Senior Fitness Testing

Definition

Senior fitness testing assesses aerobic fitness, muscular strength and endurance, and flexibility in older people, as well as in others with physical limitations that make standard fitness testing inappropriate, dangerous, or impossible. Senior fitness testing may include standard fitness tests that are appropriate for seniors or are easily adapted to their special needs or limitations. Other tests are designed specifically for seniors and may include assessments of manual dexterity, fine- and gross-motor coordination, and agility. In particular, senior fitness testing aims to assess functional fitness—the ability to carry out daily tasks safely and effectively. Therefore the tests involve everyday activities, such as walking, standing up from a chair, bending, lifting, and stretching.

Purpose

Older adults require aerobic capacity or cardiorespiratory fitness, muscular strength and endurance, and flexibility, not just to enjoy their “golden years,” but to be able to accomplish daily tasks and continue to live independently. Furthermore, more adults than ever are continuing to work long past traditional retirement age. Although physical abilities tend to decline with age, much of this decline is preventable, and possibly even reversible, with appropriate physical activity and fitness. Senior fitness testing can detect and address physical weaknesses at an early stage, before serious functional limitations develop. Test results can be used to develop individualized strength and conditioning routines for use at home or in physical therapy.

Description

Most senior fitness tests are simple to conduct and do not require specialized equipment. They usually include components of three similar test batteries:

Aerobic fitness

Walking tests are commonly used to measure the aerobic fitness of seniors. Since walking tests may not require maximal aerobic capacity, they may not be appropriate for younger or more physically fit seniors.

The Groningen walk test is a variation of the standard beep test without sharp turns. It is performed on a flat, rectangular course of 54.69 ft. (16.67 m) by 27.33 ft. (8.33 m), for a perimeter of 164 ft. (50 m), with six alternating yellow and orange marker cones placed every 27.33 ft. (8.33 m). The course is walked counterclockwise around the cones to the pace of beeps on a recording, beginning at 2.5 mph (4 kph). Every three minutes, the pace increases by 0.62 mph (1 kph), to a maximum of 4.35 mph (7 kph). The test continues until the subject quits, fails to keep pace, or completes the last stage. Failing to keep pace is defined as being more than 9.8 ft. (3 m) from the next cone for two consecutive beeps. The score is the number of 54.69-ft. (16.67-m) stages completed, with 66 as the highest possible score.

The 0.5-mile (880-yd., 0.8-km, 805-m) walk tests aerobic endurance. It can be performed on a track or field with marked distances. Participants walk at their own pace, but as quickly as possible. Rest stops are permitted. The time is recorded in minutes and seconds.

The six-minute timed walking test is an adaptation of the Cooper 12-minute run. The rectangular course is 45 yd. (41 m) by 5 yd. (4.6 m) with cones at regular intervals. Subjects walk as quickly as possible at their own pace and can rest in chairs placed at intervals. The distance covered in six minutes is measured.

The two-minute step-in-place test is appropriate for people who use orthopedic devices or have trouble balancing. The subject stands straight against a wall and a tape is placed halfway between the knee cap and the top of the hipbone. The subject marches in place, lifting the knees to the height of the tape. Holding onto the wall or a stable chair and resting are permitted. The score is the number of times the right knee is lifted to the tape in two minutes.

Strength and endurance

The arm-curl test is a seated biceps curl that measures upper-body muscular strength and endurance. Seated in a chair without armrests, the subject grasps a weight in a suitcase grip (palm facing the body), using the stronger or dominant arm and seated near that side of the chair. Women use 4–5-lb. (1.8–2.3-kg) weights and men use 8-lb. (3.6-kg) weights. The arm is held straight down beside the chair and the upper arm is held against the body or held steady by a partner, so that only the lower arm moves. The forearm is curled up through the elbow's full range of motion and the palm is gradually turned upward. The arm is returned to the starting position through its full range of motion. The arm curl is repeated as many times as possible in 30 seconds.

The handgrip-strength test assesses upper-body strength by measuring the isometric strength of the hand and forearm with an instrument called a dynamometer. The handgrip test is often used to test overall strength. The dynamometer is gripped with the hand hanging by the side and squeezed as tightly as possible. The best of three attempts is scored, with a 30-second rest between attempts.

