Norwegian reference values for the Short Physical Performance Battery (SPPB): the Troms\xf8 Study

Astrid Bergland,Bjørn Heine Strand

doi:10.1186/s12877-019-1234-8

Abstract

BackgroundThe Short Physical Performance Battery (SPPB) is a common well-established instrument to measure physical performance. It involves a timed 4-m walk, timed repeated chair sit-to-stand test, and 10-s balance tests (side-by-side, semi-tandem, and full-tandem). We aimed to establish reference values for community-dwelling Norwegian adults aged 40 years or older in terms of (1) the total score; (2) the three subtest scores; and (3) the time to complete the repeated chair sit-to-stand test and the walking speed. Additionally, we explored floor and ceiling effects for the SPPB.MethodsThe study population comprised home dwellers aged 40 years or more who participated in the 7th wave of the Tromsø study. A sample of 7474 participants (53.2% women) completed the SPPB. Crude mean values and standard deviations (SD) were evaluated according to sex and age group. Mean values at specific ages were then estimated using linear regression, along with corresponding 95% confidence intervals. Additionally, quantile regression was used to estimate age-specific percentiles (5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles).ResultsConsiderable variability in SPPB scores was observed. The mean SPPB total score of the entire sample was 11.4 (SD 1.3) points. On average, the SPPB total score was 0.28 points greater in men than in women (p < 0.001). Significant sex differences were observed in all five age groups (40–49, 50–59, 60–69, 70–74, 75–79, and 80+ years). The main decline in the physical function occurred in the mid-sixties, with a slightly earlier decline in women than in men. Ceiling effects were observed in all age groups.ConclusionsThe present study provides comprehensive, up-to-date normative values for SPPB measures in community-dwelling Norwegians aged at least 40 years that may be used to interpret the results of studies evaluating and establishing appropriate treatment goals. Because of ceiling effects, the SPPB has important limitations for the assessment of physical functioning across the full spectrum of the community-dwelling adults aged 40+ years. Furthermore, we conclude that performance on the SPPB should be reported in terms of the total sum score and registered time to complete the repeated chair sit-to stand test and timed 4-m walk test.

Highlights

The Short Physical Performance Battery (SPPB) is a common well-established instrument to measure physical performance
Observed ceiling effect for men, defined as more than 20% with the maximum score for the age groups of 40–49; 50–59; 60–69, 70–79 was 80+ was 91, 78, 64, 47, and 36%, respectively
To the best of our knowledge, the present study is the first to provide sex-specific reference values for the SPPB total score, as well as for the three subtests included in the SPPB, in community-dwelling adults aged at least 40 years

Summary

Introduction

The Short Physical Performance Battery (SPPB) is a common well-established instrument to measure physical performance. It involves a timed 4-m walk, timed repeated chair sit-to-stand test, and 10-s balance tests (side-by-side, semi-tandem, and full-tandem). We aimed to establish reference values for community-dwelling Norwegian adults aged 40 years or older in terms of (1) the total score; (2) the three subtest scores; and (3) the time to complete the repeated chair sit-to-stand test and the walking speed. The Short Physical Performance Battery (SPPB) is a wellestablished instrument for the measurement of physical performance, commonly used among community-dwelling adults, nursing home residents, and hospitalized patients [1, 5,6,7,8,9,10,11,12]. The Norwegian translation of the SPPB [21] has shown high reliability in elderly people with and without dementia, living at home or in nursing homes [22]

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