Function in Sitting Test

Link to instrument: Training and documentation available from Samuel Merrit University's website

Acronym:

FIST

Purpose:

Bedside evaluation of sitting balance stated to evaluate sensory, motor, proactive, reactive and steady state balance factors.

Description:

• 14 items
• 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:
  • One trial of each item is allowed
  • Verbal directions and demonstration are given as needed by the therapist
  • 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
  • Hands are placed in lap unless needed for support
  • See Gorman et al, 2010 for measure

Area of Assessment: Balance Non-Vestibular

ICF Domain: Activity

Assessment Type: Performance Measure

Length of Test: 06 to 30 Minutes

Time to Administer:

Less than 15 minutes

Number of Items: 14

Equipment Required:

• Standard hospital bed (without air mattress)
• Stopwatch

Training Required:

Cost: Free

Actual Cost: Free

Diagnosis: Stroke, Traumatic Brain Injury

Populations Tested:

• Acute Stroke
• Population-based, inpatient sample of adults with sitting balance dysfunction, excluding persons with SCI, signigicant bracing/orthotics, and inability to perform testing safely

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

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):

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

• MDC=5.63

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

Cut-Off Scores:

Not Established

Normative Data:

Not Established

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

Internal Consistency:

Acute Stroke: (Gorman et al, 2010)

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

Criterion Validity (Predictive/Concurrent):

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

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

Construct Validity (Convergent/Discriminant):

Not Established

Content Validity:

Not Established

Face Validity:

Not Established

Floor/Ceiling Effects:

Not Established

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).

Considerations:

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

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.

Instrument in PDF Format: Yes

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