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A health-related fitness and functional performance test battery for middle-aged and older adults: Feasibility and health-related content validity☆,☆☆,★,★★,♢,♢♢

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Abstract

Malmberg JJ, Miilunpalo SI, Vuori IM, Pasanen ME, Oja P, Haapanen-Niemi NA. A health-related fitness and functional performance test battery for middle-aged and older adults: feasibility and health-related content validity. Arch Phys Med Rehabil 2002;83:666-77. Objective: To evaluate the feasibility and health-related content validity of 6 health-related fitness (HRF) and 3 functional performance (FP) tests among middle-aged and older persons. Design: Cross-sectional methodologic study. Setting: Field laboratories in 3 communities of northeast Finland. Participants: A regionally representative, community-based cohort of 55- to 79-year-old men (n=501) and women (n=632). Interventions: Not applicable. Main Outcome Measures: Health-related test exclusion rates (%) by age groups and odds ratios (ORs) of subjective health outcomes by fitness categories (least 20%, next 40%, most fit 40%). Results: The health-related test exclusion rates increased with age, mainly because of musculoskeletal health limitations among the women and cardiovascular and musculoskeletal health limitations among the men. With the exception of dynamic back extension, 1-leg squat, 1-leg standing balance, and the 1-km walk among the women 75 years and older, 85% or more of the subjects qualified for the HRF tests and 95% or more for the FP tests. Strong and graded associations were found for cardiorespiratory and musculoskeletal fitness and the FP test levels with perceived health and functional ability status among both the men and the women (OR range, 2-31). The motor fitness test level was primarily associated with functional ability status. Conclusions: All the HRF and FP tests showed health-related content validity, and 4 of 6 of the HRF tests and all of the FP tests proved to be safe, with minor health-related test exclusions for middle-aged and older adults. The findings may help to target physical activity intervention toward persons at high risk for declining health and functional ability. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Study population

A systematic and regionally representative sample of community-based residents between the ages of 19 and 63 years was drawn from the 1979 census data of a medium-size industrial town and 2 rural municipalities in northeast Finland.33 The result was a target population of 6787 men and women, of whom 5259 (77.5%) answered the baseline survey in 1980. According to national census data from the Central Statistical Office of Finland, a total of 340 men and 150 women (9.3% of the cohort) died

Results

The demographic characteristics of the study sample are listed in table 4.

Table 4: Demographic characteristics of the sample

Empty CellMenWomenTotal
N5016321133
Age (y)
 Mean ± SD63.8±6.364.1±6.464±6.3
 Range55-7955-7955-79
Education* (%)
 Higher education454
 Secondary education222222
 Vocational training423941
 No education323433
Living situation (%)
 Independent133122
 Independent, with support866877
 Home for the elderly111
Weekly physical activity status† (%)
 Vigorous and light activity514850
 Light activity475048
 No activity22

Feasibility of the tests

The results indicate that the HRF and FP tests of the HRFTB, with the exception of 2 musculoskeletal fitness tests (dynamic back-extension, 1-leg squat), can be applied to middle-aged and older adults as long as minor health-related exclusions and physician participation are observed. As expected, the safety procedure led to a systematic increase in test-specific exclusion rates with age, mainly because of musculoskeletal health limitations among women and cardiovascular and musculoskeletal

Conclusions

The proposed test battery posseses content validity in relation to perceived health and functional ability and 4 of the 6 HRF tests (1-leg standing, trunk side-bending, knee-extension ROM, 1-km walk) and all of the FP tests (6.1-m walk, stair climb and descent, chair stand) can be safely applied to middle-aged and older adults when using the safety procedure for the HRF and FP test battery.

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    ☆

    Supported by the Finnish Ministry of Education and the Finnish Ministry of Social Affairs and Health.

    ☆☆

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.

    ★

    Reprint requests to Jarmo Malmberg, MSc, UKK Institute for Health Promotion Research, PO Box 30, FIN-33500 Tampere, Finland, e-mail: [email protected].

    ★★

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    Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.