Center for Smart Use of Technologies to Assess Real World Outcomes (C-STAR)
May 9–10
Live and Online
Offered by Academy, Shirley Ryan AbilityLab
The MDRT is an inexpensive screening tool to determine the limits of stability of individuals in 4 directions. It measures how far an individual can voluntarily reach, thereby shifting the COG to the limits of the BOS with the feet stationary.
4
Less than 5 minutes
Adult
18 - 64
yearsElderly Adult
65 +
yearsAlicia Esposito, PT, DPT, NCS & the PD EDGE Task Force of the Neurology Section of the APTA
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
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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 Parkinson Disease Hoehn and Yahr stage:
|
|
I |
II |
III |
IV |
V |
|
PD EDGE |
LS/UR |
LS/UR |
LS/UR |
LS/UR |
NR |
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) |
|
PD EDGE |
No |
No |
No |
Not reported |
Variations occur regarding mounting of yardstick, number of trials performed and whether practice trial is performed. Ensure consistency when performing serial measures.
Although there is more literature to support the Functional Reach Test, further exploration into the utility of the multidirectional reach test in necessary as individuals can fall in any direction and it does not appear that forward reach predicts reach distance in different directions.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Community Dwelling Elderly: (Newton, R, 2001; Mean age: 74.1 (7.9); Gender: Men 21.5%, Women 78.5%; Self-Reported Status: Excellent: 13.5%, Good: 53.6%, Fair: 27.8%, Poor: 5.2%; Race: African American 69.0%, Hispanic 17.1%, Caucasian 11.9%, Other 2.0%; Assistive Devices: Yes 69.6%, No 30.4%; Living Status: Alone 51.6%, With others 48.4%; Fear of Falling: Not Afraid 58.6%, Afraid (same activity level) 24.3%, Afraid (decreased activity level) 17.1%; Medications: None 19.3%, 1-4 70.5%, > 4 10.2%; Tripped/Fallen In Last 6 MO: No 78.6 %, Yes 21.4%)
(Newton, 2001)
Mean score in each direction of individuals who reported a trip or fall in the last 6 months
Community Dwelling Elderly
(Newton, R, 2001; Mean age: 74.1 (7.9); Gender: Men 21.5%, Women 78.5%; Self-Reported Status: Excellent: 13.5%, Good: 53.6%, Fair: 27.8%, Poor: 5.2%; Race: African American 69.0%, Hispanic 17.1%, Caucasian 11.9%, Other 2.0%; Assistive Devices: Yes 69.6%, No 30.4%; Living Status: Alone 51.6%, With others 48.4%; Fear of Falling: Not Afraid 58.6%, Afraid (same activity level) 24.3%, Afraid (decreased activity level) 17.1%; Medications: None 19.3%, 1-4 70.5%, > 4 10.2%; Tripped/Fallen In Last 6 MO: No 78.6 %, Yes 21.4%)
(Newton, 2001)
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|
Mean |
SD |
Min |
Max |
|
Forward Reach (in) |
8.89 |
3.4 |
0.5 |
16.8 |
|
Backward Reach (in) |
4.64 |
3.1 |
0.4 |
14.0 |
|
Right Reach (in) |
6.86 |
3.0 |
0.7 |
18.2 |
|
Left Reach (in) |
6.61 |
2.9 |
0.0 |
14.4 |
Inner City Older Adult Population
(Newton, 1997; n = 252; mean age = 74.3 years (7.7), range = 60-95 years; gender: men = 53, women = 199; race: African American = 176, Hispanic = 40, Caucasian = 30, Asian = 3, missing = 3; marital status: married = 54, not married/widowed = 198; living arrangement: alone = 130, living with others = 120; education (years completed): none or elementary = 45, middle school = 63, high school = 105, college = 31, vocational school = 5; occupation (prior to retirement): manual = 148, clerical/technical = 42, managerial/professional = 56; number of medications: none = 45, 1-3 = 141, 4 or more = 57; health status: excellent: 34, good=133, fair = 70, poor = 13; assistive device: no = 220; yes = 31; health conditions (top 4): vision corrected by glasses=137, arthritis=105, high blood pressure = 90, hearing loss = 44; tripped or fallen in the past 6 months: yes = 55, no = 195)
