Advances in Physical Education 11
2011. Vol.1, No.2, 11-15
Copyright © 2011 SciRes. DOI:10.4236/ape.2011.12003
Is There a Relationship between the Functional Reach Test and
Masanobu Uchiyama1, Shinichi Demura2, Sohee Shin3
1Research and Education Center for Comprehensive Science, Akita Prefectural University, Akita, Japan;
2Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, Japan;
3Center for Innovation Venture Business Laboratory, Kanazawa University, Kanazawa, Japan.
Received August 28th, 2011; revised September 30th, 2011; accepted October 10th, 2011.
This study examined the influence of short-term stretching and improved flexibility on functional reach (FR)
performances (reach distance and rotation angle of various joints during reaching). 17 healthy male university
students were assigned to either experimental and control groups based on the random assignment. A
pre-test/post-test design was used in this study. The variable factor for the experimental group was stretching
(jogging for warming up and stretching). Main outcome measures were flexibility (static maximum range of mo-
tion of shoulder, hip, and ankle joints) and FR of participants. FR test performances were assessed by the reach
distance and rotation angles of each joint during reaching. No significant differences between the groups were
found in the participants’ characteristics, and no skeletal muscle fatigue was found in the lower limb. In the ex-
perimental group, shoulder and hip-joint flexibility increased significantly by stretching, and showed higher
values than that of the control group. In contrast, FR test performance did not reveal any changes. Slight intrain-
dividual ROM improvements by short-term stretching may be less important for FR postural strategies. FR test
performances are little influenced by light static stretching in young healthy adults.
Keywords: Evaluation, Postural Balance, Flexibility, Reach
Humans maintain an upright stance by combining vestibular,
visual and somatosensory information (Fransson, Kristinsdottri,
Hafstrom, Magnusson, & Johansson, 2004; Vuillerme, Pinsault,
& Vaillant, 2005). These various functions contribute to bal-
ancing ability, which can be assessed by the functional reach
test (FRT) (Duncan, Weiner, Chandle, & Studenski, 1990) and
single-limb stance test (Zumbrunn, Macwilliams, & Johnson,
2011), among others. The FRT was developed essentially to
minimize fall risk for the elderly. However, it is now being
used for all age groups.
The functional reach test (FRT) (Duncan et al., 1990) is a
simple test for balance assessment in which the maximal for-
ward reach distance is measured. FRT scores are useful for
screening fall risk of the elderly with a cutoff point subtracted
15 cm from a standard value as well as for balance assessment
(Duncan et al., 1990). It was reported that the FRT has good
intra-rater and inter-rater reliabilities and correlates with gait
velocity, tandem gait, and single-limb stance (Whitney, Poole,
& Cass, 1998).
On the other hand, Nakamura et al. (2006) referred to many
previous studies that question the validity of the FRT as a per-
formance balance measure (Fujisawa, Takeda, Maeda, & Ha-
yakawa, 2005; Takakura & Ohgi, 2005; Thomas & Lane, 2005;
Tsushima, Tsushima, Ishida, Hasegawa, & Ohkura, 2001; Wer-
nick-Robinson, Krebs, & Giogetti, 1999). Wernick-Robinson et
al. (1999) reported that there was no difference in the FRT
scores between the healthy elderly and the elderly with balance
disorders. Similarly, Yamada and Ichihashi (2010) reported no
significant score differences for both groups. Fujisawa et al.
(2005) also reported that the FRT showed no significant corre-
lations with the Timed “Up & Go”, the 10 m walk in the elderly
and the single-limb stance with closed eyes, and the body sway
path length in young adults.
