Multi-Directional Reach Test Research Articles

Evaluating the Balancing Ability of Older Adults with Diabetes Mellitus Using the Multi-directional Reach Test.

The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity, disability, and bone fractures, especially hip fractures. This study aimed to investigate balancing ability using a multi-directional reach test (MDRT) in older adults with and without diabetes mellitus. 72 older adults with and without diabetes mellitus were recruited, and divided into two groups, including older adults without diabetes mellitus (n = 36) and older adults with diabetes mellitus (n = 36). All subjects completed all directions of the MDRT. There were no significant differences in MDRT scores in all directions between the two groups (p>0.05). Both groups achieved the highest MDRT scores in the forward direction. In contrast, the two groups had the lowest scores of MDRT in a backward direction. Furthermore, older adults with diabetes mellitus had lower MDRT scores in all directions than older adults without diabetes mellitus. The current study indicated that MDRT could be used to investigate the ability of balance in individuals with diabetes mellitus.

Balance Ability and Quality of Life in Older Adult with Recovery from Mild COVID-19.

In this study, we aimed to assess the ability to balance and quality of life (QoL) among older adults without a history of coronavirus disease 2019 (COVID-19 and those who had recovered from mild COVID-19. We recruited 80 older adults and categorized them into the following two groups based on their history of COVID-19: those without COVID-19 (n=40) and those who had recovered from mild COVID-19 (n=40). We assessed the participants' ability to balance using the multi-directional reach test (MDRT) and timed up and go (TUG) test, and evaluated their QoL using the short form-36 (SF-36). Compared with older adults without a history of COVID-19, those who had recovered from mild COVID-19 demonstrated no differences in the scores of the forward, backward, right, and left directions (p >0.05), but a significantly longer duration for the TUG test (p=0.02) and a reduced QoL. Our study results demonstrated decreased ability to balance and poor QoL among older adults who had recovered from mild COVID-19.

Balance Relationships Between the Multi-Directional Reach Test and Upper Body Dressing

Abstract Date Presented 04/01/2022 The Multi-Directional Reach Test’s (MDRT’s) limits of stability when reaching to the right (i.e., cm) statistically correlated with shirt dressing time (doff time rs = -.320, p = .023; total dressing time rs = -.340, p = .016). Center of pressure excursion during the MDRT and shirt dressing were very strongly correlated anteroposteriorly and mediolaterally (rs = .923-.991, p < .001). Time-based dressing tasks may be a robust indicator of balance for OT use but require further investigation. Primary Author and Speaker: Carol Getz Rice Additional Authors and Speakers: Kayla Michaels, Urvi Patel, Cassandra Stahl

Balance Assessment Using Multi-Directional Reach Test in Community-Dwelling Elderly People with Different Body Mass Index

Objective: To assess ability of balance in community-dwelling elderly people with different body mass index (BMI) using multi-directional reach test (MDRT) test. Materials and Methods: The cross-sectional study design was used to evaluate the effects of body mass index (BMI) on ability of balance using MDRT in community-dwelling elderly people. Results: Obese community-dwelling elderly people had the lowest scores in all directions of MDRT when compared with those of normal weight and overweight groups. Furthermore, in overweight group, the scores in all directions of MDRT were significantly reduced compared to those of normal weight group (p<0.05). Moreover, the scores of MDRT were negatively correlated with BMI (p<0.05). Conclusion: Obese and overweight community-dwelling elderly people had decreased ability of balance. Additionally, BMI was negatively correlated with the scores of MDRT in community-dwelling elderly people. Keywords: Body mass index; Multi-directional reach test; Falls; Elderly; Balance

The multi-directional reach test in children with Down syndrome.

