Validity and Reliability of the Short Physical Performance Battery in Two Diverse Older Adult Populations in Quebec and Brazil Predictive value of the Short Physical Performance Battery following hospitalization in older patients. Physical Performance Measures as Predictors of Mortality in a Cohort of Community-dwelling Older French Women The influence of lower-extremity function in elderly individuals' quality of life (QOL): an analysis of the correlation between SPPB and EQ-5D. Performance-Based Versus Patient-Reported Physical Function: What Are the Underlying Predictors? The relationship between physical performance and cardiac function in an elderly Russian cohort. Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. Lower limb function and 10-year survival in population aged 75 years and older. The relationship of physical performance with HIV disease and mortality Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study) Depressive symptoms and physical performance in the lifestyle interventions and independence for elders pilot study. Relationship between physical functioning and physical activity in the lifestyle interventions and independence for elders pilot. Effects of a structured physical activity intervention on measures of physical performance in frail elderly patients after cardiac rehabilitation: a pilot study with 1-year follow-up Pre‐Kidney Transplant Lower Extremity Impairment and Post‐Kidney Transplant Mortality Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: A randomized-controlled cross-over design Are changes in leg power responsible for clinically meaningful improvements in mobility in older adults?
Objectives : To assess the validity and reliability of the Short Physical Performance Battery ( SPPB ) in adults 65 to 74 years old , capable in all basic activities of daily living ( ADL ) , in Quebec and Brazil . Methods : Participants were recruited in St. Bruno ( Quebec ) by local advertisements ( n = 60 ) and in Santa Cruz ( Brazil ) by r and om sampling ( n = 64 ) . The SPPB includes tests of gait , balance , and lower-limb strength . Disability status was categorized as intact mobility , limited mobility , and difficulty in any of ADL . Results : There was a grade d decrease in mean SPPB scores with increasing limitation of lower limbs , disability , and poor health . Using the test – retest reliability the authors evaluated the intraclass correlation coefficient , which was high in both sample s : .89 ( 95 % CI : 0.83 , 0.93 ) in St. Bruno and .83 in Santa Cruz ( 95 % CI : 0.73 , 0.89 ) . Discussion : This study provides evidence for the validity and reliability of SPPB in diverse population BACKGROUND Hospitalization represents a stressful and potentially hazardous event for older persons . We evaluated the value of the Short Physical Performance Battery ( SPPB ) in predicting rates of functional decline , rehospitalization , and death in older acutely ill patients in the year after discharge from the hospital . METHODS Prospect i ve cohort study of 87 patients aged 65 years and older who were able to walk and with a Mini-Mental State Examination score ≥ 18 and admitted to the hospital with a clinical diagnosis of congestive heart failure , pneumonia , chronic obstructive pulmonary disease , or minor stroke . Patients were evaluated with the SPPB at hospital admission , were reevaluated the day of hospital discharge , and 1 month later . Subsequently , they were followed every 3 months by telephone interviews to ascertain functional decline , new hospitalizations , and vital status . RESULTS After adjustment for potential confounders , including self-report activity of daily living and comorbidity , the SPPB score at discharge was inversely correlated with the rate of decline in activity of daily living performance over the follow-up ( p < .05 ) . In a multivariable discrete-time survival analysis , patients with poor SPPB scores at hospital discharge ( 0 - 4 ) had a greater risk of rehospitalization or death ( odds ratio : 5.38 , 95 % confidence interval : 1.82 - 15.9 ) compared with those with better SPPB scores ( 8 - 12 ) . Patients with early decline in SPPB score after discharge also had steeper increase in activity of daily living difficulty and higher risk of rehospitalization or death over the next year . CONCLUSIONS In older acutely ill patients who have been hospitalized , the SPPB provides important prognostic information . Lower extremity performance-based functional assessment might identify older patients at high risk of poor outcomes after hospital discharge This prospect i ve cohort study evaluate the predictive value of physical performance measures for mortality in older French women , in particular those with a high health status . The subjects were 7,250 community-dwelling non-disabled French women aged 75 years or older , enrolled in the Epidémiologie de l’ostéoporose ( EPIDOS ) study .  