Recently, many studies have suggested correlations between
the FRT and flexibility, or the range of joint motion (Nakamura
et al., 2006; Takakura & Ohgi, 2005). For example, Thomas
and Lane (2005) reported that the FRT reflects the flexibility of
the trunk rather than movement of the center of mass (COM);
therefore, it cannot be used as a real balance measure. However,
the relationship between the FR test performance and flexibility
has been little clarified. Examining this relationship may be
important for understanding the validity of the FR test as a
In this study, we hypothesized that the FR test score would
improve with short-term stretching and increased joint flexibil-
Seventeen healthy university students of age (21.9 ± 1.2)
years, height (172.8 ± 5.2) cm and body mass (68.6 ± 6.6) kg
participated in this study, values are mean ±SD. Their physical
characteristics were almost the same as the age-matched na-
tional standard value (Laboratory of Physical Education Tokyo
Metropolitan University, 2000). Participants were assigned to
experimental (n = 7; age = (21.9 ± 1.5) yrs; height =(171.7 ±
6.5) cm; body mass = (69.7 ± 8.1) kg) and control (n = 10; age
= (22.0 ± 1.2) yrs; height =(172.7 ± 4.7) cm; body mass = (67.8
± 6.1) kg) groups based on the random assignment. Prior to the
measurements, the purpose and procedures of this study were
explained in detail to all participants and written informed con-
sent was obtained. This experimental protocol was approved by
M. UCHIYAMA ET AL.
the ethics committee (Kanazawa University Health and Science
This study used the classic controlled experimental design,
i.e. randomized pre-test/post-test design. Namely, the partici-
pants were randomly assigned to two groups or an experimental
group which is subjected to a variable factor (in this case,
stretching) and a control group which is not subjected to the
factor. The variable consisted of stretching exercises used to
improve flexibility (jogging and static stretch). It has been re-
ported that an active and static stretch increases the flexibility
of muscle fibers and tendons (Safran, Garrett, Seaber, Glisson,
& Ribbeck, 1988).
All participants were instructed not to sleep, exercise intently,
or eat for 2 hours before this experiment. First, the participants
sat quietly on a chair for 10 min. The room temperature was
kept at 23 degrees C. An experienced tester measured physical
characteristics (height and body mass) and resting heart rate
(HR) of each participant in both groups. Then base line meas-
urements of muscle strength, flexibility (ROM of shoulder, hip
and ankle joints), and FR test were conducted. Following these
initial measurements, the intervention was carried out only for
the experimental group. Lastly, muscle strength, flexibility, and
FR test results were measured for both groups, again.
The stretching consisted of the following; first, jogging for
15 min at 60% HR reserve was done followed by an active
static stretch for neck, shoulder, hip and ankle joints for 5 min
(30 sec per each joint). The heart rate during the warm-up jog-
ging was monitored by an electrocardiographic monitor (Aero
Cardinar, Minato Ikagaku, Japan). A tester indicated the pace of
jogging to make each participant keep a certain heart rate.
In the FRT, the maximum forward reaching distance of par-
ticipants was measured during standing on both feet and while
fixing their base of support (Duncan et al., 1990). Prior to the
FRT, participants stood in a comfortable position in parallel
with a rope stretched at their shoulder height on their sagittal
plane. They then flexed their shoulder 90 degrees by extending
their arm and closing their fist. A tester marked the front edge
position of each participant’s third metacarpal bone on the
above-stated stretched rope. Next, participants reached forward
as far as they possibly could without losing their balance. A
tester recorded the distance between the first marked position of
their third metacarpal bone and the position of the bone when
participants reached maximally. The participants were in-
structed to reach with their dominant arm. All participants were
The maximum active flexion and extension angles of the
shoulder, hip and ankle joints without any assistance were
measured using a regular goniometer (Yagami, Japan). Flexi-
bility measurements were conducted by a well practiced tester.
Measurements were conducted twice for each joint after one
practice trial, and the average of the two trials was used for
Strength of Plantar Flexion
In the FR test, ankle and hip postural strategies were used in
conjunction with a body trunk rotation. Plantar flexors of the
lower limbs are involved in the ankle strategy. To confirm that
there was no plantar flexor muscle fatigue (a decrease in muscle
strength) from intervening stimuli, maximum plantar flexion
1. Protocol for the experimental group
Rest Pre-testStretching Post-test
(for 10 min
(for 30 min)(for 20 min)(for 30 min)
2. Protocol for the control group
(for 10 min
(for 30 min)(for 20 min)(for 30 min)
(Jogging at 60% Hrreserve
and Stretchingof neck,
shoulder, hip and ankle
Measurement items in each experimental phase.
