Performance-based measures of physical function for high-function populations

J Am Geriatr Soc. 2006 May;54(5):737-42. doi: 10.1111/j.1532-5415.2006.00700.x.


Objectives: To improve and broaden the applicability of performance-based measures of function for use in clinical and research settings.

Design: Cross-sectional repeated-measures study.

Setting: Research clinic.

Participants: Population-based sample of Japanese Americans without significant functional impairments aged 35 to 55 and 56 to 71 (N=203).

Measurements: Performance-based measures of physical function, including range of standard tests, newer automated measures of balance and strength and data on cognitive function, lifestyle, medical history, and physical activity.

Results: Of the nonplatform balance measures, only the one-leg stand was reliable (reliability coefficient (rc) =0.69) and able to discriminate between functional levels. Combining the Fourth National Health and Nutrition Examination Survey protocol of folded arm position while standing on a foam pad with the more-sophisticated balance platform test had the highest reliability and discrimination. With the strength chair, high rcs (0.88-0.96) were found for upper and lower extremity tests. Timed chair stands, a test of lower extremity and central strength were reliable. The 6-minute walk had a high rc (0.90).

Conclusion: Many performance tests used today are not reliable. Only a few discriminate between the most highly functioning individuals and individuals with good function. Thus, a new recommended battery includes unassisted single-leg stand, balance platform "foam pad, eyes closed," elbow flexion and knee extension strength (strength chair), grip strength, timed chair stands, and the 6-minute walk. These simple performance-based tests have good reliability and discrimination across the range of function and can be used in most clinical and research settings to quickly assess global functional level.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Asian Americans*
  • Cross-Sectional Studies
  • Exercise Test
  • Exercise Tolerance / physiology
  • Female
  • Hand Strength / physiology
  • Hawaii
  • Humans
  • Male
  • Middle Aged
  • Physical Fitness / physiology*
  • Postural Balance / physiology
  • Psychomotor Performance / physiology*
  • Task Performance and Analysis
  • Walking / physiology