Modified - Physical Performance Test

Testing Protocol: Administer the test as outlined below. Subjects are given up to two chances to complete each item. Assistive devices are permitted for tasks 6 – 9.

1. Standing Static Balance
•	Feet together: “Stand still with your feet together as demonstrated for 10 seconds.”
•	Semi Tandem: “Stand with the heel of one foot placed to the side of the 1st toe of  the opposite foot for 10 seconds.”  Subject chooses which foot goes forward.
•	Tandem: “Stand with the heel of one foot directly in front of the other foot, for 10 seconds.  Subject chooses which foot goes forward.

2. Chair Rise: Use a straight back chair with a solid seat that is 16” high. Ask participant to sit on the chair with arms folded across their chest.  “Stand up and sit down as quickly as possible 5 times, keeping your arms folded across your chest.”  Stop timing when the participant stands the 5th time.

3. Book Lift: Place a Physician’s Desk Reference Book (1988 PDR: 5.5 lbs) or other heavy book on a table in front of the patient. Ask the patient, when given the command “go” to place the book, as quickly as they can, on a shelf above shoulder level. Time from the command “go” until when the book is resting on the shelf.  Starting position is with their hands at their side.

4. Put on and remove a jacket: If the subject has a jacket or cardigan sweater, ask them to remove it. If not, give the subject a lab coat. Ask the subject, on the command “go” to quickly put the coat on completely such that it is straight on their shoulders and then remove the garment completely. Time from the command “go” until the garment has been completely removed.  Hint: it is more accurate to time putting on the garment, then pause (pause the stopwatch), then time taking off the garment.

5. Pick up a penny from floor: Place a penny approximately 12 inches from the patient’s foot on the dominant side. Ask the patient, on the command “go” to pick up the penny from the floor and stand up.  This is to be done as quickly as they can; yet allowing for safety and comfort. Time from the command “go” until the subject is standing erect with a penny in hand.  If dexterity is a problem, a pen or similar lightweight object can be used

6. Turn 360 degrees: Ask the subject to turn 360 degrees “as quickly as you can, as you feel comfortable and safe”. Evaluate using the scale on PPT scoring sheet.  Additional data: count the number of steps required.

7. 50-foot walk test: Bring subject to start on a 50 foot walk test course (25 feet out and 25 feet back) and ask the subject, on the command “go” to walk as quickly as they can to the 25-foot mark and back. Time from the command “go” until the starting line is crossed on the way back.

8. Stairs: Take vital signs.  Bring subject to foot of stairs (nine to 12 steps) and ask subject, on the command ”go” to begin climbing up to a total of 4 flights stairs (as quickly as they can, as they feel comfortable and safe) or until they feel tired and wish to stop. Before beginning this task, alert the subject to the possibility of developing chest pain or shortness of breath and inform the subject to tell you if any of these symptoms occur. You will walk with the subject. Time from the command “go” until the subjects’ first foot reaches the top of the first flight of stairs. Go on to record the number of flights (maximum is four) completed (up and down is one flight).  Provide a chair for resting when completed, so vital signs can be taken immediately post.

Scoring:	32/36 - 36/36 = not frail	
25/36 - 31/36 = mild frailty						17/36 - 24/36 = moderate frailty			
< 17/36        = unlikely to be able to function in the community	

Brown, M., Sinacore, D.R. (2005). Physical and Performance Measures for the identification of mild to moderate frailty. 
           J Gerontol A Biol Sci Med Sci 55:M350-5

Modified - Physical Performance Test 

1. 	Standing Static Balance
	Feet Together: ________ sec.	Semi Tandem: ________ sec.	Tandem: ________ sec.	Score	
		10s.	10s.	 10s.	 4	
		10s.	10s.	 3-9.9s.	 3	
		10s.	10s.	 0-2.9s.	 2	
		10s.	 0-9s.	Unable 	 1	
		 0-9s.	Unable	Unable	 0	
	
	Time
	Scoring values	Score	
2.
	Chair rise		≤ 11 sec            = 4
11.1--14 sec      = 3
14.1--17 sec    = 2
>17 sec             = 1
unable               =  0		
3.	Lift a book and put it on a shelf
    
		≤ 2 sec            = 4
2.1--4 sec        = 3
4.1-- 6 sec       = 2
> 6 sec             = 1
unable            =  0		
4.	Put on and remove a jacket
		≤ 10 sec            = 4
10.1 --15 sec      = 3
15.1 – 20 sec    = 2
>20 sec             = 1
unable               =  0		
5.	Pick up a penny from floor.		≤ 2 sec            = 4
2.1--4 sec        = 3
4.1-- 6 sec       = 2
> 6 sec             = 1
unable            =  0		
6.	Turn 360 degrees	Discontinuous steps            = 0
Continuous steps                = 2		
		Unsteady (grabs, staggers)   = 0
Steady                                  = 2		
7.	50-foot walk test.
  .		≤ 15 sec            = 4
15.1--20 sec      = 3
20.1--25 sec    = 2
>25 sec             = 1
unable               =  0		
8.	Climb one flight of stairs.		≤ 5 sec            = 4
5.1--10 sec      = 3
10.1 – 15 sec    = 2
>15 sec             = 1
unable               =  0		
9.	Climb stairs.	Number of flights of stairs up and down (maximum 4)		
TOTAL SCORE	9-item score	   /36