Objective:This study investigated the limits of stability (LOS) and the movement patterns during reaching by applying the Multi-Directional Reach Test (MDRT) in children with Down syndrome (DS) aged 7–12 years old.Methods:Thirty children with DS and 30 age and gender typical development (TD) matched children, aged 7–12 years old were recruited. Each child was asked to reach as far as possible during standing in four directions using a self-selected movement pattern. The movement patterns were classified by two experienced pediatric physical therapists.Results:The reach distance in children with DS aged 7–9 years old was significantly shorter than TD children aged 7–9 years old for the forward and backward directions. Also, the reach distance in DS children aged 7–9 years old was significantly smaller than that of TD children aged 10–12 years old for all directions. For children with DS aged 10–12 years old, the reach distance was significantly less than that of TD children only in the backward direction. All children with DS in this study adopt a hip and mixed strategy during forward and backward reaching. In contrast, TD children adopt an adult-like movement pattern.Conclusion:The boundary of stability in an anteroposterior (AP) direction of children with DS aged 7–12 years old was lesser than the matched TD children, especially for the backward direction. These findings may assist therapists in detecting postural control and balance problems in children with DS.

Positive-word stimuli via a smartphone application have no immediate-term effects on multi-directional reach ability in standing position: a randomized controlled trial

Objectives The purpose of the study was to examine the immediate-term effect of positive-word stimuli via a smartphone application on the multi-directional reach ability in standing position in young adults. Methods This study was an immediate-term, assessor-blinded, two-arm, parallel-group, randomized controlled trial among young adults recruited from one university in Japan. Participants were randomly assigned to the experimental group or control group using a computer-based random number-generating programme. Participants of the experimental group used an application on iPhone and watched 3-min videos displaying positive-word stimuli. This application repeatedly displayed positive-word stimuli every 5 s. The participants of the control group used an application on iPhone and watched the same videos as in the experimental group. However, a positive-word stimulus did not appear in the videos. The primary outcome was the multi-directional reach test (MDRT) from baseline to immediately after the intervention protocol. Results Among the 62 randomized participants (experimental group, n = 31; control group, n = 31), 62 (100%) completed the MDRT immediately after the intervention protocol. There were no differences in mean group change values in MDRT between the experimental and control groups. Conclusions Among young adults, positive-word stimuli via a smartphone application did not significantly improve multi-directional reach ability in standing position. These findings do not support the superiority of this intervention among young adults. Trial Registration: Clinicaltrials.gov, NCT03546218. Registered 6 June 2018, https://clinicaltrials.gov/ct2/show/NCT03546218 KEY MESSAGES In our study, among young adults, positive-word stimuli via an SPSRS application did not significantly improve the multi-directional reach ability in the standing position. These findings do not support the superiority of this intervention among young adults.

Exploring the impact of a clinical dance therapy program on the mobility of adults with a neurological condition using a single-case experimental design

ABSTRACT Background This study built upon previous quasi-experimental design research studying the effectiveness of a 12-week dance therapy program for persons with a physical disability (DTPD) aiming to improve mobility. Methods We conducted a single-case experimental design (SCED), including pre- and post-interventions measures, with seven participants with repeated measures during pre-dance (A1), dance program (B) and post-dance phases (A2). Results Five participants completed the study and significantly (p < 0.05) improved their scores on the MiniBESTest; 2/5 and 4/5 improved scores for the 4 Square Step Test and the Multidirectional Reach Test–Behind, respectively, with very large effect size (ES). Aggregated ES (A1-A2) went from moderate to very large. Conclusions Results support the effectiveness of the DTPD program for adults with neurological conditions, and for the use of SCED to explore effectiveness of dance interventions for heterogeneous cohorts.

Effects of interactive video-game\u2013based exercise on balance in older adults with mild-to-moderate Parkinson\u2019s disease

BackgroundThis study aimed to evaluate the effectiveness of a customized interactive video game-based (IVGB) training on balance in older adults with mild-to-moderate Parkinson’s disease (PD).MethodsIn this 12-week crossover trial, PD patients ≥65 years of age were randomly divided into Group A (a 6-week intervention phase followed by a 6-week control phase) and Group B (a 6-week control phase followed by a 6-week intervention phase). Participants received IVGB exercise training during the intervention phase and no exercise during the control phase. Functional outcomes were measured using behavioral evaluation scales and questionnaires at baseline, week 6 and week 12.ResultsTwenty-four PD patients were included in this study, and were evenly divided into two groups. After Bonferroni adjustment, the changes in Modified Falls Efficacy Scale (MFES) and two subscales of Multi-Directional Reach Test were significantly different between two groups in the first 6-week period. In addition, the changes in Berg Balance Scale, MFES, and two subscales of Maximum Step Length were significantly different between two groups in the second 6-week period. Compared to controls, 6-week IVGB exercise intervention significantly improved different but overlapping functional outcomes in two groups of PD patients.ConclusionsThe customized IVGB exercise training improves balance, postural stability and confidence in preventing falls in older adults with mild-to-moderate PD. However, this IVGB exercise doesn’t have a significant impact on quality of life.Trial registrationClinicalTrials.gov. NCT03689764. Registered 27 September 2018, retrospectively registered.