The short physical performance battery ( SPPB ) , including walking speed , repeated chair st and s , and balance tests , was administered and h and grip strength was measured . Anthropometric measurements , physical function , cognitive performance , sensory status , smoking , medical history , medication use , subjective self- assessment of health status , and physical activity level were assessed at the baseline visit . During a mean follow-up of 3.8 years , 754 ( 10.4 % ) participants died . Complementary analysis was performed on the 2,157 non-disabled healthiest participants ( no disease at baseline ) . The SPPB and h and grip strength distinguished a gradient of risk for mortality from a low to high functional spectrum . Risk of death was 2.04-fold higher in poor ( SPPB 0–6 ) than in good ( SPPB 10–12 ) performers and 1.56-fold higher in participants with lower tertile grip strength . Walking speed alone also distinguished a gradient of mortality risk . After adjustment for confounders , low SPPB , grip strength score and slow walking speed remained significantly associated with death . In the non-disabled healthiest women , no physical performance measure predicted death . In community-dwelling elderly French women , physical performance measures significantly and independently predicted mortality . Increased risk of death was partly explained by baseline health status and was absent in the healthiest elderly BACKGROUND If an association between a decline in physical performance and subjective QOL is confirmed , the SPPB could be used as a predictor for declining  QOL in older people . OBJECTIVE This study aim ed to eluci date the association between the short physical performance battery ( SPPB ) and QOL ( EQ-5D ) to determine the utility of the SPPB as a predictor of declining QOL . METHODS The SPPB and the EQ-5D test were performed with a r and om sample of participants nested in the Korean Longitudinal Study of Aging ( KLoSA ) panel . Comparisons of the adjusted mean scores on the EQ-5D index between normal and abnormal SPPB groups were performed . We selected the quartiles of the EQ-5D index variables for the analysis . The association between the EQ-5D index and SPPB abnormality was examined using multinomial logistic regression analysis . Additionally , the associations between gait speed and chair st and time and the EQ-5D index were examined using the same analysis . RESULTS Four hundred and twenty-two subjects were included in the analysis . The adjusted means for the EQ-5D index were significantly lower when the SPPB score was abnormal ( p=0.022 for men , p=0.047 for women ) . An abnormal SPPB score was significantly associated with the lowest quartile of EQ-5D index score ( adjusted OR 3.54 in the lowest quartile for men ; adjusted OR 2.50 and 3.37 in the lowest and second quartiles for women ) . Gait speed was significantly associated with the EQ-5D index for participants of both sexes , but st and up time was associated with the EQ-5D index only for men . CONCLUSIONS An abnormal SPPB score was associated with lower QOL . Thus , the SPPB has the potential to be used as an early predictor of declining QOL in clinical setting s and epidemiological studies Background Functional limitations have been operationally defined for studies of rehabilitation science through measures of physical performance and patient-reported function . Although conceived as representing similar concepts , differences between these 2 modes of measuring physical functioning have not been adequately characterized scientifically . Objective The purpose of this study was to compare the Short Physical Performance Battery ( SPPB ) with the function component of the Late-Life Function and Disability Instrument ( LLFDI ) with respect to their association with physiologic factors and other psychosocial and