Function in Sitting Test (FIST)

Welcome to the Function in Sitting Test (FIST) Web-based Training. 

This online module consists of an overview of the FIST, specifics related to each of the 14 items, and documentation information. Selected FIST items have video examples showing different levels of performance, and a brief quiz to assess competency is available after you complete this tutorial. 


First, some general information about the FIST.

What is the FIST?

  • Useful: The FIST is a clinical examination of sitting balance, designed to be conducted at the patient's bedside
  • Practical: Consists of 14 functional, everyday activities as test items
  • Easy: Performance is scored by therapist using a single set of scoring criteria for all 14 items
  • Quick: Most patients can easily complete the FIST in under 10 minutes

Purposes of the FIST

The FIST can be useful for a variety of clinical uses including:

  • Assess functional sitting abilities
  • Describe sitting balance dysfunction
  • Focus interventions
  • Track changes in sitting balance over time
  • Assessment of lower level patients, especially if other balance tests may be too difficult for the patient

Is my patient appropriate for testing with the FIST?

The FIST is best suited for patients with:

  • The ability to follow simple directions, either verbal or nonverbal 
  • Known or suspected sitting balance deficits
  • Impulsiveness
  • Safety issues in sitting
  • Slow movement
  • Poor seated motor control
  • Lower level patients who...
    • cannot tolerate other balance tests
    • are unable to stand or ambulate without excessive assistance or devices

Patients who may benefit from other types of balance testing include:

  • Patients who can...
    • stand or perform more complex ADLs
    • ambulate
  • Patients who aren't yet...
    • medically stable for sitting
    • cleared for the motions or tasks on the FIST

Creation of the FIST

Creation and validation process

Please see the paper published in the Journal of Neurologic Physical Therapy detailing the development and validation of the FIST for more details, or view the abstract at PubMed.

Psychometrics of the FIST

  • FIST reliability
    • Functional sitting balance ability explains 83.33% of score variance between persons
    • Cronbach's alpha = 0.98
    • Person separation reliability = 0.978
    • Standard error of measurement = 2.03
    • Minimal detectable change (95% confidence) = 5.63
  • Studies to determine inter- and intra- rater reliability, evaluative validity in other applicable patient populations, and responsiveness are underway and/or in planning stages. See our Research Collaboration page if you would like to participate in current/upcoming studies.

 

Next, how to set up the environment, patient, and therapist to conduct the FIST .