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 s tanding 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 lo w 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 flexio n, were made. Validity was assessed by means of Spearman's correlation coef ficient. Reliability was studied by using intraclass correlation coefficien t (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 int ra- 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, re liability, and responsiveness, it can be used in clinical practice and ther apeutic trials. (C) 2001 by the American Congress of Rehabilitation Medicin e and the American Academy of Physical Medicine and Rehabilitation.