Validity, reliability, and responsiveness of the fingertip-to-floor test

Objective: To evaluate the validity. reliability, and responsiveness of the fingertip-to-floor test to assess total mobility when bending forward in standing position. Design: Experimental, prospective, correlational. Setting: Rehabilitation and radiology departments in a university hospital in France. Participants: Ten patients (6 women. 4 men; mean age, 42yr) with chronic low back pain (LBP) in the validity study; 32 LBP patients (16 women, 16 men-, mean age, 52yr) in the reliability study; and 72 LBP patients (22 women, 50 men, mean age, 30yr) in the responsiveness study. Interventions: Dynamic radiographs and fingertip-to-floor test. Main Outcome Measures: For the validity study, 2 lateral radiographs of the upper dorsal spine, I in neutral position, and then I in full trunk flexion, were made. Validity was assessed by means of Spearman's correlation coefficient. Reliability was studied by using intraclass correlation coefficient (ICC) and the Bland and Altman method. Responsiveness was assessed by the effect size and the standardized response mean (SRM). Results: The Spearman's correlation coefficient for trunk flexion assessed by the test and the radiologic measure was excellent (r(s) = -.96). The intra- and interobserver reliability were excellent (ICC = .99). The Bland and Altman method showed no systematic trend. The values observed for the test were .97 for SRM and .87 for effect size. Conclusions: Because the fingertip-to-floor test has excellent validity, reliability, and responsiveness, it can be used in clinical practice and therapeutic trials. (C) 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.