Jessie Newell by Jessie Newell

Functional assessments are a great way to determine what to address when designing a client’s resistance and flexibility training program. These assessments help identify compensations and muscular imbalances that may cause the client to deviate from proper postural or movement mechanics. Once these compensations have been identified, exercises can be selected to address them. Sometimes these deviations will stem from factors that cannot be corrected through training, but it is still helpful to be aware of these deviations.

This final installment of a blog series addressing the four main types of functional assessment takes a close look at core function and balance assessments, which includes the Sharpened Romberg Test, Stork-Stand Balance Test and McGill’s Torso Muscular Endurance Test Battery. With each of these assessments, the first thing to understand is the objective (purpose) of the assessment. In other words, what information can you gather from this assessment? Next, note  if there are any contraindications or reasons that the client should not perform the assessment. Finally, be aware of the test termination criterion for each of these assessments.

Sharpened Romberg Test

This assessment takes visual input out of the balance equation so the client must rely on vestibular and proprioceptive input. The feet are in tandem stance, which means the big toe of the back foot is touching the heel of the front foot. The test should last a minimum of 30 seconds, and if the client makes it to 60 seconds, the test can be terminated. Repeat with the opposite foot in front, and be sure to note any side discrepancies.

Stork-Stand Balance Test

This assessment examines balance on each side of the body by having the client stand in a modified stork-stance. This assessment has normative data to help your clients understand where they are with their balance. Again, make note of any side discrepancies.

McGill’s Torso Muscular Endurance Test Battery

This assessment is important because it assesses muscular balance within the core to determine if there is an imbalance that could potentially put someone at risk for back pain. If your client complains of back pain, this assessment can help you design a program that addresses any imbalances. Make sure you have a good understanding of the three desirable ratios between flexion: extension; right side: left side; and side bridge: extension (do both sides). You will find a helpful review of these ratios on page 191. A ratio compares one thing to another, and is determined by dividing the number of seconds a client can perform a movement on one side with the number of seconds this movement is performed on the other side. For example, a ratio of 1.0 means the sides were equally balanced (i.e., the client performed the movement for 60 seconds on the right and 60 seconds on the left; 60/60 = 1.0).

Because balance and core function go hand in hand, these assessments help shed light on the exercises you should focus on when designing your clients’ resistance-training programs. If a client demonstrates poor core function, you should begin working on his or her lumbar stability. If a client exhibits balanced core function, you can focus on increasing the stability and mobility of the surrounding areas and distal extremities.