Older Adult Physical Function

Chapter 5: Muscle Fitness Assessment
Physical Function Assessments

  • Purpose of Assessments:

    • One of the primary goals of clinical assessment tools is to provide a method that is:

    • Time-efficient

    • Cost-effective

    • Easy to implement

    • These assessments help in identifying factors that may limit mobility, defined as one's ability to move freely in their environment.

    • As the percentage of older adults in the population increases, preserving mobility and independence is critical through the maintenance of:

    • Strength

    • Endurance

    • Agility

    • Balance

  • Clinical Applications:

    • Clinicians can identify limitations in movement stability and mobility, providing markers for interventions that can aid:

    • Safety (e.g., fall risk)

    • Functional capacity

Assessment Tools

  1. Fullerton Senior Fitness Test (SFT)

    • Assesses various components, including:

      • Lower body strength and power (measured by 30-s chair stand)

      • Upper body strength (measured by 30-s arm curl)

      • Aerobic endurance

      • Lower body flexibility

      • Upper body flexibility

      • Agility

    • Refer to Rikli and Jones for normative data on Fullerton SFT.

  2. Timed Up and Go (TUG)

    • Also known as the "get-up and go" test.

    • Procedure:

    1. Stand from a standard chair (seat height between 17.3 and 18.5 in [44 and 47 cm]).

    2. Walk a marked distance of 3 m at a comfortable pace.

    3. Turn around and walk back to the chair, then sit down.

    • Key Features:

      • A simple, short-duration assessment of lower extremity function and functional mobility.

      • Recommended by various governing bodies (e.g., American and British Geriatric Societies, society of Nordic geriatricians).

      • Relevant associated references include and .

      • Tools to assess fall risk.

    • Specific timing capture begins on the command "go" and ends when the participant's back is against the seat back after sitting.

    • Test is performed twice, and the results provide vital health indicators.

  3. Short Physical Performance Battery (SPPB)

    • A composite measure assessing the following lower extremity functions:

      • Standing balance

      • Walking speed

      • Ability to rise from a chair

    • Can be performed at home or in a clinical setting.

    • Predictive value for health outcomes such as:

      • Mobility loss

      • Disability

      • Hospitalization

      • Length of hospital stay

      • Nursing home admission

      • Death

    • Reliability in U.S. populations indicated by ICC values between 0.88 and 0.92.

Detailed Assessment Procedures

Timed Up and Go Test (Box 5.4)

  • Steps:

    1. Participants stand from a standard chair (height requirement).

    2. Walk a distance of 3 m at a comfortable pace.

    3. Turn, walk back to the chair, and sit down.

    4. Use of walking aids is permitted, but arms should not be used for standing.

    5. Timing is conducted using a stopwatch.

    6. The test is performed two times for accuracy.

Short Physical Performance Battery (Box 5.5)

  • Components:

    1. Standing Balance: Maintain three positions:

    • Side-by-side

    • Semi-tandem

    • Full tandem

    • Scoring based on seconds held in each position.

    1. Walking:

    • Short 8-ft (2.4-m) track for normal paced walking.

    • Timing measures walking time with scoring based on speed achieved.

    1. Repeated Chair Stand:

    • Stand from seated position and perform as many cycles as possible in a given timeframe.

    • Scoring based on duration of the task.

  • Summation of Performance Scores: Total scores range from 3 to 12 by adding individual component results.

Senior Fitness Test Items (Table 1)

  • Assessment Categories & Descriptions:

    1. Lower Body Strength:

    • 30-s chair stand: Number of full stands in 30 seconds with arms folded across the chest.

    1. Upper Body Strength:

    • 30-s arm curl: Number of bicep curls performed in 30 seconds with specified weights (5 lb for women, 8 lb for men).

    1. Aerobic Endurance:

    • 6-min walk or 2-min step test as an alternate aerobic measure.

    1. Lower Body Flexibility:

    • Chair sit-and-reach: Measurement of distance in inches from fingers to toes.

    1. Upper Body Flexibility:

    • Back scratch test: Measurement of distance between extended fingers in inches when reaching over the shoulder.

    1. Agility/Dynamic Balance:

    • 8-foot up-and-go: Time taken to complete the sequence of standing, walking, turning, and returning to seated position.