Performance-based measures of physical function for high-function populations.
OBJECTIVE
To improve and broaden the applicability of performance-based measures of function for use in clinical and research settings.


METHODS
Cross-sectional repeated-measures study.


METHODS
Research clinic.


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


METHODS
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).


CONCLUSIONS
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.
Curb
J David
JD
Pacific Health Research Institute, 846 South Hotel Street, Honolulu, HI 96813, USA. jdcurb@phrihawaii.org
Ceria-Ulep
Clementina D
CD
Rodriguez
Beatriz L
BL
Grove
John
J
Guralnik
Jack
J
Willcox
Brad J
BJ
Donlon
Tim A
TA
Masaki
Kamal H
KH
Chen
Randi
R
D000328:Adult; D000368:Aged; D001213:Asian; D003430:Cross-Sectional Studies; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006254:Hawaii; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D013647:Task Performance and Analysis; D016138:Walking / Q000502:physiology