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Measuring functional

To design an effective exercise


program, you must know your
clients’ physical state. But
choosing the right assessment
tools can prove a challenge

by C. Jessie Jones and Roberta E. Rikli

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fitness of older adults


Helping to delay physical frailty and Figure 1. A functional ability framework indicating the physiologic parameters associated with
improve functional mobility among older functions required for basic and advanced everyday activities. R.E. Rikli & C.J. Jones, 2001,
adults are two of the most important Senior Fitness Test Manual (Champaign, IL: Human Kinetics). Adapted with permission.
goals of senior fitness instructors. Many
would say the quality of life in later years
depends to a large degree on being able to PHYSICAL PARAMETERS FUNCTIONS ACTIVITY GOALS
continue to do what you want, without
pain, for as long as possible. Designing Muscle strength/endurance Walking Personal care
effective exercise programs that can help
older adults maintain or improve their Aerobic endurance Stair climbing Shopping/errands
mobility requires two prerequisites:
Flexibility Standing up Housework
1. An understanding of the physical from chair
attributes needed for mobility tasks in Motor ability Gardening
later years; and power Lifting/reaching
speed/agility Sports
2. The ability to assess physical attributes, balance Bending/kneeling
so that client weaknesses can be Traveling
detected and then targeted for Body Jogging/Running
individualized programming. composition

Many senior fitness instructors have been Physical Functional Reduced ability/
especially frustrated with the lack of tests impairment limitation Disability
available to assess the functional fitness of
older adults, particularly tests that have
accompanying performance standards.
Importance of functional result in falls and physical frailty
Recognizing the need for a tool to fitness in older adults (Alliance for Aging Research, 1999).
evaluate the functional fitness Functional fitness performance is having
performance of older adults, researchers the physiologic capacity to perform normal One goal of fitness practitioners should
at California State University, Fullerton, everyday activities safely and independently be to help with the early identification of
recently developed and validated a new without undue fatigue (Rikli and Jones, at-risk participants, and either to provide
fitness test battery especially for older 1999a). Reasons why it is important to a targeted intervention program or to
adults: the Senior Fitness Test (Rikli and assess the functional fitness of older make appropriate medical referrals for a
Jones, 2001). adults include the following: complete diagnosis, treatment and
maintenance plan.
The test is based on a functional fitness Identification of at-risk participants.
framework (see Figure 1), which points Many independent older adults, often Program planning and evaluation. To
out that being able to perform everyday due to their sedentary lifestyles, function plan safe and effective exercise or physical
activities (e.g. personal care, shopping, dangerously close to their maximum activity programs for older adults, it is
housework) requires the ability to ability level during normal activities. important to know as much as possible
perform functional movements, such as Climbing stairs or getting out of a chair about the client’s health and fitness
walking, stair climbing and standing up; requires near maximum effort for many status, current physical activity level,
and that these functional movements, in older individuals (Evans, 1995). activities likes and dislikes, and personal
turn, are dependent on having sufficient Unfortunately, more than one-third of goals.
physiologic reserve (i.e. strength, community-dwelling older adults are at
endurance, flexibility, balance). One risk for mobility problems and falls A comprehensive functional fitness test
unique feature of the Senior Fitness Test (Rose, 2002). Early identification of provides specific information regarding a
is that it measures physiologic parameters physical decline and appropriate client’s physical strength and weaknesses
using functional movement tasks, such as interventions could help to prevent associated with functional tasks and
standing, bending, lifting, reaching and functional impairments, such as in activity goals important to everyday
walking. walking and stair climbing, that often Continued on page 26

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Measuring functional fitness of older adults Continued from page 25

