Tracking Progress

Introduction

In these guidelines, you will find several descriptions of assessments to measure functional capacity. The functional capacity supports you in coping with the activities of daily living and maintaining autonomy. These assessments allow you to measure personal progress. Progress can be measured in two ways. Firstly, you may maintain your current state and have no further decline, which would still be a great result after eight weeks of training. Secondly, you may improve in one or more assessments. You can also apply the assessments from time to time and follow the changes over a longer period of time.

We selected a range of assessments that can be done in a sitting position, and some assessments that require walking. We suggest to perform the assessments in sitting position with the care recipient once before you start the WHOLE training sessions and once after eight weeks of conducting the training:

• Modified Functional Reach Test (sitting)
• Back Scratch Test.

For those who are able to walk, we suggest to additionally perform the following tests:

• Functional Reach Tests (standing) (instead of the sitting Modified Functional Reach Test)
• Timed Get Up and Go
• 10 Metre Walking Test (optional for those that can walk a longer distance).

Please write the results into the Documentation Sheet for Test Results to follow up your progresses. You can find the Document Sheet for Test Results on the last page of the PDF-version of these guidelines. You can download the guidelines here.

The Modified Functional Reach Test (sitting)

The modified version of the Functional Reach Test requires the care recipient to sit in a fixed position.

Equipment Needed

• Yardstick
• Duct tape (to tape the yardstick to a solid wall)
• Chair (or wheelchair)

Set-Up

• The yardstick is fixed to the solid wall at the level of the care recipient’s shoulder

Test procedure
The modified version of the Functional Reach Test is performed as follows:

• Mount a levelled yardstick on the wall at the height of the care recipient’s shoulder level in the non-affected arm while sitting in a chair.
• Hips, knees and ankles are positioned at 90 degree angle, with feet positioned flat on the floor.
• Measure the initial reach while the care recipient is sitting against the back of the chair with the upper-extremity flexed to 90 degrees; measure from the distal end of the knuckle of the middle finger along the yardstick.
• Measure three conditions over three trials.
  • Sitting with the unaffected side near the wall and leaning forward.
  • Sitting with the back to the wall and leaning right.
  • Sitting with the back to the wall leaning left.
• Instructions should include leaning as far as possible in each direction without rotation, without moving from the chair and without touching the wall.
• Once the care recipient leans mark the position of the middle finger along the yardstick.
• Record the distance in centimetres covered in each direction.
• If the care recipient is unable to raise the affected arm, record the distance covered by the shoulder during leaning.
• The first trial in each direction is a practice trial and should not be included in the final result.
• Allow a 15 second rest break between trials.
• Please stand next to the care recipient to ensure support if a loss of balance occurs.

Functional Reach Test (standing)

This test assesses a care recipient's stability by measuring the maximum distance an individual can reach forward while standing in a fixed position.



Equipment Needed

• Yardstick
• Duct tape (to tape the yardstick to a solid wall)

Set-Up

• Look for a blank, solid wall.

Test procedure

• Please ask the care recipient to stand close to, but not touching, the wall and position the arm that is closer to the wall at a 90 degree angle with a closed fist.
• Record the starting position at the knuckle of the middle finger head on the yardstick.
• Instruct the care recipient to “Reach as far as you can forward without taking a step”.
• Record the location of the knuckle of the middle finger.
• The difference between the start and end position is the reach distance, usually measured in centimeter.
• The test allows for three total trials: one practice trial, followed by two "test" trials. The distances of the last two trials are averaged to obtain the care recipient’s score.
• Stand next to the care recipient to ensure support if a loss of balance occurs.

The Timed Get Up and Go

The “Timed Get Up and Go” is an instrument to test basic mobility skills, especially for frail elderly persons. It gives a professional overview of mobility, body balance, and the risk of falling.
Equipment Needed

• Standard height chair (seat height 46 cm, arm height 67 cm, arm rests are essential)
• 3 metre walkway
• Stopwatch or wrist watch with a second hand

Set-Up

• Measure and mark a 3 metre (9.8 feet) walkway.
• Place the armchair at the beginning of the walkway.
• Any assistive device used for walking should be nearby.
• Regular footwear and walking aids should be used.
• Instruct the care recipients to use a comfortable and safe walking speed.
• The motion sequence can be practised before the actual time measurement starts.
• The motion sequence can be demonstrated by the caregiver, if needed.

Test procedure

• The care recipient should sit on a standard armchair, placing his/her back against the chair and resting his/her arms on the arm rests.
• The Timed Get Up and Go requires the care recipient to stand up, walk 3 metres, turn around, walk back to the chair and sit down again.
• Assistive devices (walkers, crutches) can be used but should be kept consistent and documented from test-to-test.
• The carer starts the timing on the word “Go”.
• The carer stops the timing when the care recipient is seated again correctly in the chair.

The 10 Meter Walk Test

Equipment Needed

• 10 metre walkway
• Measuring tape
• Markers
• Stopwatch or wrist watch with a second hand

Set-Up

• Measure and mark a 10 metre walkway
• Add a marker at the 2 metre mark
• Add a marker at the 8 metre mark

Test procedure

• The care recipient walks without physical assistance for 10 metres (32.8 feet) and the time is measured for the intermediate 6 metres (19.7 feet) to allow for acceleration and deceleration.
  • Start timing when the toe of the leading foot crosses the 2 metre mark.
  • Stop timing when the toe of the leading foot crosses the 8 metre mark.
  • Assistive devices can be used but should be kept consistent and documented from test-to-test.
• Collect three trials and calculate the average of the three trials.

The Back Scratch Test

The Back Scratch Test measures how close the hands can be brought together behind the back.


Equipment Needed

• Yardstick or ruler

Set-Up

• This test can be performed in a standing or sitting position

Test procedure

• The care recipient places one of their hands over their shoulder and reaches as far as possible down the middle of their back, palm touching their back, fingers downward.
• Next, the care recipient reaches the other arm behind their back, palm facing outward, fingers upward, and reaches up as far as possible, attempting to touch or overlap the middle fingers of both hands.
• The Carer is required to direct the care recipient so that the fingers are aligned, and to measure the distance between the tips of the middle fingers.

Documentation Sheet for Test Results

Please click here to download the documentation sheet.