December 23, 2022 @ 2:57 PM

In the beginning, 16 years ago, Rock Steady Boxing adopted the FAB, TUG and S2S as its default assessment tools.  Good choices since they were accepted by the medical community world-wide and it would be easy to train RSB coaches without medical backgrounds to administer them.  Instant credibility.  They have served Rock Steady well.  There may be as many as 100,000 intake assessments in manila folders in Rock Steady gyms all over the country!  I know that although I currently have about 50 active boxers, I have administered several hundred assessments in my 5 years as a Rock Steady affiliate.

It has become apparent that a new approach to assessing the improvements or declines in people with Parkinson's, diabetes or other conditions is required.  Even in the fight against aging.

One of the problems with the FAB/TUG/S2S series of tests is inconsistency in administration.  Go to YouTube and enter Fullerton Advanced Balance in the search box.  You will get videos by physical therapists on how to administer the tests.  Every one of the videos I reviewed was incorrect in the instructions to clients, sloppy in their administration and observations, used inappropriate props such as the incorrect height and width for the bench in FAB test 4, and they didn't write any test results down or score the tests for the client when done.  Very sad!

The primary problem with all 3 assessment tools is that they are intended to be used in a medical environment when indicated by a reported loss of balance or fall risk.  Parkinson's Level 1 and Level 2 people are not experiencing a loss of balance or fall risk yet.  They will receive a perfect score on all 3 tests so what did the coach or the boxer learn?  As a newly diagnosed Parkie, I received a perfect score 5 years ago and probably will for another 3 years or more.

There are problems with several FAB tests... like the 10-inch forward reach test.  Again most Level 1s, Level 2s and most Level 3s can reach the pen quite easily at a fixed 10 inches.  There is an additional problem with the test which is a Level 3 person who is 6'2" can reach 10 inches with very little challenge whereas a Level 1 person who is 5'1" is challenged.  The traditional FAB scoring means nothing... is even confusing.

There is a blog specifically about the Standing Jump, FAB 8.  In summary, without recording the distance jumped, the boxer can jump further or shorter in their next assessment and still earn the same score even though they have improved or lost ground.  Read FAB 8: Standing Jump Scoring.

The Walking with Head Turns and the Reactive Posture Control tests are troublesome for non-medical administrators like RSB coaches.  Walking with Head Turns.  There are too many ways a boxer can present unexpected elements such as nodding their head or tilting their head rather than turning their head.  And what if they only turn their head 15 degrees in each direction or they turn their head in just one direction?  And for the Reactive Posture Control, the first problem is when a 5' coach tries to do this test on a 6', 175 pound boxer.  There is a real fear of getting crushed.  Even when doing the test, there is no consistency for how much weight the coach should allow before letting go...  for the same coach between boxers, for the same coach and the same boxer 6 months from now... and certainly, between coaches.

The challenge for BwP is to develop a series of assessment tests that are not designed as a diagnostic too to be administered by medical professionals.  The Rock Steady network includes some physical therapists and other medical professionals, however, the typical assessment coach is not a trained medical professional and the purpose for the assessment in the first place is not to diagnose the client.  BwP has established that the purpose of a new comprehensive assessment should be three-fold:  1)  to get a clear sense of a boxer's current capabilities and limitations; 2) to establish an assessment process and scoring algorithm that will deliver consistent results for the same client (on the same medications) by different coaches a day or a week apart; and, 3) that measure the capabilities an limitations of a client who is Level 1 through Level 3.  

New assessment tools need to have a higher performance and test ceiling where a Level 1 would be challenged to score a 100.  As an example, the FAB test 1 is to stand feet together, arms across your chest and eyes closed for 30 seconds.  Very easy for a Level 1 or a Level 2 and even doable for a Level 3 boxer.  To elevate the test to be more challenging, we could have the boxer stand feet together on a foam pad, or a little harder yet by standing on the floor in tandem, one foot in front of the other, and even harder yet by standing tandem on a foam pad.  Try standing on the floor with your feet in tandem, arms across your chest and eyes closed for 30 seconds.  The Standing Balance test score would have meaning for every Level boxer!

A reliable assessment test series must have clear coach instructions and specific, observable scoring clues or measurements such that any two RSB coaches can administer the assessment process and get the same results, within +/-3 points a day apart or a week apart.  And assessment results 6 months from now actually represent changes in the client rather than variables in administering the tests.

Quite a challenge.  We accept!  If you would like to be part of the next generation of assessment tests, please contact us.  Your input and experience can make a difference for millions of people fighting with Parkinson's, diabetes or aging.