living. This information is necessary to have related how motivated they are by measures what it is intended to measure;
design individualized, targeted exercise or taking the Senior Fitness Test and reliability refers to the dependability of
physical activity programs for clients. finding out how they compare to others test scores. A reliable test produces
Also, baseline measures repeated at of the same age and gender. The testing similar scores from one trial to another,
multiple intervals during the program itself causes many people to pay more or one day to the next, when an
provide critical data to track the progress attention to their fitness and physical individual (or group of individuals)
of clients, to make program adjustments, activity level. administers it.
to provide personalized feedback and to
evaluate program effectiveness. Selecting assessment tools Scoring accuracy is an important test
An instructor should consider several characteristic, especially if more than one
Assessment skills are especially important factors before selecting assessment tools person is going to administer the same
for fitness instructors in this era of to measure the functional fitness of older test item (Rikli and Jones, 1997).
accountability. Many facility directors adults: Literature may report a test to have good
now require fitness instructors to evaluate intrarater reliability (same evaluator) or
progress and document program and 1. interrater reliability (different evaluators),
client outcomes (Russek, Wooden, What is the purpose of the assessment tool? but it is still necessary for anyone who
Ekedahl, & Bush, 1997). These tools measure a variety of administers a test to be appropriately
physiologic parameters and functional trained on the test protocol and
Goal setting and motivation of activities. Instructors should select recording procedures and, if possible,
participants. Most people recognize that assessment tools based on what they evaluated for test reliability.
remaining physically active is essential for hope to see change in their clients.
optimal health and physical ability, yet Ideally, it is recommended that Instructors should never assume that tests
less than 25% of older adults get enough instructors measure more than just the developed and validated for younger age
exercise to derive such benefits (National physical parameters of the body, such as groups will be appropriate for older
Blueprint, 2001). According to experts in upper body strength, power, flexibility, adults. They should check that the test
the field of behavior change, setting goals aerobic endurance, dynamic balance and items being considered have supporting
powerfully motivates people to improve body composition. Assessment tools that data documenting its reliability and
their fitness levels (Blair, Dunn, Marcus, also measure functional performance, validity based on studies involving older
Carpenter, & Jaret, 2001; Dishman, such as walking distance or time and adults.
1998). Assessing the functional fitness stair climbing ability, are meaningful to
levels of participants is a precursor to older adults. 4.
helping them set worthwhile short- and Is the assessment tool feasible to use?
long-term personal goals. 2. Feasibility refers to the suitability of
What is the functional mobility level of the administering the test items in a given
To facilitate goal setting, it is especially participants? Some assessment tools are setting. Instructors should consider the
helpful to relate the purpose and results specifically designed for use with either following additional questions to
of assessments to the types of daily tasks the frail or the healthy older adult. Few determine feasibility:
and activities clients hope to continue to are able to assess the wide range of ability
do or want to do better. For example, levels that most senior fitness instructors • What type of equipment is needed?
upper body strength is important for encounter. It would be ideal for • What is the cost of the equipment?
performing household and other instructors to select test items they can • How long does each test item take to
activities that involve lifting and carrying use with a wide range of functional administer?
things, such as groceries, suitcases and abilities—from the borderline frail to the • How much space is needed?
grandchildren. A short-term goal may be highly fit. This type of test is especially • How difficult are the test items to
to improve upper body strength by 20%, useful for tracking a person over time. administer and score?
while a long-term goal may be to be able • Can paraprofessionals administer the
to do yard work or pick up a grandchild. 3. tests?
Is the assessment tool reliable and valid for • Are the test items safe to give?
The periodic assessment and monitoring use with the older adult population? This is • Is a physician’s release necessary for the
of performance motivates older adults. It one of the most important factors to participant to take the tests?
also encourages their progress and consider when selecting an assessment • Does a physician need to be present?
exercise compliance. Many older adults tool. Validity refers to whether a test item

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range would be considered above average


for their age, while those scoring below
the range would be below average.

The Senior Fitness Test Manual (Rikli and


Jones, 2001), published by Human
Kinetics, includes a complete description
of the test items. The manual describes
the theoretical basis and developmental
procedures for the test, and contains
complete information on how to
administer and score the test, interpret
results, provide feedback to test
participants about their results and
organize and test groups of older adults.
The appendix has reproducible sample
forms, charts, tables and posters for
instructors to use in their programs.
5. scientific standards for validity and Percentile norm tables for men and
Does the assessment tool have performance reliability (Rikli and Jones, 1999a). It is women ages 60 to 94, subdivided into
standards? The first thing people want to also quick and easy to administer and five-year age groups, are also included.
know after taking a test is how they did. score, requires minimal equipment, and
Performance standards improve the is safe to use with a wide range of The key to effective
usefulness and interpretability of test physical abilities. assessments
scores. Ideally, test items include both Assessing the functional fitness
normative and criterion-referenced (An important note for instructors performance of older adults is an
standards. Normative standards make it teaching group classes: the reliability of essential element in designing effective
possible for older adults to compare their each test item was determined using exercise programs for older adults. But
scores with others of the same age and trained older adult volunteers as testing not all assessment tools are the same. We
gender. Criterion-referenced standards technicians.) highly recommend that all senior fitness
provide an important threshold point for instructors meet the recommended
evaluating performance relative to some Each test item has accompanying national standards published by Jones
performance goal, such as maintaining performance standards for men and and Clark (1998) to have the knowledge
the ability to perform everyday activities. women ages 60 to 94-plus based on a necessary to select, administer and
It also provides information to help national study of more than 7,000 interpret fitness assessments.
identify individuals at risk for loss of Americans (Rikli and Jones, 1999b).
mobility. Additionally, the SFT provides threshold C. Jessie Jones, Ph.D., and Roberta E.
values on each test item (criterion- Rikli, Ph.D., are professors in the Division
One new assessment tool available to reference points) that help to identify if of Kinesiology and Health Promotion at
instructors is the Senior Fitness Test an older adult is at risk for mobility loss California State University, Fullerton. For
(SFT), which evaluates the functional (Rikli and Jones, 2001). more information, contact
fitness performance of older adults (Rikli
and Jones, 2001). The accompanying sidebar provides a
brief overview of the test items in the
New test to assess functional Senior Fitness Test, as well as the score
fitness indicating whether a person is at risk for
The SFT measures the underlying loss of functional mobility. Tables 1 and
physical parameters associated with 2 give normal range scores for men and
functional ability, and identifies whether women, with normal defined as the
an older adult may be at risk for loss of middle 50% of the population.
functional ability. The SFT meets Participants scoring above the normal

