The Relationship of Strength to Function in the Older Adult
Abstract
Reduced lower extremity strength has been associated with reductions in gait speed, balance, stair-climbing ability, and getting up from a seated position. The relationship of lower extremity strength and the ability to accomplish selected functional activities was examined in 16 healthy but frail older adults ranging in age from 75 to 88 years (x = 80.9 years). The following measures were obtained for each subject: preferred gait speed under laboratory and free walking conditions, 5 timed chair stand-ups, and time to complete an obstacle course. Strength measures of the hip extensors, hip abductors, knee extensors, planter flexors, and dorsifiexor muscle groups were obtained using a handheld dynamometer. The relationship between the time to complete the functional activities and each of the strength variables was determined using Pearson product moment correlations. In addition, performance was examined in relation to various combinations of strength measures (e.g., hip and knee extension). Weak, nonsignificant hip, knee and ankle strength/functional activity relationships were found for all of the variables examined. When hip extension, knee extension, and ankle plantar flexion strength values were combined and normalized to body weight, a significant strength-to-functional activity relationship was found for 14″ chair stand-ups (r = .636, p < .01). When values for quadriceps strength and gait speed for 35 adults ranging in age from 60–72 years were compared to those for 75–88 year olds, marked differences emerged. A more significant relationship between knee extension force and gait speed was observed for the younger adults (r = .528 vs r = .353). While it would appear that lower extremity strength is a factor in the successful completion of activities of daily living, other variables appear to contribute substantially to normal daily function. Potential barriers to the successful completion of functional tasks for the older adult may be inadequate sensation, pain, joint impairment, poor balance, and fear. It is clear that the role of factors other than muscle strength needs to be identified and investigated.
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Loss of muscle size cannot explain most, or even a major portion, of the impaired muscle performance and physical function observed in old age.
“data emerged suggesting that loss of muscle size could not explain most, or even a major portion, of the impaired muscle performance (force, power, etc.) and physical function observed in old age [4, 18–20]”
From Targeting Intramyocellular Lipids to Improve Aging Muscle Function (2025) · cites this paper as [4]
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Cavani, V., Mier, C. M., Musto, A. A., & Tummers, N. E. (2002) · Journal of Aging and Physical Activity · doi:10.1123/japa.10.4.443 · Cited by 85 · see citing works
“These activities rely on balance and a level of muscle strength and power reserve, which decrease with age (Bassey et al., 1992; Brown et al., 1995; Fiatarone et al., 1990).”
BackgroundMuscle Force and Range of Motion as Predictors of Function in Older Adults
Beissner, K., Collins, J. E., & Holmes, H. H. (2000) · Physical Therapy · doi:10.1093/ptj/80.6.556 · Cited by 85 · see citing works
Effects of Long-Term Resistive Training on Mobility and Strength in Older Adults With Diabetes
Brandon, L. J., Gaasch, D. A., Boyette, L. W., & Lloyd, A. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.8.m740 · Cited by 84 · see citing works
VanSwearingen, J. M., Perera, S., Brach, J. S., Cham, R., Rosano, C., & Studenski, S. A. (2009) · The Journals of Gerontology Series A · doi:10.1093/gerona/glp098 · Cited by 86 · see citing works
Muckelt, P. E., Warner, M. B., Cheliotis-James, T., Muckelt, R., Hastermann, M., Schoenrock, B., Martin, D., MacGregor, R., Blottner, D., & Stokes, M. J. (2022) · Scientific Reports · doi:10.1038/s41598-022-17507-2 · Cited by 82 · see citing works
“Interrater reliability was assessed using a two-way mixed, single score intraclass correlation coefficient (ICC) (3,1)34.”
MethodWalker, K. Z., Woods, J., Luliano-Burns, S., King, S., & Strauss, B. J. (2011) · Clinical Interventions in Aging · doi:10.2147/cia.s16979 · Cited by 75 · see citing works
“For example, in one study, strength of hip extensors and abductors was only weakly associated with gait speed and the ability to rise from a chair, although when these measures were combined with measures of leg and ankle strength, and normalized for weight, significant associations with performance emerged.(56) Condi…”
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“Other studies found only moderate correlations [13,17,35] between knee extension strength and gait Table 4: Spearman correlations between physical fitness and functional performance for men and women.”
Increased muscular challenge in older adults during obstructed gait
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“As an intrinsic risk factor contributing to falls, lower extremity (LE) muscle strength is a critical component in limiting an elderly individual’s dynamic stability [3–5].”
BackgroundConcurrent and predictive validity of “getting up from lying on the floor”
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Holsgaard‐Larsen, A., Caserotti, P., Puggaard, L., & Aagaard, P. (2006) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2006.00560.x · Cited by 73 · see citing works
“, 1995), single-joint handheld dynamometers (Brown et al., 1995; Kinugasa et al., 1996; Bohannon, 1997), or isometric grip strength (Cress et al.”
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“Consequences of these changes include an overall decrease in muscle cross-sectional area, a reduction in muscle mass, and a decline in strength [4, 16, 61, 62].”
[Relationship between lower extremity muscle strength and dynamic balance in people post-stroke].
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“, 2008) as well as frail, older adults (Brown et al., 1995).”
BackgroundInfluentialPilates Reformer exercises for fall risk reduction in older adults: A randomized controlled trial
Roller, M. L., Kachingwe, A. F., Beling, J., Ickes, D.-M., Cabot, A., & Shrier, G. (2017) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2017.09.004 · Cited by 67 · see citing works
Fyfe, J. J., & Loenneke, J. P. (2017) · Sports Medicine · doi:10.1007/s40279-017-0812-1 · Cited by 64 · see citing works
“With this in mind, and given the potential importance of strength for functional capacity [62] and indices of athletic performance [63], the potential for interference with strength development with concurrent training (even in the absence of interference to muscle hypertrophy) is perhaps more relevant, from a practic…”
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Impact of bariatric surgery on physical functioning in obese adults
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Hernandez, M. E., Goldberg, A., & Alexander, N. B. (2009) · Physical Therapy · doi:10.2522/ptj.20090035 · Cited by 62 · see citing works
Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty
Dreyer, H. C., Owen, E. C., Strycker, L. A., Smolkowski, K., Muyskens, J. B., Kirkpatrick, T. K., Christie, A. D., Kuehl, K. S., Lantz, B. A., Shah, S. N., et al. (2018) · JBJS Open Access · doi:10.2106/jbjs.oa.18.00006 · Cited by 61 · see citing works
Bone Mineral Density, Soft Tissue Body Composition, Strength, and Functioning After Hip Fracture
Wehren, L. E., Hawkes, W., Hebel, J. R., Orwig, D., & Magaziner, J. S. (2005) · The Journals of Gerontology Series A · doi:10.1093/gerona/60.1.80 · Cited by 60 · see citing works
Gains in Distance Walking in a 3-Month Follow-Up Poststroke: What Changes?
Pohl, P. S., Perera, S., Duncan, P. W., Maletsky, R., Whitman, R., & Studenski, S. A. (2004) · Neurorehabilitation and neural repair · doi:10.1177/0888439003260494 · Cited by 60 · see citing works
Bariatric Surgery in Adults with Obesity: the Impact on Performance, Metabolism, and Health Indices
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Controlled whole-body vibration training reduces risk of falls among community-dwelling older adults
Yang, F., King, G. A., Dillon, L., & Su, X. (2015) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2015.06.029 · Cited by 59 · see citing works
Physical Performance Tests After Stroke
Maeda, A., Yuasa, T., Nakamura, K., Higuchi, S., & Motohashi, Y. (2000) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/00002060-200011000-00008 · Cited by 56 · see citing works
Techniques to Evaluate Elderly Human Muscle Function: A Physiological Basis
Hunter, S. K., White, M. J., & Thompson, M. W. (1998) · The Journals of Gerontology Series A · doi:10.1093/gerona/53a.3.b204 · Cited by 56 · see citing works
“Note the pronounced slowing of relaxation and elevation of the baseline in the record of the elderly subject during the last 30 seconds (90-120)”
Background
- Authors
- Fukagawa, N. K., Brown, M., Sinacore, D. R., & Host, H. H.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 1995-11-01
- Volume
- 50A
- Issue
- Special
- Pages
- 55-59
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2035011145
- Cited by
- 321
- References
- 0
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 3 · 2023: 8 · 2022: 6 · 2021: 8 · 2020: 5 · 2019: 14 · 2018: 13 · 2017: 6 · 2016: 11 · 2015: 13 · 2014: 15 · 2013: 18 · 2012: 15
- FWCI
- 12.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k01ag000585-05)
- National Institute on Aging (AG05562, AG00585)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- muscle strength, functional performance, older adults, frailty, walking speed, obstacle course, lower limb strength, activities of daily living, hip extensors, knee extensors, ankle plantarflexion
- MeSH terms
- Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Aging, Ankle, Body Weight, Postural Balance, Female, Foot, Gait, Hip, Humans, Knee, Leg, Locomotion, Male, Middle Aged, Muscle Contraction, Posture, Time Factors, Walking, Frail Elderly, Muscle, Skeletal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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