Relationships between lower extremity strength and the multi-directional reach test in children aged 7 to 12 years.

Objective:This study investigates the relationships between the Multi-Directional Reach Test (MDRT) and lower extremity strength in typical children.Methods:The MDRT including forward, backward, leftward, and rightward directions was measured in 60 children aged between 7 and 12 years old with typical development. The lower extremity muscle groups were measured using a hand-held dynamometer.Results:The reaching score in each direction had positive relationships with the strengths of several lower extremity muscle groups to . Only the strengths of the hip flexor and knee flexor muscles significantly correlated with the MDRT scores in all directions to .Conclusion:This study highlights the strength of the hip and knee flexor muscle groups as being important domain to control balance in all directions. These findings may be used for therapists in planning a balance program to improve the limits of stability.

Trunk exercise training improves muscle size, strength, and function in older adults: A randomized controlled trial.

The aim of this study was to assess the effectiveness of a multimodal exercise program to increase trunk muscle morphology and strength in older individuals, and their associated changes in functional ability. Using a single-blinded parallel-group randomized controlled trial design, 64 older adults (≥60years) were randomly allocated to a 12-week exercise program comprising walking and balance exercises with or without trunk strengthening/motor control exercises; followed by a 6-week walking-only program (detraining; 32 per group). Trunk muscle morphology (ultrasound imaging), strength (isokinetic dynamometer), and functional ability and balance (6-Minute Walk Test; 30second Chair Stand Test; Sitting and Rising Test; Berg Balance Scale, Multi-Directional Reach Test; Timed Up and Go; Four Step Square Test) were the primary outcome measures. Sixty-four older adults (mean [SD]; age: 69.8 [7.5]years; 59.4% female) were randomized into two exercise groups. Trunk training relative to walking-balance training increased (mean difference [95% CI]) the size of the rectus abdominis (2.08 [1.29, 2.89]cm2 ), lumbar multifidus (L4/L5:0.39 [0.16, 0.61]cm; L5/S1:0.31 [0.07, 0.55]cm), and the lateral abdominal musculature (0.63 [0.40, 0.85]cm); and increased trunk flexion (29.8 [4.40, 55.31]N), extension (37.71 [15.17, 60.25]N), and lateral flexion (52.30 [36.57, 68.02]N) strength. Trunk training relative to walking-balance training improved 30-second Chair Stand Test (5.90 [3.39, 8.42] repetitions), Sitting and Rising Test (1.23 [0.24, 2.23] points), Forward Reach Test (4.20 [1.89, 6.51]cm), Backward Reach Test (2.42 [0.33, 4.52]cm), and Timed Up and Go Test (-0.76 [-1.40, -0.13]seconds). Detraining led to some declines but all outcomes remained significantly improved when compared to pre-training. These findings support the inclusion of trunk strengthening/motor control exercises as part of a multimodal exercise program for older adults.

The Effects of Therapeutic Horseback Riding on Balance

The purpose of this study was to determine the effects of therapeutic horseback riding (THR) as an interven-tion to improve the balance of 30 individuals who par-ticipated in a Professional Association of Therapeutic Horsemanship International (PATH INTL) therapeutic riding member program. The study lasted 10 weeks, with each participant receiving the intervention once a week for thirty minutes. The therapeutic riding program in-cluded several standard components in each session to challenge the balance of riders with disabilities. A quasi-experimental one-group pre-test-post-test design was used to examine the effects of THR for a single session, short-term 10-week period, and sustained effects after the program ended. The Multi-Directional Reach Test (MDRT; Newton, 2001) was used to quantify balance during the study. Paired t-tests were conducted to exam-ine a relationship between THR and balance outcomes. Recreational therapy applications and research implica-tions are also discussed. Subscribe to TRJ

