ASSESSMENT TYPEThe stair climb test for older adults (≥65 years) is a field-based assessment of physical function and lower body power (1–6). PURPOSE OF THE ASSESSMENT The stair climb test (also known as stair climb power test) is a clinically relevant, safe, and inexpensive field-based assessment of lower body strength, power, and physical function for older adults (1–6). Prefrail and frail elderly adults can both be differentiated within a group by poor performance on this test (4,7). Although a unified set of normative scores for older adults performing the stair climb power test have not yet been established, readers are encouraged to compare stair climbing speed and/or calculated power results from pre- and postprogram tests to measure improvements in both upper body power and in exercise program effectiveness. INTRODUCTION Power, defined as an expression of rapid force application, is considered a determinant of higher physical function, balance, and mobility in older adults (1,8–12). Pneumatic (hydraulic) and plate loaded resistance training machines have been determined viable instruments for evaluating lower body power in older adults in clinical and health and fitness facilities (13,14). However, resistance training machines are expensive, lack portability, and may not accommodate very large or small people. Lower body power in older adults can be safely and effectively evaluated with surrogate field-based assessments because of their correlation with locomotion, stair climbing, and a number of activities of daily living (ADLs) (1,3). Common field-based assessments have included tasks like rising from a chair, walking up ramps, and climbing stairs (1–4,8,9,13,15). The stair climb power test has been used to assess lower limb power and, therefore, mobility performance and risk of disability in older adults (≥65 years old) (1–5). Stair ascent is an ADL and necessary for maintaining independence in community environments (16). The stair climb power test is an inexpensive, portable, and safe test that has been shown to produce valid and reliable results in older adults (1–5). A number of protocols for administering the stair climb power test exist. The number of stairs required and phases (ascent and descent versus ascent only) vary between test protocols (1–5). A 10-stair ascent only (climbing upward) test procedure will be described in this Do It Right column. It is a relatively simple test to learn and administer and should be considered by health fitness professionals and Clinical Exercise Physiologists (CEP) for use with their older adult clients. Figure 1 depicts the stair climb power test.Figure 1: The stair climb power test.PRIMARY MUSCLE ACTIONS ASSESSED Knee extensor, ankle dorsiflexor, and plantarflexor muscles and hip extensor and knee flexor muscles are most active in producing vertical and horizontal propulsive forces, respectively, during stair ascent (climbing up) (6, 16–18). They include the rectus femoris, vastus intermedius, vastus medialis, vastus lateralis, tibialis anterior, gastrocnemius, soleus, gluteus maximus, biceps femoris, semitendinosus, and semimembranosus muscles. These muscle groups contract concentrically in the stance leg to generate the force needed to perform the test by elevating the bodyweight upward so that the contralateral (opposite) foot is raised up and placed on top of the next step (7,16–18). This is sometimes referred to as the “pulling up” or “pull-up” phase. In addition, the gluteus medius and hamstring muscle group provide medial and lateral control and stability in the stance leg and the trunk, respectively (16). The hip flexors (iliopsoas), the hamstrings, and the ankle and toe dorsiflexors (tibialis anterior and extensor digitorum longus, extensor hallucis longus, and peroneus tertius) contract concentrically to help place the contralateral foot on top of the next step. Figure 2 depicts an anterior and posterior view of active muscles during the stair climb power test.Figure 2: Active anterior and posterior muscles during the stair climb power test.EQUIPMENT To administer the stair climb power test, a stairway with at least 10 stairs and accessible handrails, a scale (for measuring body weight), a stopwatch, and a calculator are required. SAFETY POINTS The stair climb power test is a simple, two-trial task assessment. Clients climb 10 standard stairs as fast as they can safely (1). Clients should be screened for and free of musculoskeletal injuries, which would make performing this test unsafe and also should receive prior medical clearance, if deemed appropriate via the Physical Activity Readiness Questionnaire or prescreening recommendations by the American College of Sports Medicine (19). The stair climb power test should not be performed by clients who have demonstrated unsteadiness when standing, difficulty getting up from a chair, difficulty following simple directions, impulsiveness, or confusion. Table 1 contains contraindications to performing the stair climb power test. Stairs should have arm rails, and