・Resting heart rate
Pre-test phase ・Flexibility measures (ankle, hip, shoulder joint angles)
・Maximal plantarflexion strength
Post-test phase ・Flexibility measures (ankle, hip, shoulder joint angles)
・Maximal plantarflexion strength
M. UCHIYAMA ET AL. 13
muscle strength was measured before (pre-test) and after
(post-test) the intervention, using a handheld dynamometer
(μ-Tas, ANIMA, Japan). The participants were instructed to sit
down on the floor of the experimental room with extended
legs,and to keep the ankle joints at 90 degrees. Then, with
maximal effort, they used the hallux (big toe) joint of their
dominant foot to push the small force-plate of a handheld dy-
namometer, which was affixed to a wall at the height corre-
sponding to their hallus joint.
Motion Analysis System
The rotation angles of several of the participants’ joints dur-
ing the FRT was recorded and analyzed by a motion analysis
system (MA-200X, ANIMA, Japan). This system can record
each participant’s reaching motion from either side and from
diagonally forward or backward using a six video camera setup.
A tester attached 16 infrared-light emitting markers on the
participant’s anatomical landmarks and recorded a dynamic
image of their reaching motion with a sampling frequency of 60
Hz. The markers were placed bilaterally over the acrominon,
cubitus, carpus, iliac crest, great trochanter, knee joint, ankle
joint and metatarsal bone. The six cameras were set at 3m for-
ward and 3 m backward diagonally, 0 m (right and left), with 6
m apart from the participant’s sagittal plane.
A handheld dynamometer μ-Tas (ANIMA, Japan) was used
to measure a maximum plantarflexion strength before and after
a warm-up and stretching intervention. The μ-Tas consists of a
sensor and a display. A small force plate was used as a sensor.
Its pressure receiver and sensor are united together, thus it can
measure with high accuracy.
Maximum flexion and extension angles and static maximum
range of motion, i.e. sum of the flexion and extension angles, of
the shoulder, hip, and ankle joints were calculated as flexibility
To assess the reaching motion in a FRT, the difference be-
tween the joint angle at maximum reaching posture and the
angle at preparation posture was calculated for the shoulder
joint, hip joint and dorsiflexion angles. The maximum reaching
posture means the posture in which the participants reached as
far forward as possible. The preparation posture means the
posture when they extended the reaching arm prior to the onset
of the FRT and flexed the shoulder joint at 90 degrees.
The mean differences of the participants’ characteristics be-
tween both groups were examined by an unpaired t-test. To
examine the influence of the intervention stimuli on the par-
ticipants’ flexibility, lower limb muscle strength and FRT per-
formance, a two-way ANOVA which tested the group factor
(experimental vs. control) and the test with repeated measures
(pre- and post-tests) was used. When significant interaction
effect occurred, Tukey’s honestly significant difference (HSD)
post-hoc test was used. A value of p < 0.01 was considered to
Table 2 shows the results of the unpaired t-test for partici-
pants’ characteristics. No significant difference between groups
was found in all items. Therefore, both groups were considered
to be identical. Table 3 shows the results of ANOVA and
post-hoc test for parameters of flexibility (ROM), lower leg
muscle strength and FRT performances. Significant interaction
effect was found in ROM for shoulder and hip joints. These
parameters were significantly higher after the intervention in
the experimental group and were significantly higher in the
experimental group than in the control group after the interven-
tion. No treatment effect was found in lower limb muscle
strength and FRT performances. Briefly, muscle fatigue in the
lower limb did not arise due to this intervention for flexibility
improvement. In discussion, the reasons why the improvement
in mobility of various joints has no influence on the FRT per-
formances were described.
The functional reach test has been commonly used as a clini-
cal test measuring the limit of stability (margin of stability) and
was reported to have high reliability and validity as a balance
test (Duncan et al., 1990). However, participant’s flexibility,
particularly range of motion (ROM) of the shoulder and/or hip
joints, may largely influence the reaching distance, because the
motion task of this test requires maximal extension of the ex-
tremities and a large flexing action of the hip and shoulder
joints. In this study, the FRT was conducted before and after a
short-term intervention that increased joint mobility.
First, it was confirmed that there was no decline in maximal
plantar flexion strength due to the intervention and the range of
motion of shoulder and hip joints significantly increased. In this
study, moderate exercise of 60% HR reserve and static stretch-
ing exercise were selected as the intervention to increase the
participants’ ROM. This intervention was judged to be valid
due to increasing flexibility of all the body joints including the
shoulder, hip, and ankle joints without muscle fatigue of lower
Differences of physical characteristics betwe en control and experimental groups.
