COSMIN database

Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review

Mijnarends, D. M., Meijers, J. M., Halfens, R. J., ter Borg, S., Luiking, Y. C., Verlaan, S., Schoberer, D., Cruz Jentoft, A. J., van Loon, L. J., and Schols, J. M.
BACKGROUND: This study critically appraises the measurement properties of tools to measure muscle mass, strength, and physical performance in community-dwelling older people. This can support the selection of a valid and reliable set of tools that is feasible for future screening and identification of sarcopenia.

METHODS: The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane were systematically searched (January 11, 2012). Studies were included if they investigated the measurement properties or feasibility, or both, of tools to measure muscle mass, strength, and physical performance in community-dwelling older people aged >/=60 years. The consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist was used for quality appraisal of the studies.

RESULTS: Sixty-two publications were deemed eligible, including tools for muscle mass (n = 16), muscle strength (n = 15), and physical performance (n = 31). Magnetic resonance imaging, computed tomography, and a 4-compartment model were used as gold standards for muscle mass assessment. Other frequently used measures of muscle mass are dual-energy x-ray and the bioelectrical impedance (BIA); however, reliability data of the BIA are lacking. Handheld dynamometry and gait speed or a short physical performance battery provide a valid and reliable measurement of muscle strength and physical performance, respectively.

CONCLUSIONS: It can be concluded that several tools are available for valid and reliable measurements of muscle mass, strength, and performance in clinical settings. For a home-setting BIA, handheld dynamometry and gait speed or a short physical performance battery are the most valid, reliable, and feasible. The combination of selected instruments and its use for the screening and identification of sarcopenia in community-dwelling older people need further evaluation.
J Am Med Dir Assoc
1538-9375 (Electronic)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
Functional status:
Physical functioning
Seniors (65+)
Codes for special purposes
Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
8 - Imaging tests
9 - Laboratory tests
4C model - 4 Compartment model
5STS - Fives times Sit-to-Stand Test [Alias: 5RT - five repetition sit-to-stand test]
Accelerometry [alias: accelerometer]
BIA - Bioelectrical Impedance Analysis
BOD POD - measure of air displacement plethysmography
chest press
Circumference measures (versions: circumference of: metacarpal heads; Finger; Calf; Thigh)
CT - Computed Tomography
Dumbbell (press)
DXA-lean body mass REE - DXA-lean body mass Resting Energy Expenditure
Elastic bands
Equation for LBW - Equation for Lean Body Weight
F8W - Figure-of-eight Walk Test [alias: Figure-of-eight] [alias: Figure-8 walk]
FRT - Functional Reach Test   
Fullerton Functional Fitness Test battery
GaitRite walkway system
Gait speed (versions: 4MGS; 10MGS)
HHD - Hand-Held Dynamometer (Hand-held dynamometry with pulley force sensor)   
Isokinetic dynamometer
Leg press (versions: Isometric)
MAT-sf - Mobility Assessment Tool
MMT - Manual muscle testing
Modification scale: chair rise, stair ascent, kneel, supine rise
MRI - Magnetic Resonance Imaging (versions: 2D MRI; 3D MRI; pMRI; sMRI; vMRI; rsMRI)
PFP - Physical Functional Performance (Continuous scaled)
Physical capacity evaluation: walking speed, grip, etc.
PLate with spring gauge
PPT - Physical Performance Test
Pull down
Self-reported physical function
Single frequency
Sit to stand 10 times [alias: TST - Timed Stands Test]
Skin-fold thickness
SPPB - Short Physical Performance Battery   
Stair Climbs
Standing balance
STS - Sit-to-stand test (versions: 5timesSTS/FTSTS; 20sSTS; 30sSTS; 60sSTS; STST1 - 1 min STS; 2minSTS; 3minSTS; 10times STS)
Tandem Stance [alias: sharpened Romberg] (versions: Tandem and Unipedal Stance; semi-tandem; parallel)
Trunk Flexibility
TUG - Timed Up and Go test   
UEPB - Upper Extremity Performance Battery