clients should be encouraged to hold them lightly (without pulling themselves up the stairs with their arms) for safety (1). The stairs should be deep enough to accommodate the majority of the client’s foot and have a dry nonslip surface. The testing area should be well lit and free of glare. A spotter should ascend the stairs behind the client at approximately a 45° angle for safety. A gait belt can be worn by clients requiring additional security (see video footage). It should be adjusted firmly while allowing enough room for the spotter to slide their hands and fingers between the belt and the client’s waist. Before testing, the examiner should clearly explain the purpose and procedures of the test and then demonstrate it once slowly and then at full speed. It is prudent for the examiner to ask the client to explain in their own words the directions they just received and to ask them if they have any questions. To enhance safety and effective learning, clients should perform at least one to two practice trials at a slower speed and have at least 3 minutes of recovery time before the actual testing. Clients demonstrating difficulty or unsteadiness during the practice trial should not perform the stair climb power test. A general 5- to 10-minute warm-up before testing is prudent. For the purpose of viewing the entire test, the spotter has been purposely omitted. Figure 3 depicts proper spotting during the stair climb power test. Please refer to the supplemental video (https://links.lww.com/FIT/A146) for demonstrations of proper administration, execution, and spotting during the stair climb power test.TABLE 1: Contraindications to the Stair Climb TestFigure 3: Proper spotting during the stair climb power test.TESTING PROCEDURES Participants are timed as they climb a 10-step flight of stairs as quickly as possible. Handrail use is allowed if required. The test and timing begin with the examiner saying, “ready, set, go,” and starting the stopwatch once the participant begins moving. Timing stops when both of the client’s feet reach the top step (step 10). Two trials should be administered. Record time to the nearest 0.01 second and use the average of two trials. Allow 2 minutes recovery between the two trials. The mean time necessary to climb all 10 stairs from two test trials should be calculated. Bean et al. (1) have reported the test–retest reliability for the stair climb power test as excellent (with a reliability of 0.99 or R = 0.99). Either total ascent time or power can be used before and after exercise interventions to determine goals and measure progress. Power can be calculated by using the following formula: power = force × velocity. Velocity is calculated with the total vertical distance of all the stairs ascended (in meters) divided by the time taken to ascend all the stairs. To measure the vertical component, the test administer will need to measure the perpendicular height from the floor to the 10th step in meters. This can be easily done by measuring the vertical height of the bottom step and multiplying by 10. Force is measured with the mass of the client multiplied by acceleration due to gravity (9.8 m/s−2) or mass times 9.8 m/s−2 (1,5). Although the stair climb power test is a quantitative assessment (how fast the task was completed), additional value can be derived by making qualitative observations (the manner in which the test was performed and movement strategies employed) of body position, posture, time spent on each foot, coordination, steadiness, and movement symmetry during the test. Although a detailed discussion of signs of movement dysfunctions in older adults during ambulation tasks is beyond the scope of this article, exercise professionals should recognize general signs indicating that their clients are having difficulty performing tasks like walking, stepping, squatting, and climbing. Table 2 describes observable signs of potential movement dysfunctions and their potential causes. They can raise safety concerns and also serve as exercise program targets for improving physical function. Figure 4 depicts vertical measurement of a step. Figure 5 depicts commonly observable signs of potential movement dysfunctions.TABLE 2: Movement Observations and Underlying MechanismsFigure 4: Vertical measurement of a step.Figure 5: Common observable signs of potential movement dysfunctions. A, Forward flexion of the spine. B, Limited hip flexion and lateral deviation of pelvis. C, Lateral tilt of pelvis away from stance leg (Trendelenburg sign). D, Inability to dorsiflex the ankle to clear the step.SUMMARY The stair climb power test is a safe, valid, reliable, and inexpensive field assessment of lower body power and function in older adults. It can be adapted to meet the needs of apparently healthy elderly clients and frailer clients with a number of chronic medical conditions (4). It is easy to administer, and exercise professionals can use the results to better develop individualized exercise programs and to monitor program results and effectiveness.