Effects of Tai Chi, Fitness Boxing, and Video Activities on the Balance and Endurance of a Participant with Multiple Sclerosis: A Case Study

ABSTRACTVarious recreational activities have been identified as effective interventions to improve balance in individuals with compromised gait, balance, and a history of falls. This investigation explored the effectiveness of Tai chi, fitness boxing, and the Xbox Kinect on the balance of one participant with multiple sclerosis (MS). An 11-week program was implemented with each intervention scheduled for a 3-week duration. The participant’s balance was assessed prior to and at the conclusion of each intervention using the Multidirectional Reach test, Vestibular subtest of the Fullerton, and the Sensory Interaction in Balance test. The participant began each session with a warm up involving stretching and ended with a cool down of lap walking. The 2-min step test was used to measure progress toward improving endurance. Results suggest that the greatest improvement in balance occurred following the implementation of the both Tai chi and Xbox Kinect. Some improvement with endurance was additionally noted in the results of the 2-min step test. As a case study, this investigation cannot provide conclusive results that one intervention is preferred over another. However, our findings provide emerging evidence that balance can potentially be improved through the use of Tai chi, the Xbox Kinect, and fitness boxing.

Effects of Backpack Load and Load Height on Arm Reaching Ability in Several Directions

PURPOSE: The ability to reach with the arm has not been examined during load carriage with a backpack, or with the load distributed high or low in the backpack. METHODS: Arm reach was tested using the Functional Reach Test (Forward), Multi-directional Reach Test (Backward, Right, Left), Upward Reach Test (Upward) at a 50° angle, and Forward Reach to the Floor Test (Low). Subjects were healthy males (n=7) and females (n=2), 19-21 years, who wore a hiking backpack and performed using the dominant arm. Subjects were tested with no backpack, and then (in random order on different days) with the backpack empty, or load (weight) equivalent to 10, 30, and 50% of bodyweight in the bottom of the backpack. Trials were repeated with the load high in the backpack using a custom designed box. Three trials were completed for each reach. Mean values were analyzed with repeated measures ANOVA and Tukey’s post-hoc test with significance level p < 0.05. RESULTS: (Data are presented as reach in cm normalized for arm length, mean ± SD). When compared to no backpack, load high (30, 50% BW) in the backpack resulted in significant reductions in arm reach (all directions; Low = 140.5±13.8 vs 124.3±6.7, 115.5±7.7; Upward = 165.1±10.7 vs 159.9±9.3, 155.3±12.9; Left = 196.2±8.5 vs 181.6±7.3, 173.4±4.5; Right = 194.0±8.9 vs 181.7±8.0, 175.5±8.4; Backward = 180.2±9.1 vs 160.9±5.7, 153.5±7.9; Forward = 218.2±10.8 vs 208.9±8.1, 200.9±10.1) and load low (all loads) in the backpack resulted in significant reductions in arm reach for backward reach only (180.2±9.1 vs 176.8±8.1, 169.5±9.5, 164.5±1.3). When compared to empty backpack, load high (30, 50% BW) in the backpack resulted in significant reductions in arm reach (all directions; Low = 137.1±1.1 vs 124.3±6.7, 115.5±7.7; Up = 163.9±10.6 vs 159.9±9.3, 155.3±12.9; Left = 194.3±8.6 vs 181.6±7.3, 173.4±4.5; Right = 194.7±8.7 vs 181.7±8.0, 175.5±8.4; Backward = 177.9±7.4 vs 160.9±5.7, 153.5±7.9; Forward = 215.1±11.3 vs 208.9±8.1, 200.9±10.1) and load low (50% BW) in the backpack resulted in significant reductions in backward reach only (177.9±7.4 vs 164.5±1.3). CONCLUSIONS: Backpack load weight and height differentially affects arm reach. This project was funded in part by the Douglas A. & Phyllis G. Smith Student Faculty Collaborative Research Fund.