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The Senior Fitness Test items:


a brief overview
________________________________
References Table 1: Normal range of scores for men, with normal defined as the middle 50% of the population. Those
Alliance for Aging Research. (1999). Independence scoring above this range would be considered above average for their age and those below the range as below
for older Americans: An investment for our nation’s average.
future. Washington, DC: Alliance for Aging
Research
Normal Range of Scores - Men
Blair, S.N., Dunn, A.L., Marcus, B.H., Carpenter,
R.A., and Jaret, P. (2001). Active Living Every Day.
Champaign, IL: Human Kinetics 60-64 65-69 70-74 75-79 80-84 85-89 90-94
Chair stand
Dishman, R. (1998). Exercise Adherence.
Champaign, IL: Human Kinetics (no. of stands) 14 - 19 12 - 18 12 - 17 11 - 17 10 - 15 8 - 14 7 - 12
Arm Curl
Evans, W.J. (1995, October). Keys to successful
aging. Paper presented at the International (no. of reps) 16 - 22 15 - 21 14 - 21 13 - 19 13 - 19 11 - 17 10 - 14
Conference on Aging and Physical Activity, 6-Min Walk
Colorado Springs, CO
(no. of yds) 610 - 735 560 - 700 545 - 680 470 - 640 445 - 605 380 - 570 305 - 500
Jones, C.J. & Clark, J. (1998). “National standards 2-Min Step
for preparing senior fitness instructors.” Journal of
(no. of steps) 87 - 115 86 - 116 80 - 110 73 - 109 71 - 103 59 - 91 52 - 86
Aging and Physical Activity: 6, 207-221
Chair Sit-&-Reach
Rikli, R. & Jones, C.J. (2001). Senior Fitness Test (inches +/-) -2.5 - +4.0 -3.0 - +3.0 -3.5 - +2.5 -4.0 - +2.0 -5.5 - +1.5 -5.5 - +0.5 -6.5 - -0.5
Manual. Champaign, IL: Human Kinetics
Back Scratch
Rikli, R. & Jones, J. (1999a). “Development and (inches +/-) -6.5 - +0.0 -7.5 - -1.0 -8.0 - -1.0 -9.0 - -2.0 -9.5 - -2.0 -10.0 - -3.0 -10.5 - -4.0
validation of a functional fitness test for
community-residing older adults.” Journal of Aging 8-Ft Up-&-Go
and Physical Activity, 7, 129-161 (seconds) 5.6 - 3.8 5.7 - 4.3 6.0 - 4.2 7.2 - 4.6 7.6 - 5.2 8.9 - 5.3 10.0 - 6.2
Rikli, R. & Jones J. (1999b). “Functional fitness
normative scores for community-residing older
adults, ages 60-94.” Journal of Aging and Physical Table 2: Normal range of scores for women, with normal defined as the middle 50% of the population. Those
Activity, 7, 162-181
scoring above this range would be considered above average for their age and those below the range as below
Rikli, R. & Jones, J. (1997). “Assessing physical average.
performance in independent older adults: Issues
and guidelines.” Journal of Aging and Physical
Activity, 5, 244-261 Normal Range of Scores - Women
Russek, L., Wooden, M., Ekedahl, S., and Bush, A.
(1997). “Attitudes toward standardized data 60-64 65-69 70-74 75-79 80-84 85-89 90-94
collection.” Physical Therapy, 77, 714-729
Chair stand
Rose, D.J. (in press). “Promoting functional (no. of stands) 12 - 17 11 - 16 10 - 15 10 - 15 9 - 14 8 - 13 4 - 11
independence in older adults at risk for falls: The
Arm Curl
need for a multidimensional programming
approach.” Journal of Aging and Physical Activity (no. of reps) 13 - 19 12 - 18 12 - 17 11 - 17 10 - 16 10 - 15 8 - 13
6-Min Walk
(no. of yds) 545 - 660 500 - 635 480 - 615 430 - 585 385 - 540 340 - 510 275 - 440
2-Min Step
(no. of steps) 75 - 107 73 - 107 68 - 101 68 - 100 60 - 91 55 - 85 44 - 72
Chair Sit-&-Reach
(inches +/-) -0.5 - +5.0 -0.5 - +4.5 -1.0 - +4.0 -1.5 - +3.5 -2.0 - +3.0 -2.5 - +2.5 -4.5 - +1.0
Back Scratch
(inches +/-) -3.0 - +1.5 -3.5 - +1.5 -4.0 - +1.0 -5.0 - +0.5 -5.5 - +0.0 -7.0 - -1.0 -8.0 - -1.0
8-Ft Up-&-Go
(seconds) 6.0 - 4.4 6.4 - 4.8 7.1 - 4.9 7.4 - 5.2 8.7 - 5.7 9.6 - 6.2 11.5 - 7.3

