Functional Reach Test

With increasing age, many older adults experience postural instability, which is a major public health concern. Assessing gait and balance is therefore a crucial part of clinical evaluations in geriatrics. The Functional Reach Test (FRT), developed in 1990 by Pamela Duncan and colleagues, was designed to predict falls in older adults¹.

FRT is simple, quick to perform, and measures functional balance by testing a person’s ability to move their center of mass forward without changing foot position. The test provides insight into the individual’s “margin of stability” – how far the body can move before losing balance².

Target Population and Clinical Relevance

The FRT is primarily designed for older adults and people with frailty or functional decline⁴. It forms part of the Balance Outcome Measure for Elder Rehabilitation (BOOMER), alongside the Step Test, Timed Up and Go (TUG), and Timed Static Stance test.

Clinical uses include:

• Fall risk screening

• Monitoring response to balance interventions

• Rehabilitation programs for frail or mobility-impaired patients⁵

Test Procedure

Equipment needed:

• Yardstick or measuring tape fixed at shoulder height

Patient position:

• Standing upright, side to a wall

• Shoulder abducted to 90° with a closed fist

Steps:

1. Record starting position at the 3rd metacarpal.

2. Instruct the patient to reach forward as far as possible without stepping or losing balance.

3. Record end position.

4. Measure the difference in centimeters or inches.

5. Perform three trials; record the average of the last two⁶.

Safety criteria for test termination:

• Lifting feet from the floor

• Loss of balance or fall

• Inability to complete safely

The therapist should always stand in front to provide safety support.

Interpretation and Cut-off Values

Fall risk thresholds:

• ≥ 25 cm (≈10”): Low risk

• 15–25 cm (6–10”): Moderate risk (2x higher fall risk)

• ≤ 15 cm (≤6”): High risk (4x higher fall risk)

• Unable to reach: Very high risk (8x higher fall risk)⁷

Normative values (by age and sex):

Age (years)	Men (cm)	Women (cm)
20–40	42.5	37.2
41–69	38.0	35.1
70–87	33.4	26.6

Reliability and Validity

• Test-retest reliability: r = 0.89

• Inter-rater reliability: r = 0.98

• Intra-class correlations (related tests): 0.93–0.99⁹

Predictive validity:

• Sensitivity: 76%

• Specificity: 34%

• Accuracy: 46% in predicting falls¹⁰

Clinical interpretation should also consider spinal flexibility, limb length, and movement strategies¹¹.

Limitations

• Only measures forward balance – does not assess lateral or backward stability

• Results influenced by height, arm length, spinal mobility

• Should not be used as a standalone fall risk tool¹²

Responsiveness to Interventions

FRT has shown responsiveness to rehabilitation:

• In one study, reach distance improved from 18 cm to 28 cm after 10 weeks of water-based exercise in older adults with knee osteoarthritis¹³.This demonstrates its usefulness as an outcome measure in physiotherapy.

Summary

The Functional Reach Test is a practical and evidence-based tool for assessing balance and fall risk in older adults. It is easy to perform, requires minimal equipment, and provides valuable clinical insights. However, it should always be interpreted in combination with other balance tests and clinical observations for comprehensive fall risk evaluation.

Sources:

1. de Waroquier-Leroy L, Bleuse S, Serafi R, Watelain E, Pardessus V, Tiffreau AV, Thevenon A. The Functional Reach Test: strategies, performance and the influence of age. Annals of Physical and Rehabilitation Medicine. 2014 Aug 1;57(6–7):452–464.

2. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional Reach: A New Clinical Measure of Balance. Journal of Gerontology. 1990 Nov 1;45(6):M192–197.

3. Weiner DK, Duncan PW, Chandler J, Studenski SA. Functional Reach: A Marker of Physical Frailty. Journal of the American Geriatrics Society. 1992 Mar;40(3):203–207.

4. Billek-Sawhney B, Gay J. The Functional Reach Test. Topics in Geriatric Rehabilitation. 2005 Apr;21(2):144–148.

5. Ivan Miguel Pires, Garcia NM, Eftim Zdravevski. Measurement of Results of Functional Reach Test with Sensors: A Systematic Review. Electronics. 2020 Jun 30;9(7):1078. Hentet fra: https://www.mdpi.com/2079-9292/9/7/1078. Sist brukt: 05.07.2025

6. Colin Hoobler. Functional Reach Test. Hentet fra: https://www.youtube.com/watch?v=yrV7MEGVBxU. Sist brukt: 05.07.2025

7. Rosa MV, Perracini MR, Ricci NA. Usefulness, assessment and normative data of the Functional Reach Test in older adults: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics. 2019 Mar;81:149–170.

8. Schenkman M, Morey M, Kuchibhatla M. Spinal Flexibility and Balance Control Among Community-Dwelling Adults With and Without Parkinson’s Disease. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2000 Aug 1;55(8):M441–445.

9. Eagle DJ, Salama S, Whitman D, Evans LA, Ho E, Olde J. Comparison of Three Instruments in Predicting Accidental Falls in Selected Inpatients in a General Teaching Hospital. Journal of Gerontological Nursing. 1999 Jul;25(7):40–45.

10. Wernick-Robinson M, Krebs DE, Giorgetti MM. Functional Reach: Does it really measure dynamic balance? Archives of Physical Medicine and Rehabilitation. 1999 Mar;80(3):262–269.

11. Wallmann HW. Comparison of Elderly Nonfallers and Fallers on Performance Measures of Functional Reach, Sensory Organization, and Limits of Stability. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001 Sep 1;56(9):M580–M583.

12. Jonsson E, Henriksson M, Hirschfeld H. Does the Functional Reach Test Reflect Stability Limits in Elderly People? Journal of Rehabilitation Medicine. 2003 Jan 1;35(1):26–30.

13. Lau MC, Lam JK, Siu E, Fung CS, Li KT, Lam MW. Physiotherapist-designed aquatic exercise programme for community-dwelling elders with osteoarthritis of the knee: a Hong Kong pilot study. Hong Kong Medical Journal. 2013 Sep 11.