Reliability and validity of the function in sitting test among non-ambulatory individuals with spinal cord injury

Abstract

Context: Trunk impairment among non-ambulatory individuals with spinal cord injury (SCI) reduces the ability to maintain a functional sitting position and perform activities of daily living. Measuring functional sitting balance is complex and difficult in a clinical setting. The function in sitting test (FIST) is a clinical measure that includes the assessment of all the components of sitting balance. The purpose of this study is to assess the reliability and validity of the 14-item FIST among non-ambulatory individuals with SCI. Participants: Twenty-six individuals with chronic SCI. Outcome measures: Participants were evaluated with the FIST, the modified Functional Reach Test (lateral and forward mFRT) and a posturography assessment (virtual time to contact -VTC). The FIST was re-assessed during a second study visit 12 weeks later. Test-retest reliability was evaluated using intraclass coefficient correlation (ICC), the minimal detectable change (MDC) was calculated and the internal consistency reliability was assessed using Cronbach's coefficient-α. Concurrent validity of the FIST was also tested with the mFRT and the VTC. Results: Test-retest reliability was found to be excellent (ICC = 0.95) with a MDC of 4. The internal consistency was satisfactory (0.81). Moreover, the FIST correlates with the lateral mFRT (r = 0.64, P = 0.001) but not with the forward mFRT and the VTC. Conclusion: These observations provide evidence that the FIST is a reliable clinical measure with partially established validity for non-ambulatory individuals with SCI. Further studies are needed to strengthen the validity of the FIST and explore this measure in a larger sample.

The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study

“…Clinical tests, particularly the FIST and TCT, have been reported as reliable measures of seated postural control in clinical populations (Quinzaños et al, 2014;Abou et al, 2019). The current results confirm the reliability of the FIST, Tee-shirt Test, Forward Reach, and Lateral Reach.…”

“…Although ML postural control has been implicated in impairment in standing balance (Sosnoff et al, 2011), we believe this is one of the first investigations to highlight this in seated postural control. Recent work also supports this observation by providing evidence that those with impaired seated postural control exhibit greater decrements in their lateral (ML) reach than forward (AP) reach (Abou et al, 2019). These collective findings indicate that smartphone technology may have the sensitivity to identify those with and without impaired seated postural control and that postural instability within wheelchair users may be rooted in mediolateral instability.…”

“…The first experimental session began by obtaining written informed consent and participant demographic information. At each session, participants completed three clinical tests that have been shown to provide a valid measure of seated posture control: the Function in Sitting Test (FIST) (Abou et al, 2019), Trunk Control Test (TCT) (Quinzaños et al, 2014), and Tee-shirt Test (Boswell-Ruys et al, 2009). An individual's maximum forward and lateral reach distances (cm) were recorded during the FIST and also used as a clinical outcome, as they are an indication of seated balance (Lynch et al, 1998;Boswell-Ruys et al, 2009;Kalron et al, 2016).…”

“…There are numerous ways to measure seated postural control. Researchers have developed several clinical measures including, but not limited to, the Function in Sitting Test (Gorman et al, 2010;Sung et al, 2016;Abou et al, 2019), Trunk Control Test (TCT) (Quinzaños et al, 2014), and the Tee-shirt Test (Boswell-Ruys et al, 2009) to assess seated postural control. These clinical measures have few technological requirements but require clinical expertise to perform.…”

Exploring Baseline Concussion-Assessment Performance in Adapted Wheelchair Sport Athletes

“…Gait and balance testing also poses a challenge in the adapted sports population, as no widely accepted, validated tool for sideline or clinical assessment of balance and postural stability in adapted and wheelchair-using athletes is available. [15][16][17] In 1 study, 18 a seated reach test was administered to measure trunk balance in wheelchair-using basketball players. However, a seated reach test may be more indicative of hamstrings and lumbopelvic flexibility than balance and postural stability.…”