Multi-directional reach test in South Asian children: Normative reference scores from 5 year to 12 years old

Multi-directional reach test (MRT) emerged as a valid and reliable assessment tool for balance evaluation among elderly. The normative reference scores have been established in adults and elderly people, but they were not yet established for children. Hence, we aimed at establishing the normative reference scores of MRT among the school going children aged between 5 and 12 years. Children (N = 194; 124 males, 70 females) were recruited by the stratified random sampling for the normative study. MRT was performed by the custom made, multi-directional reach estimator. MRE device consists of three adjustable wooden frames with two metallic rulers each of 600 mm. Children were asked to reach maximum distance in forward reach (FR), backward reach (BR), right lateral reach (RLR) and left lateral reach (LLR) directions to obtain their maximum reaching ability. The mean of three readings were used to report the normative reference scores of MRT. Median age, height, weight and body mass index (BMI) were 8.5 years, 1240 mm, 27 kg and 17.24 kg/m2 respectively. The normative reference scores [median (95% confidence Interval, CI)] of MRT among the children aged 5–12 years old were FR [169.7 mm (CI, 166.1–183.3 mm)], BR [77.7 mm (CI, 78.0–85.5 mm)], RLR [122.0 mm (119.6–130.9 mm)] and LLR [107.0 (105.8–119.3 mm)] respectively.

Experimental Validation of Depth Cameras for the Parameterization of Functional Balance of Patients in Clinical Tests.

In clinical practice, patients’ balance can be assessed using standard scales. Two of the most validated clinical tests for measuring balance are the Timed Up and Go (TUG) test and the MultiDirectional Reach Test (MDRT). Nowadays, inertial sensors (IS) are employed for kinematic analysis of functional tests in the clinical setting, and have become an alternative to expensive, 3D optical motion capture systems. In daily clinical practice, however, IS-based setups are yet cumbersome and inconvenient to apply. Current depth cameras have the potential for such application, presenting many advantages as, for instance, being portable, low-cost and minimally-invasive. This paper aims at experimentally validating to what extent this technology can substitute IS for the parameterization and kinematic analysis of the TUG and the MDRT tests. Twenty healthy young adults were recruited as participants to perform five different balance tests while kinematic data from their movements were measured by both a depth camera and an inertial sensor placed on their trunk. The reliability of the camera’s measurements is examined through the Interclass Correlation Coefficient (ICC), whilst the Pearson Correlation Coefficient (r) is computed to evaluate the correlation between both sensor’s measurements, revealing excellent reliability and strong correlations in most cases.

A comparative study on the effects of Tai Chi and Matter of Balance on measures of balance and fall efficacy in older adults

The purpose of this study was to compare two intervention strategies, Tai Chi (TC) (n = 12) and Matter of Balance (MOB) (n = 13) on balance and fall efficacy of older adults (≥65 years) as compared to a control group (n = 12). The study compared changes in balance and fall efficacy of the two strategies in an effort to evaluate fall reduction programs for future application. Participants were assessed via a pretest to post-test, 8-10 weeks apart using two balance tests: 8-Foot Up and Go test and the Multi-Directional Reach Test. Fall efficacy was measured with the Activities-specific Balance Confidence (ABC) Scale. Results from this study indicate that the TC group and MOB group were both effective in improving or maintaining balance and fall efficacy as compared to the control group. Results demonstrated trending toward TC as having a greater impact on participants’ overall balance measures.

Feasibility and Impact of an 8-Week Integrative Yoga Program in People with Moderate Multiple Sclerosis-Related Disability: A Pilot Study.

