Cara GeenwaldCara Greenwald, PT, tDPT, Clinical Coordinator for RehabCare at El Camino HCara Greenwald El Caminoospital Rehabilitation Center in Los Gatos, was published in the Archives of Physical Medicine and Rehabilitation recently for her work establishing the responsiveness of the FIST test in inpatient rehabilitation.

The Function in Sitting Test (FIST) is a 14-item test developed to provide an objective measure of sitting balance. The purpose of the study was to validate the FIST in adults undergoing inpatient rehabilitation, determine responsiveness to change of the FIST, compare change over course of inpatient rehabilitation to other measures of balance and function and calculate the minimal clinically important difference (MCID) of the FIST.

125 adults with documented sitting balance deficits participated in the study. During their inpatient rehabilitation stay, participants completed FIST, Berg Balance Scale (BBS), Functional Independence Measure (FIM) assessments both at admission and discharge.

The FIST showed excellent concurrent validity with the reference balance test, the Berg Balance Scale (BBS) and good concurrent validity with the activity based measure, Functional Independence Measure (FIM).

All outcome measures in the study showed statistically significant improvement over the course of inpatient rehabilitation, including the FIST. This finding supports the responsiveness of the FIST to capture change in patient’s sitting abilities during inpatient rehabilitation. No floor effect was found in the FIST, making it well suited to assess sitting balance for lower functioning patients.

The MCID for balance improvements on the FIST was determined to be change of greater than or equal to 7 points.

Access the complete study at no charge until February 7: http://www.archives-pmr.org/article/S0003-9993(14)00965-4/abstract

Cara has worked for ten years in inpatient, rehab, acute rehab and skilled nursing settings, with the majority of her time spent in acute rehab units. She earned her Doctorate of Physical Therapy from the joint University of California, San Francisco/San Francisco State University Physical Therapy program in 2010 and is actively involved in her local district of the California Physical Therapy Association.