FaME Adoption and Spread – results from the FLEXI Study so far
The Functional Grid (along with FRAT score) has formed the basis of SUITABILITY to join FaME sessions since our first ever PSI training course, with people scoring mainly 1-3s suitable for FaME, those with 4s and 5s more likely to require more seated based options and those scoring 6s not appropriate and requiring referral back to the Rehab Team.
Summary of changes
- The Functional Grid now has 7 functional assessments (previously 6)
- Functional Reach removed
- 4-point balance test added
- 30s sit to stand added
- Getting down/up from floor (using backwards chaining method) links added – which will not form part of suitability but will aid the PSI in individualising their approach to floor rise skills and home exercise for that individual.
Rationale for the changes
Functional Reach has been removed – as in the early days of FaME it was one of the more commonly used assessments for balance and some early research suggested it was related to falls risk as people unwilling or unable to reach forward would likely have poor ability to move out of their base of support. However, it is now rarely used as it is so easy to ‘cheat’ and takes a while to set up and measure, plus we have ConfBal as a marker of balance confidence and other balance tests in the grid.
4-point balance has been added – this gives an indication of ability to balance with reduced base of support and links in with the Otago Exercise Programme assessment so supports the level of balance exercises you might give someone for their home exercise prescription.
30 sec Sit to Stand added – as this is now a common assessment measure used by services and gives a good indication of lower limb strength and also on number of reps that a person may well be able to achieve later in the class or in their home exercise.
In addition, there is now a row at the bottom of the grid that does not determine suitability but does inform exercise tailoring. Getting onto/up from the floor is assessed but as someone who cannot get up from the floor is a prime candidate to come along to FaME sessions and relearn that skill it is NOT part of the suitability criteria. Instead, it can be used to inform whether that person can do links in the backward chaining approach such that they could do this in a class or indeed practice at home.
Download the new FaME / PSI Functional Grid here.
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