This pilot study determined the feasibility of a specifically designed 8-week yoga program for people with moderate multiple sclerosis (MS)-related disability. We explored the program's effect on quality of life (QOL) and physical and mental performance. We used a single-group design with repeated measurements at baseline, postintervention, and 8-week follow-up. Feasibility was examined through cost, recruitment, retention, attendance, and safety. Outcomes included the Multiple Sclerosis Quality of Life Inventory (MSQLI), 12-item Multiple Sclerosis Walking Scale (MSWS-12), Timed 25-Foot Walk test (T25FW), 6-Minute Walk Test (6MWT), Nine-Hole Peg Test (NHPT), Five-Times Sit-to-Stand Test (FTSTS), Multidirectional Reach Test (MDRT), maximum expiratory pressure, and Paced Auditory Serial Addition Test-3″ (PASAT-3″). Fourteen participants completed the study. The program was feasible. There were significant main effects on the 36-item Short Form Health Status Survey Mental Component Summary (SF-36 MCS), Modified Fatigue Impact Scale (MFIS), Bladder Control Scale (BLCS), Perceived Deficits Questionnaire (PDQ), Mental Health Inventory (MHI), MSWS-12, T25FW, NHPT, PASAT-3″, 6MWT, FTSTS, and MDRT-Back. Improvements were found on the SF-36 MCS, MFIS, BLCS, PDQ, MHI, and MSWS-12 between baseline and postintervention. The effect on PDQ persisted at follow-up. Improvements were found on the T25FW, NHPT, 6MWT, FTSTS, and MDRT-Back between baseline and postintervention that persisted at follow-up. The PASAT-3″ did not change between baseline and postintervention but did between postintervention and follow-up. The yoga program was safe and feasible. Improvements in certain measures of QOL and performance were seen at postintervention and follow-up.

Relevance of nerve conduction velocity in the assessment of balance performance in older adults with diabetes mellitus

Purpose This study investigated the relationship between peripheral nerve conduction velocity (NCV) and balance performance in older adults with diabetes. Methods Twenty older adults with diabetes were recruited to evaluate the NCV of their lower limbs and balance performance. The balance assessments comprised the timed up and go (TUG) test, Berg balance scale (BBS), unipedal stance test (UST), multidirectional reach test (MDRT), maximum step length (MSL) test and quiet standing with eyes open and closed. The relationship between NCV and balance performance was evaluated by Pearson’s correlation coefficients, and the balance performances of the diabetic patients with and without peripheral neuropathy were compared by using Mann–Whitney U tests. Results The NCV in the lower limbs exhibited a moderate to strong correlation with most of the balance tests including the TUG (r = −0.435 to −0.520, p < 0.05), BBS (r = 0.406–0.554, p < 0.05), UST (r = 0.409–0.647, p < 0.05) and MSL (r = 0.399–0.585, P < 0.05). In addition, patients with diabetic peripheral neuropathy had a poorer TUG (p < 0.05), BBS (p < 0.01), UST (p < 0.05) and MSL performance (p < 0.05) compared with those without peripheral neuropathy (p < 0.05). Conclusion Our findings revealed that a decline in peripheral nerve conduction in the lower limb is not only an indication of nerve dysfunction, but may also be related to the impairment of balance performance in patients with diabetes.Implications for RehabilitationNerve conduction velocity in the lower limbs of diabetic older adults showed moderate to strong correlations with most of the results of balance tests, which are commonly used in clinics.Decline in nerve conduction velocity of the lower limbs may be related to the impairment of balance control in patients with diabetes.Diabetic older adults with peripheral neuropathy exhibited greater postural instability than those without peripheral neuropathy.

Maximal lateral reaching distance on the affected side using the multi-directional reach test in persons with stroke.

[Purpose] This study aimed to examine the relationship between maximal lateral reaching distance on the affected side and weight shifting using the Multi-directional Reach Test in persons with stoke. [Subjects] Fifty-one chronic stroke participants were recruited from two rehabilitation hospitals. This study administered the Berg Balance Scale, Timed Up-and-Go, Trunk Impairment Scale, Modified Barthel Index and measured different maximal reaching distances. [Results] The maximal lateral reaching distance on the affected side was correlated with the BBS (r=0.571), TUG (r=−0.478), TIS (r=0.561), and MBI scores (r=0.499), the lateral reaching distance in all directions on the non-affected side (r=0.785), the maximal backward reaching distance (r=0.723), and the maximal forward reaching distance (r=0.673). The maximal reaching distance on the affected side was also affected by that on the non-affected side, in addition to the maximal backward reaching distance and MBI score. The final step model of stepwise multiple regression was explained 69.5%. [Conclusion] Maximal lateral reaching distance on the affected side as determined by the Multi-directional Reach Test is a good method of assessing functional performance in stroke patients. Data regarding maximal reaching distance on the non-affected side can be used to measure functional impairment on the affected side in clinical settings.

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