EG (n = 7) CG (n = 10)
Mean ± S.D. Mean ± S.D. t-value p-value
Age (yrs) 21.9 ± 1.46 22.0 ± 1.15 –0.23 .82 n.s.
Heigh (cm) 171.7 ± 6.47 172.7 ± 4.70 –0.35 .73 n.s.
Weight (kg) 69.7 ± 8.10 67.8 ± 6.08 0.57 .58 n.s.
Note. n.s.: Not significant (p > .01). EG: Experimental group. CG: Control group.
M. UCHIYAMA ET AL.
The Mean differences in flexibility (ROM), lower l eg m uscle stren g t h a nd FRT performanc e s between b o t h g r oups.
EG (n = 7) CG (n = 10) Two-way ANOVA Post-hoc, HSD
Mean ± S.D. Mean ± S.D. Factor F-value p-value
Range of Motion of each joints
Shoulder (deg) Pre 257.8 ± 30.83 255.3 ± 18.80 Group 0.75 .4 EG: Pre < Post
Post 273.3 ± 30.05 254.1 ± 18.19 Test 10.18 .006 * Post: CG < EG
Interaction14.06 .002 *
Hip (deg) Pre 180.6 ± 13.12 173.7 ± 12.82 Group 4.69 .05 EG: Pre < Post
Post 191.8 ± 15.14 169.8 ± 12.67 Test 5.46 .03 Post: CG < EG
Interaction14.95 .002 *
Ankle (deg) Pre 73.1 ± 8.58 77.5 ± 9.07 Group 0.52 .48
Post 75.3 ± 7.77 77.4 ± 9.12 Test 1.00 .33
Plantarflex (kg) Pre 90.7 ± 12.64 83.6 ± 19.09 Group 0.38 .55
Post 89.0 ± 14.03 86.1 ± 16.24 Test 0.04 .85
Reach Distance (cm) Pre 39.7 ± 3.98 41.8 ± 2.30 Group 1.17 .3
Post 40.6 ± 3.66 41.9 ± 2.65 Test 1.50 .24
Angle (deg) Pre 8.6 ± 3.09 12.6 ± 3.94 Group 0.21 .66
Post 21.8 ± 15.27 11.3 ± 3.83 Test 0.13 .73
Hip Rotation Angle (deg) Pre 15.4 ± 10.26 18.1 ± 11.30 Group 0.04 .84
Post 17.2 ± 7.22 15.5 ± 10.58 Test 0.73 .41
Ankle Rotation Angle (deg) Pre 8.6 ± 4.54 9.5 ± 3.04 Group 0.01 .92
Post 10.2 ± 4.45 8.8 ± 3.30 Test 0.39 .54
Note. *p < .01. EG: Experimental group. CG: Control group.
In contrast, there was no intervention effect in the FRT per
formances (reach distance and rotation angle of various joints
during reaching). The stretching used in this study increased the
ROM of various joints. However, it was suggested that this
change in ROM makes neither the motion nor the reach dis-
tance of the FRT change. This finding disproved our hypothesis.
Barrett and Smerdely (2002) used elderly participants to exam-
ine the influences of long-term (10 months) progressive resis-
tant training routines and flexibility exercises on FRT scores.
They reported that the FRT improvement ratio of the incre-
mental strength training group was 11.7% larger than that of the
flexibility exercise group. The intervention time period and
demographic of the present study are different from those used
by Barrett and Smerdely. However, both studies suggest that
long- and short-term stretching exercises and subsequent intra-
individual improvements in mobility of various joints have no
influence on the FRT score.
Although healthy young adults were tested in this study, it
will be important to assess balance ability in the elderly with a
high risk of falling using a simple performance balance meas-
ure, e.g. the FRT. Various elements of physical fitness in the
elderly clearly decreases compared with young adults. The
elderly must perform various activities of daily living with
decreased physical fitness. Mecagni, Smith, Roberts, O’sullivan
(2004) examined the relationship between the ankle range of
motion (ROM), which has been reported to decrease with aging,
and the FRT score using elderly females, and observed a sig-
nificant correlation between them. Further research considering
the age level difference in physical fitness elements between
age levels will be needed.
