title: Examining the function in sitting test for validity, responsiveness, and minimal clinically important difference in inpatient rehabilitation.
abstract: OBJECTIVE
  To determine the responsiveness of the Function In Sitting Test (FIST), compare scores at admission and discharge from inpatient rehabilitation (IPR) with other balance and function measures, and determine the minimal clinically important difference (MCID).
  
  
  METHODS
  Prospective, nonblinded, reference-standard comparison study.
  
  
  METHODS
  Four accredited inpatient rehabilitation units.
  
  
  METHODS
  Population-based sample of adults (N=125) with sitting balance dysfunction, excluding persons with spinal cord injury, significant bracing/orthotics, and inability to perform testing safely.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  FIST, FIM, and Berg Balance Scale (BBS) at admission and discharge, and Global Rating of Change for function and balance at discharge.
  
  
  RESULTS
  The FIST demonstrated good to excellent concurrent validity with the BBS and FIM at admission and discharge (Spearman ρ=.71-.85). Significant improvement (P<.000; 95% confidence interval [CI], 10.73-15.41) occurred in the FIST from admission (mean ± SD: 36.81±15.53) to discharge (mean ± SD: 49.88±6.90). The standard error of measurement for the FIST was 1.40, resulting in a minimal detectable change of 5.5 points. The receiver operator characteristic curve differentiated participants with meaningful balance changes (area under the curve, .78; P>.000; 95% CI, .66-.91), with a change in FIST score of ≥6.5 points designating the MCID. Findings support the strong responsiveness of the FIST during IPR as evidenced by the large effect size (.83), standardized response mean (1.04), and index of responsiveness (1.07).
  
  
  CONCLUSIONS
  In this study, the FIST correlated well with balance and function measures (concurrent validity) and was responsive to change during IPR. A clinically meaningful change was indicated by an increase in score of ≥6.5 points.
authors.affiliation: Department of Physical Therapy, Samuel Merritt University, Oakland, CA. Electronic address: sgorman@samuelmerritt.edu.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Gorman
authors.affiliation: Physical Therapy Department, Grand Valley State University, College of Health Professions, Grand Rapids, MI.
authors.forename: Cathy C
authors.initials: CC
authors.lastname: Harro
authors.affiliation: Physical Therapy Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI.
authors.forename: Christina
authors.initials: C
authors.lastname: Platko
authors.affiliation: Physical Therapy Department, Alta Bates Summit Medical Center, Herrick Campus, Berkeley, CA.
authors.forename: Cara
authors.initials: C
authors.lastname: Greenwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D011597:Psychomotor Performance; D012372:ROC Curve; D012678:Sensation Disorders / Q000503:physiopathology* / Q000534:rehabilitation*; D055815:Young Adult
keywords: Outcome assessment (health care); Postural balance; Psychometrics; Rehabilitation