Table 2.
Included functional tests
| Dimension/Test (references) | Rationale | Performance |
|---|---|---|
| Fitness | ||
| Ekblom-Bak ergometer test [40, 41] | Established test. Takes less than 10 min. Normal values available according to age and sex. Validity tested. Sub-maximal test so should permit performance of other tests shortly afterwards. | Published manual: https://www.gih.se/ekblombaktest |
| 2-minute Step-test [42–46] | Established test, simple, quick, minimal equipment. Normal values available for age ≥ 50. Extrapolated reference value. Values which predict later physical independence available. Validity and reliability tested. | March on the spot as fast as possible without running for 2 min. Lift knees to halfway between patella and SIAS. Count number of steps with right leg. |
| Strength upper extremity | ||
| Handgrip Strength [47–52] | Established test, simple, quick, minimal equipment. Normal values available according to age and sex. Reliability tested for several target groups. Predicts cardiovascular disease and early mortality. Correlated to osteoporosis, general weakness, falls/fractures, diabetes, multimorbidity, dementia, depression, sleeping problems and quality of life. | Sit without arm or back support. Hold elbow at 90° and with a small gap between elbow and trunk. Grip a Jamar hand dynamometer as hard as possible for 3–5 s. Note maximum value. Repeat 3 times per hand. Alternate measurements of right and left so that each hand has at least 20 s to rest between measurements. Use maximum values for right and left. |
| Biceps [42–44] | Established test, simple, quick, minimal equipment. Normal values and values which predict later physical independence available for age ≥ 60. Extrapolated reference value. Validity and reliability tested among older adults. | Sit without arm or back support. Free choice of arm. Start with elbow in full extension and holding a dumbbell (2 kg for women, 4 kg for men). Perform as many full flexions of the elbow as possible during 30 s. Examiner holds two fingers on the biceps. Contact with participants underarm ensures full flexion. |
| Strength lower extremity | ||
| 30s Chair-stand [42, 43, 53, 54] | Established test, simple, quick, minimal equipment. Normal values available for younger and older age groups. Extrapolated reference value. Validity and reliability tested among older adults. Validity tested as fitness indicator among younger adults. | Sit on chair, height 45 cm, arms crossed over chest. Rise to full standing position with full extension in knees and hips as many times as possible during 30s. |
| Single-foot Heel Rises [55–57] | Established test, simple, quick, minimal equipment. Normal values available. Associated with knee osteoarthritis, and balance problems, fall risk and mobility impairments in elderly. | Stand on 1 foot on 10° wedge near a wall with balance support of 2 fingers on each hand on the wall. Lift heel as high as possible at the rate of 1 heel rise/s. Use a metronome to hold the pace. Maximum number of repetitions at same pace. |
| Strength trunk muscles | ||
| Plank [58–60] | Established test, simple, quick, minimal equipment. Normal values available. Validity and reliability tested. Endurance in trunk muscles associated with back problems. | Lie on stomach. Lift body in a straight line resting on elbows and toes. Hold position as long as possible. |
| Back Endurance [61–64] | Established test, simple, quick, minimal equipment. Normal values available. Validity tested. Endurance in back muscles associated with back problems in men. | Lie prone on examination bench with SIAS in line with the edge and upper body free. Support with hands on a chair until test starts. Strap lower body to bench with one belt below the hips and one at ankle level. Lift hands and cross arms over chest. Hold upper body parallel with floor for as long as possible. |
| Supine Bridge [58, 60] | Established test, simple, quick, minimal equipment. Normal values available. Validity and reliability tested. Endurance in trunk muscles is associated with back problems. | Lie on back with bent knees. Feet on floor, hip breadth. Hands by ears or crossed over chest. Raise pelvis so that knees, hips and shoulders form a straight line. Hold as long as possible. If still holding at 2 min, extend the dominant* leg at the knee. |
| Mobility | ||
| Sit-Rise [65–67] | Established test, simple, quick, minimal equipment. Normal values available. Correlates to general flexibility. Predicts early mortality. | Stand in front of an exercise mat. Sit down on the mat using as little support as possible. Stand up again with as little support as possible. Maximum 5 points for sitting and 5 points for rising, reduce by 1 point for every point of contact and by 0.5 points for uncontrolled movement. Best of 2 repetitions. |
| Finger-Floor [68–71] | Established test, simple, quick, minimal equipment. Values which predict low back pain and return to work after sick leave for low back pain available. Correlates to reduced back pain after treatment. | Stand with feet together, extended knees, no shoes. Bend forward as far as possible while keeping knees extended. Measure distance from tip of middle finger to floor. |
