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Health-related fitness tests for older adults


The purpose of this prospective study was to analyze the value of health-related fitness tests in predicting the occurrence of mobility difficulties among high-functioning older adults.

In addition, the study described six-year changes in health-related fitness test performance and associations between test performance and physical activity.

The safety and feasibility of the tests were also considered.


The study was based on the Kainuu Study on Living Habits and Health, which is a longitudinal cohort study conducted by the UKK Institute for Health Promotion Research. The study started as a postal questionnaire survey in 1980.

In 1996 and 2002 the assessment of health-related fitness targeted at persons aged 55 years and older was included into the study. The sample of the present study consisted of 55 to 79-year-old men and women who participated in the assessment of health-related fitness in 1996.

The assessment included seven field-based tests that were considered to represent the most important fitness factors for mobility function.

  • Balance was assessed by one-leg stand and backwards walk
  • functional muscle strength of the lower extremities by one-leg squat
  • trunk extensor muscle strength by dynamic back extension
  • flexibility by trunk side-bending
  • walking ability by 6.1-m walking speed and 1-km walking time.

Additionally, body mass index was used as a relative indicator of body composition.

Mobility difficulties and participants’ level of physical activity were assessed by self-reported questionnaires. Participants were regarded as having mobility difficulties if they reported at least some difficulties in walking 2 km or climbing several flights of stairs without a rest.


During six-year follow-up the study sample was selected to younger, healthier and physically more active individuals who performed the baseline health-related fitness assessment better than those who were lost to follow-up.

Over six years performance in health-related fitness tests deteriorated, especially among the older age groups and among women. Deteriorations were greatest in the 6.1-m walk, backwards walk and trunk side-bending tests.

Poor performance in the health-related fitness tests, non-vigorous physical activity and overweight in terms of high body mass index were all independent predictors of new mobility difficulties.

The least active people with the poorest health-related fitness test performance or with overweight had the highest risk of mobility difficulties. The most powerful predictors of risk of mobility difficulties were:

  • backwards walk 
  • dynamic back extension 
  • one-leg squat 
  • 1-km walk. 

Optimal cut-off values predicting mobility difficulties were successfully identified for these tests.

The results suggest that the proposed health-related fitness tests are valid, safe and feasible tools to assess mobility function among high-functioning older adults.

The tests can be used to identify those at increased risk of declining mobility.

The test results can also be utilized in physical activity counseling in order to target activity at those components of fitness that are not adequate for good mobility.

Project finished.


Pauliina Husu, Senior Researcher 



Husu, Pauliina, Predictive value of helath-related fitness tests on mobility difficulties in high functioning older adults. Acta Univesitas Tamperensis 1320. Tampere University Press, Tampere 2008.

Hämäläinen P, Suni J, Pasanen M, Malmberg J, Miilunpalo S. Changes in physical performance among high-functioning older adults: a 6-year follow-up study. European Journal of Ageing 2006;3:3-14.

Hämäläinen P, Suni J, Pasanen M, Malmberg J, Miilunpalo S, Predictive value of health-related fitness tests for self-reported mobility difficulties among high-functioning elderly men and women. Aging Clin Exp Res 2006; 18: 218-226.

Husu P, Suni J, Pasanen M, Miilunpalo S. Health-related fitness tests as predictors of difficulties in long-distance walking among high-functioning older adults. Aging Clin Exp Res 2007;19;444-450.

Husu P, Suni J, Pasanen M, Miilunpalo S. Does physical activity affect the predictive value of health-related fitness tests on walking difficulty? J Phys Act Health 2008;5:732-745.

Husu P, Suni J. Predictive validity of health-related fitness tests on back pain and related disability – a six-year follow-up study among high-functioning older adults. J Phys Act Health 2012;9(2):249-258.

Malmberg JJ, Miilunpalo SI, Vuori IM, Pasanen ME, Oja P, Haapanen-Niemi NA. Improved functional status in 16 years of follow up of middle aged and elderly men and women in north eastern Finland. J Epidemiol Community Health2002; 56:905-912.

Malmberg JJ, Miilunpalo SI, Vuori IM, Pasanen ME, Oja P, Haapanen-Niemi NA. A health-related fitness and functional performance test battery for middle-aged and older adults: feasibility and health-related content validity. Arch Phys Med Rehabil 2002;83:666-677.

Malmberg JJ, Miilunpalo SI, Pasanen ME, Vuori IM, Oja P. Associations of leisure-time physical activity with mobility difficulties among middle-aged and older adults. J Aging Phys Act 2006;14:133-153.

Last updated: 25.11.2020

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