traditional measure of aerobic fitness. However, because gait speed is both a measure of overall health in older adults and an easy, short, and simple test to administer, it should be included in all fitness assessments and is an appropriate test for almost all settings. Self-selected gait speed can be assessed over any distance, but 4 meters is most commonly used. Ideally, 2 meters should be allowed for acceleration and deceleration on either side of the test. This means that if gait speed is tested over 4 meters, an 8-meter course should be used to allow for 2 meters for acceleration, 4 meters for testing, and 2 meters for deceleration. When testing self-selected gait speed, patients should be instructed to start walking at their normal speed. Timing begins once they cross the 2-meter mark and ends when they cross the 6-meter mark, with 2 meters remaining to allow for deceleration. To obtain the gait speed, the distance (i.e., 4 meters) is divided by the time in seconds that it took to complete the test. Two trials should be completed and the average of the two trials taken to ensure the most reliability. A minimal clinically important difference for gait speed depends on the specific population measured, but generally is 0.1 meter per second for community-dwelling older adults (Middleton et al., 2015). Normal values for self-selected gait speed broken down by age and gender can be found in Table 11. is ready, they assume a seated position. At the word “Go,” the participant stands up and sits back down as many times as possible in 30 seconds. Only full chair stands are counted, but if the individual goes more than halfway on the last repetition, it should be counted. Any adaptations a person may have needed for chair height, the use of arms, or required assistance to complete a chair stand must be described. The range of normal values for the 30-second chair stand test for both males and females can be found by referring back to Table 11. These normal values apply only when the test is not modified. Grip strength Grip strength is a significant check-in with a client, as it tells how their strength functionally impacts ADL skills (Caughlin et al., 2022). This skill is used to generally characterize upper extremity strength and is predictive of functional abilities in older adults (Eckstrom et al., 2020). A hand- held dynamometer is a device used to measure grip that is available in most clinical settings and easily transported for use outside of the clinic (Shirley Ryan Ability Lab, 2022). Older adults with poor grip strength generally have poor overall function and are at risk for future declines and increased risk of mortality compared to older adults with good grip strength, which possibly explains the good responsiveness relating the test to upper arm pain (Eckstrom, 2020; Shirley Ryan Ability Lab, 2022). To test grip strength, the patient should be seated with feet flat on the floor. The forearm should rest on an armrest with the elbow flexed 90 degrees and the forearm in a neutral position with thumb facing upward. The patient should be instructed to squeeze the dynamometer as hard as possible until told to stop. Once the patient starts squeezing, verbal encouragement can be given until the needle of the dynamometer stops rising, which indicates that their maximum force has been reached. Three trials on each arm, alternating sides between tests, should be completed, and the single highest grip score from all six trials should be used as the patient’s grip strength score (Shirley Ryan Ability Lab, 2022). The normal values for grip strength for both the left and right hands for males and females can be found in Table 11.
Lab, 2022). The norms presented in Table 11 are only for those individuals who did not touch another object during the test. Using hands during this test causes an individual to score a 0. In those instances, if the individual puts a fingertip on the wall, a measurement of where the fingertip was placed or how many fingers were used from one point in time to another will be used to indicate progress. The use of fingertips to balance initially and progressing to not needing any upper extremity support would also be significant. Self-selected gait speed Self-selected gait speed is increasingly recognized as an important measure of overall health in older individuals (Studenski et al., 2011). It can be used in a variety of settings and with a wide range of diagnoses, making it an ideal measure for many therapists (Middleton et al., 2015). Slow gait speed is a predictor of functional decline, disability, falls, and mortality in older adults (Guralnik et al., 2000; Hardy et al., 2007; Studenski et al., 2011). Improvements in gait speed are associated with decreased mortality (Hardy et al., 2007), and physical therapy interventions can result in improved gait speed (Barthuly et al., 2012; Braden et al., 2012; Middleton et al., 2015). Gait speeds of less than 1 meter per second identify older adults at high risk of negative health-related outcomes and increased mortality (Studenski et al., 2011). Self-selected gait speed is not a How to measure changes after resistance exercise In a gym or a research setting, progression with resistive exercise has traditionally been documented using a one- repetition max test or a dynamometer. A one-repetition max test is a measure of the maximum amount of weight that can be moved one time through a full range of motion with good form. Hand-held or computerized dynamometers have been used in research settings to assess maximal isokinetic and isometric strength; however, few practitioners have this equipment. Additionally, the time and equipment necessary for a one-repetition max test may not be available in all settings. Use of the timed chair rise, grip strength, and Short Physical Performance Battery (SPPB) tests will allow for measurement of both lower and upper extremity strength and will also allow for documenting progression with resistive exercise in almost all settings with only minimal equipment needed. 30-second chair stand The 30-second chair stand (30CST) is a simple test to assess lower extremity strength that can be used in almost any setting with a minimal amount of equipment (Cobo et al., 2020). It can also be self-administered by a patient at home without supervision (Cobo et al., 2020). This test has been used to measure strength in a variety of older adult populations, including healthy older adults, as well as older adults with cardiovascular disease, osteoarthritis, and dementia (Shirley Ryan Ability Lab, 2022). For this test, the number of times a participant moves from sitting to standing in 30 seconds is counted (Shirley Ryan Ability Lab, 2022). Timed chair rise is a good functional measure of lower extremity extensor strength for older adults and is used in combination with other medical exams to assess functional status in older adults (Cobo et al., 2020). The patient should start the test seated in a chair, and the same chair should be used every time testing is performed (i.e., pre- and postexercise testing). The patient should cross their arms over the chest to minimize arm use during this task. The patient should practice one or two chair stands to ensure that they can do it safely without the use of their arms. Patients who are unable to perform even one stand without the use of their arms should be allowed to use their arms to assist in pushing up, but this information should be documented for future reference. Once the participant
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