health factors potentially influencing rehabilitative care . Design This study was a cross-sectional analysis of baseline data from a sample of community-dwelling older adults ( N=137 ) with mobility limitations enrolled in a r and omized controlled trial of exercise . Methods A performance-based measure of function ( the SPPB ) and a self-report measure of function ( the LLFDI ) served as functional outcomes . Physiologic factors included measures of leg strength , leg velocity , and exercise tolerance test ( ETT ) duration , which served as a surrogate measure of aerobic capacity . Psychosocial and health factors included age , sex , height , body mass index , number of chronic conditions , depression , and falls efficacy . Results Separate multivariable regression models predicting SPPB and LLFDI scores described 33 % and 42 % of the variance in each outcome ( R2 ) , respectively . Leg velocity and ETT duration were positively associated with both performance-based and patient-reported functional measures . Leg strength and age were positively associated with SPPB scores , whereas number of chronic conditions , sex , and falls efficacy were associated with the LLFDI scores . Limitations This study included older adults with mobility limitations and may not generalize to other population s. Conclusions Performance-based and patient-reported measures of physical function appear to assess different aspects of an older person 's functioning . The SPPB was associated with age and physiologic factors , whereas patient-reported function measured by the LLFDI was associated with these factors as well as with psychosocial and health factors This study aims to determine the cardiac dysfunction prevalence , to investigate the relationship between the Short Physical Performance Battery ( SPPB ) test and structural and functional echocardiographic parameters and to determine whether SPPB scores and cardiac dysfunction are independent mortality predictors in an elderly Russian population . A r and om sample of 284 community-dwelling adults aged 65 and older were selected from a population -based register and divided into two age groups ( 65 - 74 and ≥75 ) .  The SPPB test , echocardiography and all-cause mortality were measured . The prevalence of cardiac dysfunction was 12 % in the 65 - 74 group and 23 % in the ≥75 group . The multivariate models could explain 15 % and 23 % of the SPPB score total variance for the 65 - 74 and ≥75 age groups , respectively . In the younger age group , the mean follow-up time was 2.6±0.46 years , and the adjusted hazard ratio ( HR ) for risk of mortality from cardiac dysfunction was 4.9 . In the older age group , the mean follow-up time was 2.4±0.61 years , and both cardiac dysfunction and poor physical performance were found to be independent predictors of mortality ( adjusted HR=3.4 and adjusted HR=4.2 , respectively ) . The cardiac dysfunction prevalence in this elderly Russian population was found to be comparable to , or even lower than , reported prevalences for Western countries . Furthermore , the observed correlations between echocardiographic abnormalities and SPPB scores were limited . Cardiac dysfunction was shown to be a strong mortality predictor in both age groups , and poor physical performance was identified as an independent mortality predictor in the oldest subjects OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity BACKGROUND Scientific societies recommend assessing lower limb function in usual clinical practice . The Short Physical Performance Battery ( SPPB ) is one of the most vali date d tools to assess this , but its capacity to predict long-term mortality in very old population attending primary care has not been studied . OBJECTIVE To assess the ability of the SPPB to predict 10-year survival in individuals aged 75 and over . METHODS Prospect i ve cohort study with a 10-year follow-up . A representative sample of people aged 75 years or older without severe dependence ( Barthel Index > 20 ) treated at a Spanish primary care centre ( n = 315 ) . Baseline evaluation included  geriatric assessment  with most well-known death predictors . The three SPPB subtasks ( st and ing balance , walking speed and chair st and tests ) were administered . Kaplan-Meier curves and Cox proportional hazard models were calculated for all-cause mortality . RESULTS Mean age was 81.9 years ( 60.6 % female ) . Ten-year survival of elders with SPPB score < 7 and ≥7 was 0.23 and 0.37 ( P < 0.001 ) , respectively . This difference remained statistically significant in the Cox model adjusted by age , gender , number of drugs prescribed , cognitive status , body mass index and visual sharpness ( adjusted hazard ratio = 1.37 ; 95 % confidence interval : 1.01 - 1.86 ) . Also , walking speed and chair st and subtasks were both individual-independent predictors of 10-year survival . CONCLUSIONS Our findings indicate that SPPB is an independent predictor of long-term survival . The chair st and subtask could be a predictor as useful as the full performance battery , becoming a good alternative for primary care where the burden of performing all three subtasks could be excessive Objective : To evaluate whether HIV infection was associated with reduced physical performance , and to examine if reduced physical performance predicted mortality in our aging cohort of HIV-infected and HIV-uninfected persons . Design : Prospect i ve , observational cohort of current and former injection drug users in the AIDS Linked to the IntraVenous Experience study in Baltimore , Maryl and , USA . Methods : The  Short Physical Performance Battery ( SPPB )  was used as an objective measure of physical performance and measured semiannually along with behavioral and demographic data . Correlates of reduced physical performance ( SPPB score ⩽10 ) were identified and the relationship between reduced physical performance , HIV infection and mortality was analyzed by Cox regression . Results : Among 12 270 person-visits contributed by 1627 participants , the median age was 51 , 30.3 % were HIV-infected and 32.6 % had an SPPB score 10 or less . In multivariable models , HIV infection was independently associated with 30 % increased odds of reduced physical performance [ odds ratio 1.30 ; 95 % confidence interval (CI):1.12–1.52 ] . Reduced physical performance predicted mortality in a dose-response manner and within all HIV disease strata . Whereas reduced physical performance alone ( hazard ratio 2.52 , 95 % CI : 1.59–4.00 ) and HIV infection alone ( hazard ratio 2.78 , 95 % CI : 1.70–4.54 ) increased mortality , HIV-infected participants with reduced physical performance had a six-fold increased mortality risk ( hazard ratio 6.03 , 95 % CI : 3.80–10.0 ) compared with HIV-uninfected participants with higher physical performance . Conclusion : HIV infection was independently associated with reduced physical performance . HIV and reduced physical performance have independent and joint effects on mortality . Physical performance measurement may be an important research and clinical tool to predict adverse outcomes among aging HIV-infected persons BACKGROUND The Short Physical Performance Battery ( SPPB ) , which includes walking , balance , and chair st and s tests , independently predicts mobility disability and activities of daily living disability . To date , however , there is no definitive evidence from r and omized controlled trials that SPPB scores can be improved . Our objective was to assess the effect of a comprehensive physical activity ( PA ) intervention on the SPPB and other physical performance measures . METHODS A total of 424 sedentary persons at risk for disability ( ages 70 - 89 years ) were r and omized to a moderate-intensity PA intervention or a successful aging ( SA ) health education intervention and were followed for an average of 1.2 years . RESULTS The mean baseline SPPB score on a scale of 0 - 12 , with 12 corresponding to highest performance , was 7.5 . At 6 and 12 months , the PA versus SA group adjusted SPPB ( + /- st and ard error ) scores were 8.7 + /- 0.1 versus 8.0 + /- 0.1 , and 8.5 + /- 0.1 versus 7.9 + /- 0.2 , respectively ( p < .001 ) . The 400-meter walking speed was also significantly improved in the PA group . The PA group had a lower incidence of major mobility disability defined as incapacity to complete a 400-meter walk ( hazard ratio = 0.71 , 95 % confidence interval = 0.44 - 1.20 ) . CONCLUSIONS A structured PA intervention improved the SPPB score and other measures of physical performance . An intervention that improves the SPPB performance may also offer benefit on more distal health outcomes , such as mobility disability Objective Performance measures provide important information , but the meaning