The chair-stand test for the lower body assesses leg strength and endurance. A straight-backed or folding chair, with a seat 17 in. (44 cm) high and without armrests, is placed against a wall. The subject sits in the center of the seat, with feet shoulder-width apart and flat on the floor. One foot may be slightly in front of the other. The arms are crossed at the wrists and held close to the chest. The subject stands completely up and sits completely down as many times as possible in 30 seconds. The arms can be used for assistance or safety.

Flexibility

The back-scratch test measures upper-body flexibility, especially shoulder range of motion. With the subject standing, one hand reaches over the shoulder as far as possible down the middle of the back, with the palm touching the back and the fingers downward. The other arm is placed around the back, palm out, and reaches as far up as possible, trying to touch or overlap the middle fingers of the upper hand. An assistant aligns the fingers of the two hands, measures the distance to the nearest 0.5 in. (1.3 cm), and records the best of two attempts.

The shoulder-circumduction test also assesses shoulder flexibility. A cord with one fixed handle and one sliding handle is adjusted to the subject's shoulder width. Holding a handle in each hand, the subject passes the cord from the front of the body, overhead, and as far back as possible with the arms extended. The score is the fanning-out angle recorded with an instrument.

The chair sit-and-reach test measures lower-body (trunk and leg) flexibility. It is a variation of the standard sit-and-reach flexibility test. The subject sits in a straight-back or folding chair about 17 in. (44 cm) high, placed against a wall. With one foot flat on the floor, the other leg is extended with the knee straight, the heel on the floor, and the ankle bent at 90°. With one hand on top of the other and the tips of the middle fingers even, the subject inhales and then exhales and, bending at the hips, reaches toward the toes of the extended foot. The back should be straight and the head up. The farthest reach is held for two seconds. The distance from the fingertips to the toes is measured to the nearest inch.

KEY TERMS
Aerobic fitness—
Aerobic capacity; cardiorespiratory fitness; the maximum amount of oxygen that can be transported by the heart, lungs, and blood to the muscles and utilized by the muscles during exercise.
Biceps—
The large flexor muscle of the front of the upper arm.
Body mass index (BMI)—
A measure of body fat; the ratio of body weight in kilograms to the square of height in meters.
Circumduction—
Movement of a limb or extremity such that the end closest to the body remains fixed while the other end makes a circle, such as circling the arm from the shoulder.
Dynamometer—
A device for measuring force, such as the strength of the arms, grip, back, or legs.
Fine-motor skills—
Control of the smaller muscles of the body, especially in the hands, feet, and head, for activities such as writing and crafts.
Functional fitness—
The physical ability to safely and effectively carry out tasks of daily life.
Gross-motor skills—
Control of the large muscles of the body, including the arms, legs, back, abdomen, and torso, for activities such as sitting and walking.
Isometric—
Muscular contraction against resistance without significant change in muscle-fiber length.
Normative—
Test performance assessment based on results previously achieved by a selected sample of subjects, rather than by independent or absolute standards.
Manual dexterity, coordination, balance, and agility

The block-transfer test assesses fine-motor skills by measuring the speed at which blocks can be moved in a specific sequence. In a typical test, 40 blocks are moved from holes in one board to holes in a board farther away, in a given sequence, as quickly as possible.

The reaction-time test of fine-motor skills requires a special hand-held module. When the red light in the middle of the module comes on, the subject responds as quickly as possible by pushing a button at the top. The light comes on at intervals of 4–9 seconds. The module displays the reaction times in milliseconds. After three practice trials, 15 trials are recorded.

The soda-pop test measures arm and hand coordination. The subject is seated at a table with an elbow bent about 100–120° and the thumb up. In one version of the test, a soda can in a drawn circle is grasped, inverted into an adjacent empty circle, and then returned to its original position in the first circle as quickly as possible. The process is repeated with two more cans. In another version, six soda cans are turned over in a specified order as fast as possible.

Seniors with poor balance are at risk for falls and injury. The balance board or platform test measures balance and agility. The wooden balance platform is about 20 in. (51 cm) square, with a 0.8-in.-wide (2-cmwide) beam down the middle of the bottom. Stoppers at the corners prevent the board from tilting more than 18°. The subject stands on the platform with the toes pointed outward 15° and the heels 6 in. (15 cm) apart and tries to keep the platform balanced for 30 seconds. The best time of three trials is recorded.

The eight-foot-up-and-go test measures coordination, balance, agility, and speed. A straight-back or folding chair about 17 in. (44 cm) high is placed against a wall. A cone or other marker is set 8 ft. (2.4 m) away. Starting from a fully seated position with hands on the knees and feet flat on the floor, the subject stands and walks as quickly as possible around the cone and sits back in the chair, and the process is timed. A cane or walker may be used.

