Simple Tests, Big Benefits: Empowering Your Health at Home

Introduction
 
Taking charge of your health doesn't always require expensive equipment or specialist visits. Several quick and easy self-assessments can be performed at home, providing valuable insights into your overall well-being. These tests, like the Grip Strength Test, One-Leg Stand Test, Sit-to-Stand Test, and Supine-to-Stand Test, are not replacements for professional medical advice, but rather complementary tools that empower individuals to participate actively in their healthcare journey.
 
The beauty of these tests lies in their simplicity. They require minimal equipment and can be done without supervision. More importantly, numerous medical and scientific studies have established a strong correlation between performance in these tests and future health outcomes [Vaishya et al., 2024, de Brito et al., 2014, , Bergland, A., & Laake, K, 2006, Bohannon, 1995]. For example, research suggests that grip strength may be indicative of overall muscle health and bone density, both of which decline with age and are associated with increased risk of falls and fractures [Vaishya et al., 2024].
These self-assessments are particularly valuable for older adults, especially those facing financial limitations that might restrict access to frequent doctor visits. Regularly performing these tests allows individuals to monitor their own physical capabilities and identify potential areas of concern. Early detection empowers proactive intervention, potentially preventing more serious health issues down the line.
 
These simple tests position themselves as powerful tools in the realm of preventive medicine. By identifying potential risks early, individuals can modify their lifestyle habits, incorporate targeted exercises to improve strength and balance, and ultimately contribute to a healthier and more independent future.
 
References 
1.       Vaishya R., Misra A., Vaish A., Ursino N. & D’Ambrosi R.. (2024). Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. Journal of Health, Population and Nutrition, 43:7
2.       Bohannon RW (1995). Sit-to-Stand Test for Measuring Performance of Lower Extremity Muscles. Perceptual and Motor Skills, 80(1), 163-166.
3.       Bergland, A., & Laake, K. (2005). Concurrent and predictive validity of “getting up from lying on the floor”. Aging clinical and experimental research, 17(3), 181-185.
4.       de Brito, Leonardo Barbosa Barreto, et al. “Ability to sit and rise from the floor as a predictor of all-cause mortality.” European journal of preventive cardiology 21.7 (2014): 892-898.
 

The Grip Test

​The grip test is a simple measure of hand strength, which has been found to be associated with overall muscle strength and functional ability. Research has shown that hand grip strength is a predictor of mortality, cardiovascular disease, and disability in older adults (Leong et al., 2015). This test can be easily performed at home using a hand dynamometer or even a simple household object like a can of food.

The One-Leg-Stand Test

​The one-leg-stand test is a measure of balance and stability, which are important for preventing falls, especially in older adults. Studies have shown that poor performance on this test is associated with an increased risk of falls and fractures (Arai et al., 2020). Moreover, it was recently shown to be predictive of survival in middle-aged and older individuals (Araujo et al., 2022). To perform this test, simply stand on one leg for as long as possible, with eyes open, and then repeat with eyes closed.

The Sit-to-Stand Test

​The sit-to-stand test is a measure of lower body strength and functional mobility. Research has shown that performance on this test is associated with a variety of health outcomes, including mortality, disability, and hospitalization (Bohannon, 2006). Recently, it was shown to be equivalent to if not better than the Grip Test in predicting recurrent falls and fractures in older adults (Kirk et al., 2023). To perform this test, simply sit in a chair without using your arms for support, and then stand up and sit back down as quickly as possible for a set period of time.

The Supine-to-Stand Test

​The supine-to-stand test is an extension of the sit-to-stand test, albeit requiring a bit more efforts and skills. It is also a measure of lower body strength, balance, and flexibility. This test involves lying flat on your back and then standing up without using your arms for support. Research has shown that poor performance on this test is associated with an increased risk of falls and fractures in geriatrics and patients with neurologic diseases (Alexander et al., 2000, Schenkman et al., 1998, Schenkman et al.,2011, ). A recent and comprehensive study confirmed this test as a universal tool to track motor functional competence and musculoskeletal fitness throughout life for clinical or research purposes (Cattuzzo et al. 2020).

Conclusion
 
These four quick and easy health tests can provide valuable insights into one's health status and serve as effective tools of preventive medicine, especially for older individuals. They are easy to perform without professional supervision, complement physical examinations by doctors, and are supported by medical and scientific studies. By incorporating these tests into their routine, individuals can take proactive steps to maintain their health and well-being, ultimately leading to a better quality of life.
 