In conclusion, in healthy young adults, improvement of the
range of motion of joints by warming-up and stretching has
little influence on FRT scores.
Barrett C. J., & Smerdely P. (2002). A comparison of community-based
resistance exercise and flexibility exercise for seniors. The Australian
Journal of Physiotherapy, 48, 215-219.
Boulgarides, L. K., McGinty, S. M., Willett, J. A., & Barnes, C. W.
(2003). Use of clinical and impairment-based tests to predict falls by
community-dwelling older adults. Physical Therapy, 83, 328-339.
Duncan, P. W., Weiner, D. K., Chandle, J., & Studenski, S. (1990).
Functional reach: A new clinical measure of balance. Journal of Ger-
ontology, 45, 192-197.
Fransson, P. A., Kristinsdottri, E. K., Hafstrom, A., Magnusson, M., &
Johansson, R. (2004). Balance control and adaptation during vibra-
tory perturbations in middle-aged and elderly humans. European
Journal of Applied Physio l o gy , 91, 595-603.
Fujisawa, H., Takeda, R., Maeda, S., & Hayakawa, Y. (2005). Signifi-
cance of functional reach test and one-footed standing duration in
hemiplegia: Relationship between balance and walking abilities.
Journal of the Japanese Physical Therapy Association, 32, 416-422.
[In Japanese with English Abstract]
Laboratory of Physical Education Tokyo Metropolitan University.
(2000). New physical fitness standards of Japanese people (5th ed.).
Tokyo: Fumaido. [In Japanese]
Mecagni, C., Smith, J. P., Roberts, K. E., O’Sullivan, S. B. (2000).
Balance and ankle range of motion in community-dwelling women
aged 64 to 87 years: A correlational study. Physical Therapy, 80,
M. UCHIYAMA ET AL. 15
Nakamura, I., Okuda, M., Kage, H., Kunitugu, I., Sugiyama, S., Hobara,
T., & Asami, I. (2006). The relationship between a functional reach
test and other balance tests. Rigakuryoho Kagaku, 21, 335-339. [In
Japanese with English Abstract] doi:10.1589/rika.21.335
Safran, M. R., Garrett, W. E. Jr., Seaber, A. V., Glisson, R. R., & Rib-
beck, B. M. (1988). The role of warmup in muscular injury preven-
tion. The Americ an Journal of Sports Medicine, 16, 123-129.
Takakura, S., & Ohgi, S. (2005). The relationship between the standing
postural control test using the elderly balance board type N and gait
performance. Rigakuryoho Kagaku, 20, 315-319. [In Japanese with
English Abstract] doi:10.1589/rika.20.315
Thomas, J. I., & Lane, J. V. (2005). A pilot study to explore the predic-
tive validity of 4 measures of falls risk in frail elderly patients. Ar-
chives of Physical Medicine and Rehabilitation, 86, 1636-1640.
Tsushima, E., Tsushima, H., Ishida, M., Hasegawa, T., & Ohkuma, K.
(2001). Correlation of functional reach distance, sagittal displace-
ment and envelope area of the center of gravity in functional reach
test by hip, ankle, and heels-up strategy in normal subjects. Riga-
kuryoho Kagaku, 16, 159-165. [In Japanese with English Abstract]
Vuillerme, N., Pinsault, N., & Vaillant, J. (2005). Postural control dur-
ing quiet standing following cervical muscular fatigue: Effects of
changes in sensory inputs. Neuroscience Letters, 378, 135-139.
Wernick-Robinson, M., Krebs, D. E., & Giorgetti, M. M. (1999). Func-
tional reach: Does it really measure dynamic balance? Archives of
physical medicine and rehabilitation, 80, 262-269.
Whitney, S. L., Poole, J. L., & Cass, S. P. (1998). A review of balance
instruments for older adults. The American journal of occupational
therapy. Official Publication of the American Occupational Therapy
Association, 52, 666-671. doi:10.5014/ajot.52.8.666
Yamada M., & Ichihashi N. (2010). Predicting the probability of falls in
community-dwelling elderly individuals using the trail-walking test.
Environmental Health and Preventive Medicine, 15, 386-391.
Zumbrunn T., Macwilliams B. A., & Johnson B. A. (2011). Evaluation
of a single leg stance balance test in children. Gait & Posture, 34,