of change in these measures is not well known . The purpose of this research is to 1 ) examine the effect of treatment assignment on the relationship between self-report and performance ; 2 ) to estimate the magnitude of meaningful change in 400- meter walk time ( 400MWT ) , 4-meter gait speed ( 4MGS ) , and Short Physical Performance Battery ( SPPB ) and 3 ) to evaluate the effect of direction of change on estimates of magnitude . Design This is a secondary analysis of data from the LIFE-P study , a single blinded r and omized clinical trial . Using change over one year , we applied distribution-based and anchor-based methods for self-reported mobility to estimate minimally important and substantial change in 400MWT , 4MGS and SPPB . Setting Four university-based clinical research sites . Participants Sedentary adults aged 70–89 whose SPPB scores were less than 10 and who were able to complete a 400MW at baseline ( n=424 ) . Interventions A structured exercise program versus health education . Measurements 400MWT , 4MGS , SPPB . Results Relationships between self-report and performance measures were consistent between treatment arms . Minimally significant change estimates were 400MWT : 20–30 seconds , 4MGS : 0.03–0.05 m/s and SPPB : 0.3–0.8 points . Substantial changes were 400MWT : 50–60 seconds , 4MGS : 0.08 m/s , SPPB : 0.4–1.5 points . Magnitudes of change for improvement and decline were not significantly different . Conclusions The magnitude of clinical ly important change in physical performance measures is reasonably consistent using several analytic techniques and appears to be achievable in clinical trials of exercise . Due to limited power , the effect of direction of change on estimates of magnitude remains uncertain OBJECTIVES To determine whether the presence of high depressive symptoms ( Center for Epidemiologic Studies Depression Scale ( CES-D ) score ≥ 14 ) diminished physical performance benefits after a comprehensive physical activity intervention in older adults . DESIGN A post hoc analysis of data from the Lifestyle Interventions and Independence for Elders Pilot ( LIFE-P ) study , a single-blind r and omized controlled trial comparing a moderate-intensity physical activity intervention ( PA ) with a successful aging control ( SA ) . SETTING Multicenter U.S. institutions participating in the LIFE-P trial . PARTICIPANTS Four hundred twenty-four sedentary , noninstitutionalized adults aged 70 to 89 .  MEASUREMENTS Depressive symptoms were assessed using the CES-D. Physical performance tests included the Short Physical Performance Battery ( SPPB ) and 400-m walk time ( 400 mw ) at baseline and 6 and 12 months . RESULTS Of the participants , 15.8 % had high depressive symptom scores ( CES-D ≥ 14 ) . For participants with low depressive symptoms , SPPB scores improved more in the PA than the SA group over 12 months ( adjusted score difference + 0.70 ; P < .001 at 6 months and + 0.58 ; P = .004 at 12 months ) , and 400 mw times improved in the PA group at 6 months ( adjusted score difference -0.41 minutes ; P = .02 ) . For participants with high depressive symptoms , the difference in improvement fell short of statistical significance on the SPPB between the PA and SA groups ( adjusted score difference + 0.76 ( P = .18 ) at 6 months and + 0.94 ( P = .12 ) at 12 months ) . CONCLUSION The presence of high depressive symptoms did not substantially diminish physical performance benefits realized after a PA intervention in sedentary older adults OBJECTIVES To determine whether participation in usual moderate-intensity or more-vigorous physical activity ( MVPA ) is associated with physical function performance and to identify sociodemographic , psychosocial , and disease-related covariates that may also compromise physical function performance . DESIGN Cross-sectional analysis of baseline variables of a r and omized controlled intervention trial . SETTING Four academic research centers . PARTICIPANTS Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability ( scoring < 10 on the Short Physical Performance Battery ( SPPB ) ) and able to complete the 400-m walk test within 15 minutes . MEASUREMENTS  Minutes of MVPA ( dichotomized according to above or below 150 min/wk of MVPA ) assessed according to the Community Healthy Activities Model Program for Seniors question naire , SPPB score , 400-m walk test , sex , body mass index ( BMI ) , depressive symptoms , age , and number of medications . RESULTS The SPPB summary score was associated with minutes of MVPA ( ρ=0.16 , P=.001 ) . In multiple regression analyses , age , minutes of MVPA , number of medications , and depressive symptoms were associated with performance on the composite SPPB ( P<.05 ) . There was an association between 400-m walk time and minutes of MVPA ( ρ=-0.18 ; P<.001 ) . In multiple regression analyses , age , sex , minutes of MVPA , BMI , and number of medications were associated with performance on the 400-m walk test ( P<.05 ) . CONCLUSION Minutes of MVPA , sex , BMI , depressive symptoms , age , and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability The objective of this prospect i ve r and omized controlled study was to compare the long-term effects of a structured physical activity intervention with those of aerobic exercises alone , in a cohort of elderly patients who had undergone elective cardiac surgery , and who were classified as frail at the end of rehabilitation based on their Short Physical Performance Battery ( SPPB ) score . At the end of rehabilitation , 140 frail elderly patients were r and omly allocated either to the intervention group ( IG ) or to the control group ( CG ) . CG participants received the usual aerobic exercise prescription , while IG participants were also taught additional exercises for strength , flexibility , balance and coordination . The improvement in SPPB score after 1 year was the outcome of the study . IG showed a significant improvement in SPPB score ( 9.0 ± 1.1 vs. 7.7 ± 1.4 , p < 0.001 ) , while no significant change was found in CG ( 7.7 ± 1.6 vs. 7.6 ± 1.5 , p = 0.252 ) . IG also showed a significantly higher proportion of participants who improved their SPPB score of at least 1 point ( 70 vs. 37 % , p < 0.001 ) . In conclusions , our structured physical activity intervention  significantly improves the SPPB score in frail elderly patients who have undergone elective cardiac surgery . An intervention that improves the SPPB score might delay the occurrence of mobility disability Prediction models for post‐kidney transplantation mortality have had limited success ( C‐statistics ≤0.70 ) . Adding objective measures of potentially modifiable factors may improve prediction and , consequently , kidney transplant ( KT ) survival through intervention . The Short Physical Performance Battery ( SPPB ) is an easily administered objective test of lower extremity function consisting of three parts ( balance , walking speed , chair st and s ) , each with scores of 0–4 , for a composite score of 0–12 , with higher scores indicating better function .  SPPB performance and frailty ( Fried frailty phenotype ) were assessed at admission for KT in a prospect i ve cohort of 719 KT recipients at Johns Hopkins Hospital ( 8/2009 to 6/2016 ) and University of Michigan ( 2/2013 to 12/2016 ) . The independent associations between SPPB impairment ( SPPB composite score ≤10 ) and composite score with post‐KT mortality were tested using adjusted competing risks models treating graft failure as a competing risk . The 5‐year posttransplantation mortality for impaired recipients was 20.6 % compared to 4.5 % for unimpaired recipients ( p < 0.001 ) . Impaired recipients had a 2.30‐fold ( adjusted hazard ratio [ aHR ] 2.30 , 95 % confidence interval [ CI ] 1.12–4.74 , p = 0.02 ) increased risk of postkidney transplantation mortality compared to unimpaired recipients . Each one‐point decrease in SPPB score was independently associated with a 1.19‐fold ( 95 % CI 1.09–1.30 , p < 0.001 ) higher risk of post‐KT mortality . SPPB‐derived lower extremity function is a potentially highly useful and modifiable objective measure for pre‐KT risk prediction Background Older adults have the highest rates of disability , functional dependence and use of healthcare re sources . Training interventions for older individuals are of special interest where regular physical activity ( PA ) has many health benefits . The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention ( MTI ) on functional fitness in old adults . Methods For this study , 117 participants , 71 to 90 years old , were r and omized in immediate intervention group and a control group ( delayed intervention group ) . The intervention consisted of daily endurance and twice-a-week strength