. Ayrıca postüral kontrolde hareket süresini değerlendirmek için posturografinin uygulanamadığı durumlarda YDFUT kullanılabilir.

Keywords

Fonksiyonel uzanma, Postüral kontrol, Denge değerlendirmesi, Kararlılık sınırı

An alternative postural control test: Correlation of modified functional reach with limits of stability

Abstract

Purpose: To evaluate the correlation of Functional Reach Test (FRT) and its modified versions (mFRTs) with the outcomes of Limits of Stability (LoS), and to identify the most appropriate test method to use in postural control assessment.
Methods: Forty-six participants were included in the study. The participants performed FRT and mFRTs: firm ground dominant arm (FRT), firm ground both arms (FRTFB), soft ground dominant arm (FRTSD), soft ground both arms (FRTSB) and firm ground lateral FRTs. LoS was carried out with static posturography. The correlation of FRT and mFRTs with LoS parameters was evaluated as reaching distance and movement time.
Results: A strong positive correlation was found between FRTFB and LoS-I (forward direction) endpoint excursion and maximum excursion (p<0.001, r=0.690; p<0.001, r=0.637), respectively. A negative moderate correlation was obtained between the movement time in FRTSD and the movement velocity in LoS-I (p=0.011; r=-0.463).
Conclusion: We revealed that FRTFB is the most suitable version to be used in postural control measurements. Besides, to evaluate the movement time in postural control, FRTSD may be used when posturography is not applicable.

Keywords

Functional reach, Postural control, Balance assessment, Stability limit

References

• Juras G, Słomka K, Fredyk A, et al. Evaluation of the limits of stability (LOS) balance test. J Hum Kinet. 2008;19:39-52.
• Vervoort G, Nackaerts E, Mohammadi F, et al. Which aspects of postural control differentiate between patients with Parkinson’s disease with and without freezing of gait? Adv Neurol. 2013 Jun 27;2013.
• Duncan PW, Weiner DK, Chandler J, et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45:192-197.
• Maranesi E, Ghetti G, Rabini RA, et al. Functional reach test: movement strategies in diabetic subjects. Gait Posture. 2014;39:501-505.
• Outermans JC, van Peppen RP, Wittink H, et al. Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study. Clin Rehabil. 2010;24:979-987.
• de Waroquier-Leroy L, Bleuse S, Serafi R, et al. The Functional Reach Test: strategies, performance and the influence of age. Ann Phys Rehabil Med. 2014;57:452-464.
• Weiner DK, Bongiorni DR, Studenski SA, et al. Does functional reach improve with rehabilitation? Arch Phys Med Rehab. 1993;74:796-800.
• Duncan PW, Studenski S, Chandler J, et al. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol. 1992;47:93-98.
• Jonsson E, Henriksson M, Hirschfeld H. Does the functional reach test reflect stability limits in elderly people? J Rehabil Med. 2003;35:26-30.
• Arsh A, Darain H, Rahman MU, et al. Reliability of modified functional reach test in the assessment of balance function in people with spinal cord injury: a systematic review. Journal of the Pakistan Medical Association. 2021:1-12.
• Marchesi G, Ballardini G, Barone L, et al. Modified Functional Reach Test: Upper-Body Kinematics and Muscular Activity in Chronic Stroke Survivors. Sensors. 2022;22:230.
• Singh P, Hujon N. Normative data of Modified Functional Reach Test in younger and middle-aged North Eastern Indian population. Archives of Medicine and Health Sciences. 2013;1(2):109.
• Deshmukh AA. Normal values of functional reach and lateral reach tests in children with knee hypermobility. Pediatric Physical Therapy. 2014;26:230-6.
• Pradhan M, Sharma S. A Comparative Study between One Arm and Two Arm Functional Reach Test in Children with Balance Impairment. Ind J Phys Ocup Ther. 2015;9:177-182.
• Katz-Leurer M, Fisher I, Neeb M, et al. Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke. Disabil Rehabil. 2009;31:243-248.
• Takahashi T, Ishida K, Yamamoto H, et al. Modification of the functional reach test: analysis of lateral and anterior functional reach in community-dwelling older people. Arc Gerontol Geriat. 2006;42:167-173.
• Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573-577.
• Molina-Rueda F, Molero-Sánchez A, Carratalá-Tejada M, et al. Limits of stability in patients with vascular (due to diabetes) and nonvascular unilateral transtibial amputation: a cross-sectional study. Int J Rehabil Res. 2017;40:227-231.
• Clark S, Rose DJ, Fujimoto K. Generalizability of the limits of stability test in the evaluation of dynamic balance among older adults. Arch Phys Med Rehab. 1997;78:1078-1084.
• Woollacott MH, Shumway-Cook A. Concepts and methods for assessing postural instability. J Aging Phys Activ. 1996;4:214-233.
• Behrman AL, Light KE, Flynn SM, et al. Is the functional reach test useful for identifying falls risk among individuals with Parkinson's disease? Archives of physical medicine and rehabilitation. 2002;83:538-42.
• Uchiyama M, Demura S, Shin S. Is there a relationship between the functional reach test and flexibility. Adv Phys Educ. 2011;11:11-5.
• Nakamura, I., Okuda, M., Kage, H., et al. The relationship between a functional reach test and other balance tests. Rigakuryoho Kagaku. 2006;21:335-339. [In Japanese with English Abstract doi:10.1589/rika.21.335.
• Takakura, S., Ohgi, S. The relationship between the standing postural control test using the elderly balance board type N and gait performance. Rigakuryoho Kagaku, 2005;20:315-319. [In Japanese with English Abstract] doi:10.1589/rika.20.315.
• Thomas, J. I., & Lane, J. V. A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients. Archives of Physical Medicine and Rehabilitation. 2005;86: 1636-1640.
• Kage H, Okuda M, Nakamura I, et al. Comparison of the one-arm and two-arm functional reach test in young adults. J Phys Ther Sci. 2009;21:207-212.
• Wallmann HW. Comparison of elderly nonfallers and fallers on performance measures of functional reach, sensory organization, and limits of stability. J Gerontol A Biol Sci Med Sci. 2001;56:580-583.
• Wernick-Robinson M, Krebs DE, Giorgetti MM. Functional reach: does it really measure dynamic balance? Arch Phys Med Rehab. 1999;80:262-269.
• Horak FB, Wrisley DM, Frank J. The balance evaluation systems test (BESTest) to differentiate balance deficits. Phys Ther. 2009;89:484-498.