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The Function in Sitting Test (FIST) is a bedside evaluation of sitting balance that evaluates sensory, motor, proactive, reactive, and steady state balance factors.
Not a CDE--last searched 10/26/2025
14
Less than 15 minutes
Adults
18 - 64
yearsElderly Adult
65 +
yearsReviewed by Heidi Roth, DHS, PT, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 5/2012. Updated in September 2025 by Nikol Brevik, OTS, CUW, Andrea Hermsen, OTS, McKenzie Johnson OTS, and reviewed by Jessica Schmidt, OTD, OTR/L, from Concordia University of Wisconsin.
Recommendations for use of the instrument from the Neurology For detailed information about how recommendations were made, please visit:
Recommendations based on level of care in which the assessment is taken:
Recommendations for use based on acuity level of the patient:
Recommendations based on EDSS Classification:
Recommendations for use based on ambulatory status after brain injury:
Recommendations for entry-level physical therapy education and use in research:
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Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Acute Stroke: (Gorman et al, 2010; n=31, age 61.5 (10.9) years, <=3 months post stroke, Modified Rankin Scale of moderate / moderately severe / severe)
Acute Stroke: (Calculated from Gorman et al, 2010)
Stroke: (Alzyoud et al., 2022; n = 40; mean age (SD) = 71.6 (11.4) years; age range = 47-96 years; male = 23 (57.5%); mean time post CVA (SD) = 106 (247.7) days; skilled nursing facility sample)
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Stroke: (Alzyoud et al., 2022)
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Acute Stroke: (Gorman et al, 2010)
Stroke: (Alzyoud et al., 2022)
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Stroke: (Alzyoud et al., 2022)
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Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko and Greenwald, 2014, n=125, age=60.0 (16.6) years)
Balance Participants: (Gorman, Rivera, and McCarthy, 2014) (n=6; Mean Age= 68.7)
***Medical diagnoses of the balance participants included Parkinson’s disease (n=1), multiple sclerosis (n=1), and cerebrovascular accident (n=5).
Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko & Greenwald, 2014)
Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko & Greenwald, 2014)
Balance Participants: (Gorman, Rivera, and McCarthy, 2014), n=6; mean age = 68.7
***Medical diagnoses of the balance participants included Parkinson’s disease (n=1), multiple sclerosis (n=1), and cerebrovascular accident (n=5).
Balance Participants: (Gorman, Rivera, and McCarthy, 2014), n=6; mean age = 68.7
***Medical diagnoses of the balance participants included Parkinson’s disease (n=1), multiple sclerosis (n=1), and cerebrovascular accident (n=5).
Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko & Greenwald, 2014)
Concurrent Validity: Good to Excellent concurrent validity with the Berg Balance Scale and Functional Independence Measure at both admission and discharge (Spearman ρ=.71–.85).
Adults With Sitting Balance Dysfunction: (Gorman, Harro, Platko and Greenwald, 2014, n=125, age=60.0 (16.6) years)
Responsiveness: Strong as evidenced by the large effect size (.83), standardized response mean (1.04), and index of responsiveness (1.07).
SCI: (Abou et al., 2020; n = 26; mean age (SD) = 39 (15) years; age range = 20-72 years; female = 16 (61.5%); mean time post injury (SD) = 21(18) years; Cervical and thoracic injuries with AIS A-D and non-ambulatory)
SCI: (Palermo et al., 2020; n = 38; mean age (SD) = 39.67 (11.78) years; age range = 20-72 years; mean time post injury (SD) = 14.1 (11.5) years; C1 to T10 with AIS A-C; FIST modified into FIST-SCI to evaluate functional seated balance in persons with SCI)
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SCI: (Abou et al., 2020)
SCI: (Palermo et al., 2020)
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SCI: (Palermo et al., 2020, n = 37)
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SCI: (Abou et al., 2020)
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SCI: (Palermo et al., 2020)
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SCI: (Abou et al., 2020; n = 26)
SCI: (Palermo et al., 2020; n = 38)
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*Scores higher than 0.9 may indicate redundancy in the scale questions.
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Concurrent validity: SCI: (Abou et al., 2020)
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Convergent validity: SCI: (Palermo et al., 2020)
Discriminate validity: SCI: (Palermo et al., 2020)
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Palermo et al. (2020) established face validity for the FIST-SCI through discussion of expert clinicians and researchers (one of whom was a physical therapist working in the SCI field and the other an individual with SCI) (p. 1962).
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SCI: (Abou et al., 2020)
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Multiple Sclerosis: (Sung et al., 2016; n = 20; mean age (SD) = 56.8 (10.9) years (range = 27-83 years); mean MS duration (SD) = 17.8 (9.2) years (range = 7-35 years); non-ambulatory w/mean wheelchair usage duration = 5.9 (4.7) years (range = 1-19 years))
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Multiple Sclerosis: (Sung et al., 2016)
*Scores higher than 0.9 may indicate redundancy in the scale questions.
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Concurrent validity Multiple Sclerosis: (Sung et al., 2016)
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Multiple Sclerosis: (Sung et al., 2016)
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Abou, L., Sung, J., Sosnoff, J. J., & Rice, L. A. (2020). Reliability and validity of the Function in Sitting Test among non-ambulatory individuals with spinal cord injury. The Journal of Spinal Cord Medicine, 43(6), 846–853.
Alzyoud, J., Medley, A., Thompson, M., & Csiza, L. (2022). Responsiveness, minimal detectable change, and minimal clinically important difference of the Sitting Balance Scale and Function in Sitting Test in people with stroke. Physiotherapy Theory and Practice, 38(2), 327–336.
Gorman, SL, Radtka, S, et al. "Development and validation of the function in sitting test in adults with acute stroke." Journal of Neurologic Physical Therapy 34(3)(2010): 150-160.
Gorman, SL, et al. "Examining the Function in Sitting Test for Validity, Responsiveness, and Minimal Clinically Important Difference in Inpatient Rehabilitation." Archives of Physical Medicine and Rehabilitation 95.12 (2014): 2304-11.
Gorman SL, Rivera M, McCarthy L. "Reliability of the Function in Sitting Test (FIST)." Rehabilitation research and practice. 2014; 2014:593280.
Palermo, A. E., Cahalin, L. P., Garcia, K. L., & Nash, M. S. (2020). Psychometric testing and clinical utility of a modified version of the Function in Sitting Test for individuals with chronic spinal cord injury. Archives of Physical Medicine and Rehabilitation, 101(11), 1961–1972.
Sung, J., Ousley, C. M., Shen, S., Isaacs, Z. J. K., Sosnoff, J. J., & Rice, L. A. (2016). Reliability and validity of the Function in Sitting Test in nonambulatory individuals with multiple sclerosis.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.