Validity of the sock test for sitting balance: A functional sitting balance assessment for use in the acute care setting

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INTRODUCTION: Balance is a foundation for function as, “The ability to control our body’s position in space is fundamental to everything we do” (Shumway-Cook & Woollacott, 2007, p.158). The importance of sitting balance has been established with several studies strongly correlating sitting balance to self-care functioning (Gorman et al., 2014; Oh, Im, Ko, Ko, & Park, 2012; Juneja, Czyrny, & Linn,1998). However, no universally accepted method of assessing or describing a patient’s sitting balance has been identified (Sibley, Beauchamp, Van Ooteghem, Straus, & Jaglal, 2015), and current standardized sitting balance assessments are not grounded in an occupation-based approach of assessing the ‘whole person’. The Sock Test for Sitting Balance (STSB), developed using the Occupational Adaptation framework, has the potential to be an effective and efficient measure of sitting balance and function, but had not been compared to a validated balance tool and had not been tested to see if it could differentiate between a healthy versus hospitalized population. OBJECTIVES: The aim of this study was to determine if the STSB is a valid assessment of sitting balance for use by occupational therapists in the acute care setting.
METHODS: Twenty-one hospitalized participants were case-matched to 21 apparently healthy individuals. Concurrent validity of the STSB was then investigated by correlating the sitting balance results obtained on the STSB to those of the “Adapted Functional Reach” (AFR) assessment (Thompson & Medley, 2007), the Functional Independence Measure (FIMTM) Chair Transfer subscale (Zeltzer, 2011), and to the Kansas University Sitting Balance Scale (KUSBS) (Kluding, Swafford, Cagle & Gajewski, 2006). RESULTS: There is a significant relationship between STSB results and Adapted Functional Reach-Forward results (rs (40) = -.382, p = .012) for all participants but not for the hospitalized cohort alone (rs (19) = -.178, p = .440). Validity was established with a significant relationship between ranked STSB results and ranked level of independence on the FIMTM bed-chair transfer subscale (rs (19) = -.677, p = .001), and to levels of sitting balance on the KUSBS (, rs (19) = -.614, p = .003.). The results of the study also showed that the STSB can differentiate between a hospitalized population and an apparently healthy population (z = 2.377, p = .017, r = .37). CONCLUSION: This study advances the use of the task of sock donning and doffing as a sitting balance measurement tool, helping establish the STSB for use by occupational therapists in the acute care setting.

sitting balance, sock test, occupation-based assessment, occupational therapy