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RehabMeasures Instrument

Function in Sitting Test

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Purpose

The Function in Sitting Test (FIST) is a bedside evaluation of sitting balance that evaluates sensory, motor, proactive, reactive, and steady state balance factors.

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Instrument Details

Acronym FIST

Area of Assessment

Balance – Non-vestibular

Assessment Type

Performance Measure

Cost

Free

Diagnosis/Conditions

  • Brain Injury
  • Stroke Recovery

Key Descriptions

  • 14 items with an ordinal scale (0-4) for each test item:
    4) Independent, completes the task independently and successfully
    3) Needs Cues, completes the task independently and successfully; may need verbal / tactile cues or more time
    2) Upper extremity support, unable to complete task without using upper extremities for support or assistance
    1) Needs assistance, unable to complete task successfully without physical assistance
    0) Complete assistance, requires complete physical assistance to perform task successfully, is unable to complete task successfully with physical assistance, or dependent
  • Testing Instructions:
    1) One trial of each item is allowed
    2) Verbal directions and demonstration are given as needed by the therapist
    3) Standard position: Individual seated at edge of hospital bed with half of upper leg supported (neutral abd / adduction / rotation), hips and knees at 90 degrees, and feet flat in support
    4) Hands are placed in lap unless needed for support
  • See Gorman et al., 2010 for measure

Number of Items

14

Equipment Required

  • Standard hospital bed (without air mattress)
  • Stopwatch

Time to Administer

Less than 15 minutes

Required Training

No Training

Instrument Reviewers

Reviewed by Heidi Roth, DHS, PT, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 5/2012

ICF Domain

Activity

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

MS EDGE

UR

UR

UR

NR

UR

TBI EDGE

LS

LS

LS

LS

LS

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

NR

LS

LS

LS

 

 

Recommendations based on EDSS Classification:

 

EDSS 0.0 – 3.5

EDSS 4.0 – 5.5

EDSS 6.0 – 7.5

EDSS 8.0 – 9.5

MS EDGE

NR

NR

NR

UR

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

MS EDGE

No

No

No

Yes

TBI EDGE

No

No

No

Not reported

Considerations

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Stroke

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Standard Error of Measurement (SEM)

Acute Stroke:  (Gorman et al, 2010; n=31, age 61.5 (10.9) years, <=3 months post stroke, Modified Rankin Scale of moderate / moderately severe / severe)

  • SEM= 2.03

Minimal Detectable Change (MDC)

Acute Stroke: (Calculated from Gorman et al, 2010)

  • MDC=5.63

Internal Consistency

Acute Stroke: (Gorman et al, 2010)

  • Excellent internal consistency (Cronbach’s alpha = 0.98)

Vestibular Disorders

back to Populations

Standard Error of Measurement (SEM)

Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko and Greenwald, 2014, n=125, age=60.0 (16.6) years)

  • SEM= 1.40

 

Balance Participants: (Gorman, Rivera, and McCarthy, 2014) (n=6; Mean Age= 68.7)
***Medical diagnoses of the balance participants included Parkinson’s disease (n=1), multiple sclerosis (n=1), and cerebrovascular accident (n=5).

  • SEM= 3.58

Minimal Detectable Change (MDC)

Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko & Greenwald, 2014)

  • MDC=5.5

Minimally Clinically Important Difference (MCID)

Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko & Greenwald, 2014)

  • MCID> 6.5

Test/Retest Reliability

Balance Participants: (Gorman, Rivera, and McCarthy, 2014), n=6; mean age = 68.7
***Medical diagnoses of the balance participants included Parkinson’s disease (n=1), multiple sclerosis (n=1), and cerebrovascular accident (n=5).

  • Excellent: ICC=0.97

Interrater/Intrarater Reliability

Balance Participants: (Gorman, Rivera, and McCarthy, 2014), n=6; mean age = 68.7
***Medical diagnoses of the balance participants included Parkinson’s disease (n=1), multiple sclerosis (n=1), and cerebrovascular accident (n=5).

  • Intra-rater Reliability: Excellent ICC=0.99
  • Inter-rater Reliability: Excellent ICC=0.991

Criterion Validity (Predictive/Concurrent)

Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko & Greenwald, 2014)

Concurrent ValidityGood to Excellent concurrent validity with the Berg Balance Scale and Functional Independence Measure at both admission and discharge (Spearman ρ=.71–.85).

Responsiveness

Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko and Greenwald, 2014, n=125, age=60.0 (16.6) years)

Responsiveness: Strong as evidenced by the large effect size (.83), standardized response mean (1.04), and index of responsiveness (1.07).

Bibliography

Gorman, SL, Radtka, S, et al. "Development and validation of the function in sitting test in adults with acute stroke." Journal of Neurologic Physical Therapy 34(3)(2010): 150-160. Find it on PubMed

Gorman, SL, et al. "Examining the Function in Sitting Test for Validity, Responsiveness, and Minimal Clinically Important Difference in Inpatient Rehabilitation." Archives of Physical Medicine and Rehabilitation 95.12 (2014): 2304-11.

Gorman SL, Rivera M, McCarthy L. "Reliability of the Function in Sitting Test (FIST)." Rehabilitation research and practice. 2014; 2014:593280.

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