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This study aims to assess the reliability of the Elbow Performance Test as an upper extremity-based alternative for evaluating sarcopenia severity. Unlike traditional lower extremity-focused assessments, this test may offer a practical solution for individuals with mobility limitations or comorbidities affecting the lower limbs. Participants will include older adults with sarcopenia and healthy young adults. Functional tests, including the 4-meter Gait Speed Test, SPPB, TUG, and the Elbow Performance Test, will be administered twice within a 7-10-day interval. Reliability will be analyzed using intraclass correlation coefficients (ICC).
Background:Sarcopenia is a generalized and progressive skeletal muscle disorder characterized by a decline in muscle strength, mass, and function. The severity of sarcopenia is commonly assessed using functional performance tests, which are also used for monitoring disease progression and treatment response. However, lower extremity-based tests may have limited applicability in the presence of various comorbidities.
Objective: This study proposes an upper extremity-based alternative, the Elbow Performance Test, and aims to evaluate its reliability in comparison to the commonly used 4-meter Gait Speed Test.
Method:This planned cross-sectional study will include two groups: older adults with sarcopenia and healthy young adults. All participants will undergo the 4-meter Gait Speed Test, the Short Physical Performance Battery (SPPB), the Timed Up and Go (TUG) test, and the Elbow Performance Test on two separate occasions, with a 7-10-day interval between sessions. In the Elbow Performance Test, a 1-kilogram sandbag will be attached to the distal forearm of the dominant arm, and participants will be instructed to perform 30 consecutive elbow flexion-extension movements. The total time required to complete the repetitions will be recorded. The reliability of the test will be evaluated using intraclass correlation coefficients (ICC).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | older adults with sarcopenia |
| |
| Group 2 | healthy young adults |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| physical performance tests | Other | All participants underwent the 4-meter Gait Speed Test, the Short Physical Performance Battery (SPPB), the Timed Up and Go (TUG) test, and the Elbow Performance Test twice, with a 7-10-day interval between sessions. In the Elbow Performance Test, a 1-kilogram sandbag was fixed to the distal forearm of the dominant arm, and participants were asked to perform 30 consecutive elbow flexion-extension movements. |
| Measure | Description | Time Frame |
|---|---|---|
| the Elbow Performance Test | The total time required to complete thirty consecutive elbow flexion-extension movements, performed with a one-kilogram sandbag attached to the distal forearm of the dominant arm. | Two assessment sessions conducted seven to ten days apart to evaluate test-retest reliability using intraclass correlation coefficients (ICC). |
| Measure | Description | Time Frame |
|---|---|---|
| the 4-meter Gait Speed Test | The 4-Meter Gait Speed Test was used to evaluate functional mobility. Participants walked a total of 6 meters at their usual pace, with timing recorded only for the central 4-meter section. A stopwatch was used to measure the time, and gait speed was calculated in meters per second. | Two assessment sessions conducted seven to ten days apart to evaluate test-retest reliability using intraclass correlation coefficients (ICC). |
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Inclusion Criteria:
Individuals who consent to participate in the study
*Sarcopenia Group
Male participants aged 60 years or older
Diagnosed with sarcopenia according to EWGSOP2 criteria
*Healthy Young Control Group
Male participants aged 40 years or younger
SARC-F screening test score < 4
Exclusion Criteria:
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Sarcopenia Group and Healthy Young Control Group
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| Name | Affiliation | Role |
|---|---|---|
| Ä°lhan Karacan, Prof. | Istanbul Physical Medicine Rehabilitation Training and Research Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Physical Medicine Rehabilitation Training and Research Hospital | Istanbul | 31180 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26922142 | Result | Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, Erten N, Karan MA, Cruz-Jentoft AJ. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr. 2016 Dec;35(6):1557-1563. doi: 10.1016/j.clnu.2016.02.002. Epub 2016 Feb 11. | |
| 27011872 | Result |
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| ID | Term |
|---|---|
| D055948 | Sarcopenia |
| ID | Term |
|---|---|
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| the Short Physical Performance Battery (SPPB) | Physical performance will be assessed using the Short Physical Performance Battery (SPPB), which includes balance tests (standing positions), the 4-meter gait speed test, and the five-times sit-to-stand test. Each component is scored from 0 to 4, yielding a total score ranging from 0 to 12, with higher scores indicating better physical function. | Two assessment sessions conducted seven to ten days apart to evaluate test-retest reliability using intraclass correlation coefficients (ICC). |
| Timed Up and Go (TUG) | Functional mobility and balance will be assessed using the Timed Up and Go (TUG) test, which measures the time required to stand up from a chair, walk three meters, turn around, and sit back down. | Two assessment sessions conducted seven to ten days apart to evaluate test-retest reliability using intraclass correlation coefficients (ICC). |
| Power GA, Dalton BH, Rice CL. Human neuromuscular structure and function in old age: A brief review. J Sport Health Sci. 2013 Dec;2(4):215-226. doi: 10.1016/j.jshs.2013.07.001. |
| 39119811 | Result | Karacan I, Turker KS. Exploring neuronal mechanisms of osteosarcopenia in older adults. J Physiol. 2026 Jan;604(2):672-688. doi: 10.1113/JP285666. Epub 2024 Aug 9. |
| 30312372 | Result | Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31. doi: 10.1093/ageing/afy169. |
| 41499000 | Derived | Yildirim TY, Kalaoglu E, Aydin T, Turker KS, Karacan I. A novel upper-extremity-based performance test for sarcopenia: reliability and clinical utility of the elbow performance test. Ir J Med Sci. 2026 Feb;195(1):213-219. doi: 10.1007/s11845-025-04263-1. Epub 2026 Jan 7. |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |