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. Author manuscript; available in PMC: 2011 Dec 1.
Published in final edited form as: J Rehabil Med. 2010 Apr;42(4):323–331. doi: 10.2340/16501977-0537
1. SIT TO STAND
Examiner Instructions: Note the initiation of the movement, and the use of hands on the arms of the chair or their thighs or thrusts arms forward. Patient: Cross arms across your chest. Try not to use your hands unless you must. Don’t let your legs lean against the back of the chair when you stand. Please stand up now.
2. RISE TO TOES
Examiner Instructions: Allow the patient to try it twice. Record the best score. (If you suspect that subject is using less than their full height, ask them to rise up while holding the examiners’ hands.) Make sure subjects look at a non-moving target 4-12 ft / 10-30 cm away. Patient: Place your feet shoulder width apart. Place your hands on your hips. Try to rise as high as you can onto your toes. I’ll count out loud to 3 seconds. Try to hold this pose for at least 3 seconds. Look straight ahead. Rise now.
3. STAND ON ONE LEG
Examiner Instructions: Allow the patient two attempts and record the best. Record the no. of seconds they can hold posture up to a maximum of 30 s. Stop timing when subject moves their hand off hips or puts a foot down. Make sure subjects look at a non-moving target 4-12 ft / 10-30 cm ahead. Patient: Look straight ahead. Keep your hands on your hips. Bend one leg behind you. Don’t touch your raised leg on your other leg. Stay standing on one leg as long as you can. Look straight ahead. Lift now.
Repeat other side.
4. STEPPING - FORWARD
Examiner Instructions: Stand in front to the side of patient with one hand on each shoulder and ask them to push forward. Make sure there is room for them to step forward. Require them to lean until their shoulders and hips are in front of their toes. Suddenly release your push when the subject is in place and providing constant pressure to a level just before the heels lift off. The test must elicit a step. NOTE: Be prepared to catch patient. Patient: Stand with your feet shoulder width apart, arms at your sides. Lean forward against my hands beyond your forward limits. When I let go, do whatever is necessary, including taking a step, to avoid a fall.
5. STEPPING - BACKWARD
Examiner Instructions: Stand in back to the side of the patient with one hand on each scapula and ask them to push backward. Make sure there is room for them to step backward. Require them to lean until their shoulders and hips are in back of their heels. Release your push when the subject is in place, and providing constant pressure to a level just before the heels lift off. Test must elicit a step. NOTE: Be prepared to catch patient. Patient: Stand with your feet shoulder width apart, arms down at your sides. Lean backward against my hands beyond your backward limits. When I let go, do whatever is necessary, including taking a step, to avoid a fall.
6. STEPPING - LATERAL
Examiner Instructions: Stand behind the patient, place one hand on either the right (or left) side of the pelvis, and get them to lean their whole body into your hand. Require them to lean until the midline of pelvis is over the right (or left) foot and then suddenly release your hold. NOTE: Be prepared to catch patient. Patient: Stand with your feet together, arms down at your sides
Lean into my hand beyond your sideways limit.
When I let go, step if you need to, to avoid a fall.
7. STANCE – EYES OPEN ; 8. STANCE ON FOAM – EYES CLOSED
Examiner Instructions: Do the tests in order. Record the time the patient was able to stand in each condition to a maximum of 30 s. Repeat condition if not able to stand for 30 s and record both trials (average for category). In # 8, use medium density Temper® foam, 4” / 10 cm thick. Assist subject in stepping onto foam. Have the subject step off the foam between trials. Include leaning or hip strategy during a trial as “instability” (31). Patient: For the next 2 assessments, you’ll either be standing on the normal ground (# 7) or on this foam (# 8), with your eyes open or closed. Place your hands on your hips. Place your feet together until almost touching. Look straight ahead. Each time, stay as stable as possible until I say stop.
9. INCLINE - EYES CLOSED
Examiner Instructions: Aid the patient onto the ramp. Once the patient closes their eyes, begin timing and record and average both times. Note if sway is greater than when standing on firm, level surface with eyes closed or if there is poor alignment to vertical. Assist includes a cane or light touch any time during the trial. Patient: I will be timing this next assessment. Please stand on the incline ramp with your toes toward the top. Place your feet shoulder width apart. Keep arms at your sides. Place your hand on your hips. I will start timing when you close your eyes.
10. Change in Speed
Examiner Instructions: Allow the patient to take 3-5 steps at their normal speed, and then say “fast”, after 3-5 fast steps once say “slow”. Allow 3-5 slow steps before they stop walking. Patient: Begin walking at your normal speed, when I tell you “fast” walk as fast as you can. When I say “slow”, walk very slowly.
11. Walk With Head Turns – Horizontal
Examiner Instructions: Allow the patient to reach their normal speed, and give the commands “right, left” every 3-5 steps. Score if you see a problem in either direction. If patient has severe cervical restrictions allow combined head and trunk movements (en bloc). Patient: Begin walking at your normal speed, when I say “right”, turn your head and look to the right. When I say “left” turn your head and look to the left. Try to keep yourself walking in a straight line.
12. Walk With Pivot Turns
Examiner Instructions: Demonstrate a pivot turn. Once the patient is walking at normal speed, say “turn and stop”. Count the steps from turn” until the subject is stable. Instability may be indicated by wide stance width, extra stepping or trunk motion. Patient: Begin walking at your normal speed. When I tell you to “turn and stop”, turn as quickly as you can to face the opposite direction and stop. After the turn, your feet should be close together.
13. Step over obstacle
Examiner Instructions: Place the 2 stacked boxes (9” / 23 cm height) 10 ft. / 30 cm away from where the patient will begin walking. Use a stopwatch to time gait duration to calculate average velocity by dividing the number of seconds into 20 ft / 60 cm. Patient: Begin walking at your normal speed. When you come to the shoe boxes (9” / 23 cm height), step over them, not around them and keep walking
14. Timed get Up & Go (TUG) with cognitive task
Examiner Instructions: First, time the patient performing the TUG without a cognitive task. Then, while sitting, ask the patient to count backward from a number between 80 and 100 by 3s, and keep track of how many numbers they can subtract within 10 s. Then, ask the patients to count backwards from a different number and after a few numbers say “go” for the TUG. Time the patient from when you say “go” until they return to sitting. Stop timing when the patient’s buttocks touch the chair bottom. The chair should be firm with arms to push from, if necessary. Patient: a) Practice counting out loud, backwards from a number between 80 and 100 by 3s while sitting in the chair. b) I will see how long it takes you to get up from the chair, walk past the tape on the floor and turn around to walk back to the chair and sit down. c) Now count backwards from a number between 80 and 100 by 3s and when I say “go,” stand up from the chair, walk at your normal speed across the tape on the floor, turn around, and come back to sit in the chair but continue backward counting.