(Newton, 1997)
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|
N |
Mean |
SD |
Min |
Max |
|
Forward reach (in) |
250 |
8.9 |
3.3 |
0.8 |
16.7 |
|
Reach backward (in) |
204 |
4.6 |
3.0 |
0.5 |
13 |
|
Reach right (in) |
204 |
6.8 |
3.0 |
0.7 |
18.2 |
|
Reach left (in) |
204 |
6.6 |
2.8 |
0.4 |
14.4 |
Personal Care Home (PCH) Residents
(Holbein-Jenny, M, et al, 2005; typically PCHs offer 24-hour staff availability for assistance with ADLs where residents may live in an apartment type setting and generally, are more independent than institutionalized elderly such as those in skilled nursing facilities; n = 26; female = 21, male = 5; mean age = 85.3 (4.9) years, range = 74-92; inclusion criteria: at least 65 years old, capability of flexing and holding the shoulders at 90 degrees of flexion or abduction for the MDRS, ability to stand for each component of the test without the use of an assistive device; medications: 1 individual reported taking only 1 daily medication, 6 individuals reported taking 2 medications, 10 individuals reported taking 3 or 4 medications and 8 individuals reported taking 5 or more medications daily, 1 person declined to share the information; falls: 52% of participants reported that they did not fall in the past year, 24% fell once and 24% report of falling from 2 to 5 times in the past year; fear of falling: half of participants who reported that they did not fall in the past year also reported having a fear of falling, 42% of those who reported falling in the past year denied a fear of falling.
(Holbein-Jenny, M, et al, 2005)
|
|
Mean |
SD |
Range |
95% CI |
|
Forward reach (in) |
5.6 |
3.0 |
0-11.7 |
4.4-6.8 |
|
Backward reach (in) |
2.9 |
2.2 |
0-7.3 |
2.0-3.8 |
|
Right reach (in) |
3.3 |
2.5 |
0-10.5 |
2.3-4.2 |
|
Left reach (in) |
3.7 |
3.1 |
0-10.2 |
2.6-4.9 |
Community Dwelling Adults
(Steffen, TM, Mollinger, LA, 2005)
Personal Care Home (PCH) Residents
(Holbein-Jenny, M, et al, 2005)
Community Dwelling Elderly
(Newton, 2001)
Intrarater Reliability
Indicates a practice effect across the 2 trials for backward, right and left reach
Personal Care Home (PCH) Residents
(Holbein-Jenny, M, et al, 2005)
Interrater Reliability
Community Dwelling Elderly
(Newton, 2001)
Personal Care Home (PCH) Residents
(Holbein-Jenny, M, et al, 2005)
Community Dwelling Elderly
(Newton, 2001)
Personal Care Home (PCH) Residents
(Holbein-Jenny, M, et al, 2005)
Holbein-Jenny, M. A., Billek-Sawhney, B., et al. (2005). "Balance in personal care home residents: a comparison of the Berg Balance Scale, the Multi-Directional Reach Test, and the Activities-Specific Balance Confidence Scale." J Geriatr Phys Ther 28(2): 48-53. Find it on PubMed
Newton, R. A. (1997). "Balance screening of an inner city older adult population." Arch Phys Med Rehabil 78(6): 587-591. Find it on PubMed
Newton, R. A. (2001). "Validity of the multi-directional reach test: a practical measure for limits of stability in older adults." J Gerontol A Biol Sci Med Sci 56(4): M248-252. Find it on PubMed
Steffen, T. M. and Mollinger, L. A. (2005). "Age- and gender-related test performance in community-dwelling adults." J Neurol Phys Ther 29(4): 181-188. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.