Measuring physical capability Background

These slides can be used freely, translated and adapted to national use (e.g. concerning the equipment and fieldwork organization). However, it is important to keep in mind that no changes should be made to the measurement techniques, which need to be standardized.

Physical capability Physical capability refers to an individual’s capacity to undertake physical tasks of everyday living (such as rising from a chair, walking at normal speed, carrying heavy loads) Handgrip strength and chair stand tests are objective measures of physical capability (Kuh et al. 2014; Cooper et al. 2010)

Correlates of poor physical capability Musculoskeletal disorders (for example arthritis, rheumatic disorders) (Kuh et al. 2005) Chronic diseases (for example CVD) (Bohannon 2015; Kuh et al. 2014; Leong et al. 2015) Sedentary lifestyle, particularly lack of physical activity (Kuh et al. 2005; Leong et al. 2015) Poor nutritional status (Bohannon 2015) Genetics 14 – 60 % of differences in handgrip strength can be explained by genetics (Silventoinen et al. 2008; Tiainen et al. 2004)

Poor physical capability as a risk factor Poor physical capability, especially at older age relate with higher risk of Mortality (Cooper et al. 2010) Cardiovascular disease (Cooper et al. 2011) Accidents (falls) and fractures (Cooper et al. 2011) Cognitive decline (Cooper et al. 2011) Restrictions in daily activities (Kuh et al. 2014)

Muscle strength and physical capability Measured handgrip strength and chair stand test performance reflect level of muscle strength (Bohannon et al. 2010; Bohannon 2015) Muscle strength is required for activities of daily living such as stair rising or walking or carrying shopping bags (Macaluso & De Vito 2004; Rantanen et al. 1999) Ageing is related to lower muscle strength (Macaluso & De Vito 2004)

Handgrip strength Peak in 4th decade of life and starts to decline around 5th or 6th decade (Kuh et al. 2014) Relate to gender and height (Leong et al. 2015; Kuh et al. 2005) Low handgrip strength is predictive of difficulties in everyday tasks like toileting, dressing and doing heavy household work (Rantanen et al. 1999)

Example of classification of hand grip strength Women Men Low 17kg 28kg Medium 25kg 39kg High 32kg 50kg Based on 139 691 participants, median age 50 years, representing low-, middle- and high-income countries over the world Grip strength measured by Jamar dynamometer (Leong et al. 2015)

Chair stand test Affected by strength, sensorimotor function, balance, psychological factors such as pain or motivation (Lord et al. 2002) Obesity and higher weight related with poorer performance (Kuh et al. 2014, Lord et al. 2002) In general young subjects perform faster on timed chair test (Bohannon et al. 2008; Kuh et al. 2014) Poor performance or unability to perform predict functional disability in everyday tasks (Kuh et al. 2014)

Strengths of physical capability measurements Both handgrip strength and chair stand tests are Quick to perform (take less 3 minutes) Easy Cheap to perform Only handgrip strength measurement requires a special device

Reporting bias Objective measurements of physical capability using standardized assessment complement self-report Objective measurements provide improved validity and reproducibility ability to capture change over time comparability across studies due to reduced impact of cognitive function, culture, language and education possibility to study the variation across a broader spectrum of function (Kuh et al. 2014)

Acknowledgements Slides prepared by: Heini Wennman, Hanna Tolonen, Päivikki Koponen Photographs: Hanna Tolonen Test demonstrations by voluntary participants Experiences and feedback from the EHES network have been utilized in the preparation of these slides Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in 2009-2012 through SANCO/2008/C2/02-SI2.538318 EHES and Grand Agreement number 2009-23-01, and in 2015-2017 through Grand Agreement number 664691/BRIDGE Health

Disclaimer The views expressed here are those of the authors and they do not represent the Commission’s official position.

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