Usefulness, assessment and normative data of the Functional Reach Test in older adults: A systematic review and meta-analysis

Objective: To identify the evidence about the usefulness of the Functional Reach Test to evaluate balance and falls risk; to verify the Functional Reach Test assessment method and other variables that could interfere in its results; and to establish normative data for older adults. Data sources: Manual and electronic searches (MEDLINE, Embase, Web of Science, LILACS, CINAHL, AgeLine and PsycINFO) were conducted with no language restrictions and published since 1990. Study selection: Observational studies about the Functional Reach Test in older adults with no specific health condition were selected. Data extraction: Two independent reviewers extracted data from studies and a third reviewer provided consensus. The studies methodological quality was appraised using the Newcastle-Ottawa Scale. Studies were submitted to critical analysis and meta-analysis. Results: 40 studies were selected (8 prospective and 32 cross-sectional). 33 studies used the Functional Reach to assess balance and 21 studies the falls risk. The meta-analysis of Functional Reach normative data was 26.6 cm [95% CI: 25.14; 28.06] for community-dwelling older adults (n= 21 studies) and was 15.4 cm [95% CI: 13.47; 17.42] for non-community older adults (n= 5 studies), with statistics differences between settings. Functional Reach Test performance was found to decrease with age. Sex and prospective history of falls did not influence the test results. Methodological quality analysis determined high to low risk of bias of the studies. Conclusion: This review revealed that the method of assessment and data of the Functional Reach Test varied greatly. Different values should be used for community- and non-community-dwelling older adults.