Precautions

Seniors, as well as anyone who is overweight or has a history of high blood pressure or heart disease, should consult a physician before undergoing fitness testing. Medical screening questionnaires are commonly used before testing. Medical assistance, firstaid supplies, and resuscitation equipment should be available in the testing area. Examiners should be trained in recognizing dangerous symptoms and have an emergency action plan in place.

All safety precautions should be followed. Chairs should be placed against a wall or otherwise stabilized. Tests should never involve running, bouncing, quick movements, or stretching to the point of pain. A test should be terminated immediately if the subject reports pain, dizziness, nausea, excessive fatigue, or other symptoms. Patients with severe osteoporosis should not perform the chair sit-and-reach test.

WHAT TO ASK YOUR DOCTOR

Preparation

The purpose and procedures of each test should be carefully explained. Most senior fitness tests involve one or more practice trials, but these should not cause fatigue. A trial to practice pacing is helpful for the 0.5-mile and six-minute walks.

Aftercare

Test results are clearly explained and may be compared with standardized norms for the subject's gender and age. Specific suggestions for improving fitness should be included. A report may be forwarded to the subject's physician.

Complications

Senior fitness tests are designed to be safe for the elderly and those with physical limitations. Therefore they seldom involve complications.

Results

Tests are scored and interpreted in various ways. The Senior Fitness Test uses normative data based on nationwide performance scores of more than 7,000 men and women between the ages of 60 and 94 who were living independently. Calculators and software are available. Some test results, such as for the sixminute walk, are calculated taking into account gender, age, height, and, for women, body mass index (BMI). However, results are often interpreted in functional terms. For example, fewer than 11 arm curls in 30 seconds indicates risk for the inability to perform activities requiring arm strength. Fewer than eight chair stands in 30 seconds indicates risk for the inability to perform activities requiring leg strength. Taking more than nine seconds on the eight-foot-up-and-go test is considered a risk for being unable to move safely from one place to another.

If the fingertips touch on a scratch test, the score is zero. If they overlap, the score is the positive distance; otherwise the score is the negative distance. Scores are agedependent, but in general, men whose fingertips are more than 8 in. (20 cm) apart and women whose fingertips are more than 5 in. (13 cm) apart are at risk for poor performance in activities that require upper-body flexibility.

See also Senior fitness .

Resources

BOOKS

Lemmink, K.A.P.M., et al. “The Groningen Fitness Test for the Elderly: Composition and Application in Large-Scale Fitness Events.” In Physical Activity, Aging and Sports: Toward Healthy Aging—International Perspectives. Part 2, edited by S. Harris, E. Heikkinen, and W.S. Harris, 221–230. Albany, NY: Center for the Study of Aging of Albany, 1995.

Osness, W.H., et al. Functional Fitness Assessment for Adults Over 60 Years (a Field Based Assessment). Reston, VA: American Alliance for Health, Physical Education, Recreation, and Dance, 1996.

Rikli, Roberta E., and C. Jessie Jones. Senior Fitness Test Manual, 2nd ed. Champaign, IL: Human Kinetics, 2012.

PERIODICALS

Wiacek, Magdalena, et al. “Deterioration of Basic Coordinative Parameters Defines Life Quality of Elderly.” Archives of Gerontology and Geriatrics 49, no. 2 (September/October, 2009): 212–14.

WEBSITES

“The Senior Fitness Test.” Topend Sports. January 13, 2011. http://www.topendsports.com/testing/senior-fitnesstest.htm (accessed August 9, 2011).

ORGANIZATIONS

Cooper Institute, 12330 Preston Rd., Dallas, TX, 75230, (972) 341-3200, (800) 635-7050, Fax: (972) 341-3227, fitnessgram@cooperinst.org, http://www.cooperinstitute.org .

SHAPE America, 1900 Association Dr., Reston, VA, 20191-1598, (800) 213-7193, Fax: (703) 476-9527, http://www.shapeamerica.org .

Sit and Be Fit, PO Box 8033, Spokane, WA, 99203-0033, (509) 448-9438, Fax: (509) 448-5078, sitandbefit@sitandbefit.org, http://www.sitandbefit.org .

Margaret Alic, PhD

  This information is not a tool for self-diagnosis or a substitute for professional care.