training . The method was based on a r and omized-controlled cross-over design . Short Physical Performance Battery ( SPPB ) , 8 foot up- and -go test , strength performance , six min walking test ( 6 MW ) , physical activity , BMI and quality of life were obtained at baseline , after a 6-month intervention- and control phase , again after 6-month crossover- and delayed intervention phase , and after anadditional 6-month follow-up . Results After 6 months of MTI , the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery ( SPPB ) score ( mean diff = 0.6 , 95 % CI : 0.1 , 1.0 ) and 8-foot up- and -go test ( mean diff = −1.0 s , 95 % CI : -1.5 , -0.6 ) , and in endurance performance via 6-minute walking test ( 6 MW ) ( mean diff = 44.2 meters , 95 % CI : 17.1 , 71.2 ) . In strength performance via knee extension the intervention group improved while control group declined ( mean diff = 55.0 Newton , 95 % CI : 28.4 , 81.7 ) , and also in PA ( mean diff = 125.9 cpm , 95 % CI : 96.0 , 155.8 ) . Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4 : SPPB ( 1.1 points , 95 % CI : 0.8 , 1.4 ) ; 8-foot up- and -go ( −0.9 s , 95 % CI : -1.2 , -0.6 ) ; 6 MW ( 18.7 m , 95 % CI : 6.5 , 31.0 ) ; knee extension ( 4.2 Newton , 95 % CI : -10.0 , 18.3 ) ; h and grip ( 6.7 Newton , 95 % CI : -4.4 , 17.8 ) ; PA ( −4.0 cpm , 95 % CI : -33.9 , 26.0 ) ; BMI ( −0.6 kg/m2 , 95 % CI : -0.9 , -0.3 ) and Icel and ic quality of life ( 0.3 points , 95 % CI : -0.7 , 1.4 ) . Conclusions Our results suggest that regular MTI can improve and prevent decline in functional fitness  in older individuals , influence their lifestyle and positively affect their ability to stay independent , thus reducing the need for institutional care . Trial registration This study was approved by the National Bioethics Committee in Icel and , VSNb20080300114/03 - OBJECTIVES From among physiological attributes commonly targeted in rehabilitation , to identify those in which changes led to clinical ly meaningful differences ( CMDs ) in mobility outcomes . DESIGN Secondary analysis of data collected for a r and omized controlled trial of exercise using binary outcomes defined by recording a large CMD ( Short Physical Performance Battery (SPPB)=1 unit ; gait speed (GS)=0.1 m/s ) . Iterative models were performed to evaluate possible confounding between physiological variables and relevant covariates . SETTING Outpatient rehabilitation centers . PARTICIPANTS Community-dwelling mobility-limited older adults ( n=116 ) participating in a 16-week r and omized controlled trial of two modes of exercise .  MEASUREMENTS Physiological measures included leg power , leg strength , balance as measured according to the Performance-Oriented Mobility Assessment ( POMA ) , and rate pressure product at the maximal stage of an exercise tolerance test . Outcomes included GS and SPPB . Leg power and leg strength were measured using computerized pneumatic strength training equipment and recorded in Watts and Newtons , respectively . RESULTS Participants were 68 % female , had a mean age of 75.2 , a mean of 5.5 chronic conditions , and a baseline mean SPPB score of 8.7 . After controlling for age , site , group assignment , and baseline outcome values , leg power was the only attribute in which changes were significantly associated with a large CMD in SPPB ( odds ratio (OR)=1.48 , 95 % confidence interval (CI)=1.09 - 2.02 ) and GS ( OR=1.31 , 95 % CI=1.01 - 1.70 ) . CONCLUSION Improvements in leg power , independent of strength , appear to make an important contribution to clinical ly meaningful improvements in SPPB and GS
The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length , subsets of participants , geographic area , and age of the population .
Conclusions An SPPB score lower than 10 is predictive of all-cause mortality .
The systematic implementation of the SPPB in clinical practice setting s may provide useful prognostic information about the risk of all-cause mortality .
Background The Short Physical Performance Battery ( SPPB ) is a well-established tool to assess lower extremity physical performance status .
Its predictive ability for all-cause mortality has been sparsely reported , but with conflicting results in different subsets of participants .
The aim of this study was to perform a meta- analysis investigating the relationship between SPPB score and all-cause mortality  .