| Lateral Flexion [72–76] | Established test, simple, quick, minimal equipment. Limited lateral flexion predicts low back pain. Reliability tested. Cut-off values available. | Stand with heels and shoulders against a wall, 15 cm between heels. Arms hanging along sides. Measure from floor to tip of long finger. Bend to the side letting the hand glide down the leg. Measure distance from floor to tip of long finger. Mean of left and right. |
| Beighton Hypermobility Score [77, 78] | Established test, simple, quick, no equipment. General hypermobility associated with joint pain. Accepted system for grading degree of hypermobility. | 1 point for each of the following: at least 90° extension in little finger, > 10° hyperextension in elbow or knee, can bend the wrist enough for the thumb to touch the underarm, standing with extended knees can place palms on floor. All tests made bilaterally except for the standing flexion. |
| Balance | ||
| Stand-on-one-leg-eyes-open [79, 80] | Established test, simple, quick, minimal equipment. Normal values available but tested with maximum 2 min. Validity and reliability tested. Measures static balance. | Stand on one leg without support for as long as possible without moving the foot on the floor. Free choice of leg. Arms hanging at sides from start but arm movement may be used to maintain balance. Maximum 3 min. |
| Stand-on-one-leg-eyes-closed [80] | Established test, simple, quick, minimal equipment. Normal values available but tested with maximum 2 min. Validity tested. Measures static balance. | Stand on one leg with eyes closed without support for as long as possible without moving the foot on the floor. Free choice of leg. Arms hanging at sides from start but arm movement may be used to maintain balance. Maximum 3 min. |
| Functional Reach [81–86] | Established test, simple, quick, minimal equipment. Normal values available. Validity and reliability tested. Correlates to Bergs balance test and to fall risk. Measures dynamic balance in the sagittal plane. | Stand with right side towards a wall but without touching, wearing comfortable shoes. Stretch right arm forward to 90°. Mark starting point on the wall from the tip of the middle finger. Stretch as far forward as possible without moving the feet or touching the wall. Mark the furthest point from the tip of the long finger. Measure horizontal distance between the 2 points. Best of 2 tries. |
| Lateral Reach [82, 83, 87] | Established test, simple, quick, minimal equipment. Normal values available. Validity and reliability tested. Measures dynamic balance in the frontal plane. | Stand with back towards a wall but without touching, wearing comfortable shoes. Stretch one arm to the side to 90°. Mark starting point on the wall from the tip of the middle finger. Stretch as far to the side as possible without moving the feet, touching the wall, bending the knees or twisting the trunk. Mark the furthest point from the tip of the long finger. Measure horizontal distance between the 2 points. Repeat 3 times/side. Use mean values. |
| Sharpened Romberg [88, 89] | Established test, simple, quick, minimal equipment. Normal values available. Validity and reliability tested. Calculated reference value. | Stand heel to toe with the dominant foot forward. Arms crossed over the chest. Eyes closed. Time until eyes open, foot moves or support is taken with hands. Repeat 3 times. Use mean value. Maximum 3 min total for 3 repetitions. |
| Posture | ||
| Occiput-to-wall [90] | Established test, simple, quick, minimal equipment. Normal values available. Related test, Tragus-to-wall, is validity and reliability tested and correlates to Occiput-to-wall. Correlates to radiological deviations and other mobility and postural measurements. | Stand with back towards a wall, heels 10 cm from the wall, wall contact with pelvic region and thoracic spine. Pull in chin and press back of head against the wall. Contact– yes or no. |
| Navicular Drop [91–93] | Established test, simple, quick, minimal equipment. Recommended values available. Validity and reliability tested. Measures pronation which is associated with low back pain, pain and injuries in the lower extremity and predicts ankle injuries in children who play sports. | Stand barefoot with most weight on one foot. Os navicularis is marked with a pen on the non-weightbearing foot. Examiner adjusts foot into neutral position and measures the distance between the floor and os navicularis. Redistribute weight to normal standing position. Measure distance from floor to os navicularis once more. Use difference between measurements for each foot. |
| Patella Mobility in Standing [94, 95] | Established test, simple, quick, no equipment. Patella is locked if knee is flexed or hyperextended. Hyperextension is associated with knee pain among the obese and predicts knee injuries among children who play sports. | Stand relaxed in habitual pose. Examiner tests patella mobility. Locked– yes or no. |
SIAS = spina iliaca anterior superior; *dominant leg defined by preferred leg to kick a ball