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30-Second Chair Stand Description Description


Number of bicep curls that can be Number of full steps completed in 2
completed in 30 seconds holding a hand minutes, raising each knee to a point
weight of 5 lbs (2.27 kg) for women; 8 midway between the patella (kneecap)
lbs (3.63 kg) for men. and iliac crest (top hip bone). Score is
number of times right knee reaches the
Risk zone required height.
Less than 11 curls using correct form for
men and women. Risk zone
Less than 65 steps for men and women.
6-Minute Walk
Chair Sit-and-Reach
Purpose
To assess lower body strength, needed for
numerous tasks such as climbing stairs,
walking and getting out of a chair, tub or
car. Also reduces the chance of falling.

Description
Number of full stands that can be
completed in 30 seconds with arms Purpose
folded across chest. To assess aerobic endurance, which is Purpose
important for walking distances, stair To assess lower body flexibility, which is
Risk zone climbing, shopping, sightseeing while on important for good posture, for normal
Less than 8 unassisted stands for men vacation, etc. gait patterns and for various mobility
and women. tasks, such as getting in and out of a
Description bathtub or car.
Arm Curl Number of yards/meters that can be
walked in 6 minutes around a 50-yard Description
(45.7 meter) course. (5 yds = 4.57 From a sitting position at front of chair,
meters) with leg extended and hands reaching
toward toes, the number of inches (cm)
Risk zone (+ or -) between extended fingers and tip
Less than 350 yards for men and women. of toe.

2-Minute Step Test Risk zone


Men: Minus (-) 4 inches or more
Women: Minus (-) 2 inches or more

SFT Brief Summary


Purpose ©1999 R.E. Rikli and C.J. Jones
To assess upper body strength, needed
for performing household and other
activities involving lifting and carrying
things such as groceries, suitcases and Continued on page 30
grandchildren.

Purpose
Alternate aerobic endurance test, for use
when space limitations or weather
prohibits taking the 6-minute walk test.

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The Senior Fitness Test items: a brief overview Continued from page 29

Back Scratch back, the number of inches (cm) between maneuvering, such as getting off a bus in
extended middle fingers (+ or -). time or getting up to attend to
something in the kitchen, to go to the
Risk zone bathroom or to answer the phone.
Men: Minus (-) 4 inches or more
Women: Minus (-) 2 inches or more Description
Number of seconds required to get up
8-Foot Up-and-Go from a seated position, walk 8 feet (2.44
m), turn, and return to seated position.

Risk zone
More than 9 seconds.

Purpose
To assess upper body (shoulder) SFT Brief Summary
flexibility, which is important in tasks ©1999 R.E. Rikli and C.J. Jones
such as combing one’s hair, putting on
overhead garments and reaching for a The Senior Fitness Test Manual and
seat belt accompanying training video and
software can be purchased through
Description Purpose Human Kinetics: 1-800-747-4457
With one hand reaching over the To assess agility/dynamic balance, which (U.S.), 1-800-465-7301 (Canada), or
shoulder and one up the middle of the is important in tasks that require quick www.humankinetics.com

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30 The Journal on Active Aging • March April 2002

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