References
1.       Leong, D. P., et al. (2015). Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet, 386(9990), 266-273.
2.       Arai, T., et al. (2020). The one-leg portion of the Stand–Up Test predicts fall risk in aged individuals: A prospective cohort study. Journal of Orthopaedic Science, 25(4), 688-692.
3.       Bohannon, R. W. (2006). Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Perceptual and Motor Skills, 103(1), 215-222.
4.       Alexander NB, Galecki AT, Nyquist LV , et al. (2000). Chair and bed rise performance in ADL-impaired congregate housing residents. J Am Geriatr Soc., 48(5), 526-533.
5.       Schenkman M, Ellis T, Christiansen C, et al. (2011). Profile of functional limitations and task performance among people with early- and middle-stage Parkinson disease. Phys Ther., 91(9), 1339-1354.
6.       Schenkman M, Cutson TM, Kuchibhatla M, et al. (1998). Exercise to improve spinal flexibility and function for people with Parkinson's disease: a randomized, controlled trial. J Am Geriatr Soc., 46(10),1207-1216.
7.       Araujo, C.G. et al. (2022). Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine, 56, 975-980.
8.       Kirk, B. et al. (2023). Diagnostic power of relative sit-to-stand muscle power, grip strength, and gait speed for identifying a history of recurrent falls and fractures in older adults. Eur. Geriatr. Med. 14, 421–428.
9.       Cattuzzo, M.T. et al. (2020). Assessment in the Supine-To-Stand Task and Functional Health from Youth to Old Age: A Systematic Review. Int. J. Environ. Res. Public Health 17(16), 5794

Practical aspects

Test frequency

​The ideal frequency for performing these home health tests depends on your individual situation and goals. Here’s a breakdown for each test:
 
Grip Strength Test:
·         General monitoring: Once a month can be a good starting point.
·         Tracking progress: If you’re actively working on improving grip strength, you can test weekly or bi-weekly, but be sure to rest your hands for a day or two between tests to avoid fatigue affecting results.
·          
One-Leg Stand Test and Sit-to-Stand Test:
·         General monitoring: Every 1-2 months is reasonable.
·         Fall risk assessment: If you’re concerned about falls, testing more frequently (every 3-4 weeks) might be beneficial, but prioritize proper form over speed or repetitions.
·          
Supine-to-Stand Test:
·         General monitoring: Every 2-3 months is sufficient.
·         Balance assessment: Similar to the one-leg stand, you could test more often (every 4-6 weeks) if specifically focusing on balance improvement.
·          
Important Considerations:
·         Consistency: Aim for similar times of day and try to replicate conditions (like having a meal beforehand) for each test to ensure reliable comparisons.
·         Listen to your body: Stop the test if you experience pain or dizziness.
·         Focus on trends: Don’t get discouraged by minor fluctuations. Look for sustained changes over time.
·         Consult your doctor: Discuss your results with your doctor, especially if you notice a significant decline or suspect underlying issues.
 
Please emember that these tests are meant to be a starting point for self-awareness and shouldn’t replace professional medical advice.
 

Best predictive health outcomes

It’s difficult to pinpoint a single “best” test as each offers insights into different aspects of health. Here’s a breakdown of their strengths for predicting health outcomes:
 
·         Grip Strength Test: Strongest association with overall muscle mass and bone density, which decline with age and increase fall risk (Vaishya et al., 2024).
·         One-Leg Stand Test: Highly predictive of fall risk, especially in older adults (Michikawa et al., 2009, Maki et al., 2004).
·         Sit-to-Stand Test: Evaluates lower body strength and functional mobility, both linked to overall health and risk of disability (de Brito et al., 2014, Bergland, A., & Laake, K, 2006, Bohannon, 1995).
·         Supine-to-Stand Test: Assesses lower body strength, balance, and coordination, impacting mobility and potentially fall risk (de Brito et al., 2014, Bergland, A., & Laake, K, 2006).
 
Choosing the Most Relevant Test:
·         Focus on Falls: If fall prevention is a primary concern, the One-Leg Stand Test is particularly informative.
·         Overall Health and Mobility: For a broader picture, the Sit-to-Stand Test can be a good choice.
·         Muscle and Bone Health: The Grip Strength Test is most relevant here.
·         Balance and Coordination: The Supine-to-Stand Test provides insights into these aspects.
 
Ultimately, the most valuable test depends on your individual goals and health priorities. The beauty lies in the cumulative value of performing all four tests regularly. This comprehensive approach provides a broader understanding of your overall physical health and potential risk factors.
 
The above notwithstanding, among the four tests, grip strength is often considered the best predictor of health outcomes. Research has shown that grip strength is strongly correlated with overall muscle strength and functional ability, making it a good indicator of overall health status, particularly in older adults.
 
Several studies have demonstrated that low grip strength is associated with an increased risk of mortality, cardiovascular disease, disability, and other adverse health outcomes (Garcia-Hermoso et al., 2020, Leong et al., 2015). Grip strength has also been shown to be a useful tool for predicting frailty and sarcopenia, which are common conditions in older adults that can lead to functional decline and loss of independence (Cruz-Jentoft et al., 2019).
 
The simplicity of the grip strength test, along with its strong association with health outcomes, makes it a valuable tool for assessing overall health status and predicting future health risks. However, it's important to note that while grip strength is a useful measure, it should be used in conjunction with other health assessments and not relied upon as the sole indicator of health.
 
References
1.       Vaishya R., Misra A., Vaish A., Ursino N. & D’Ambrosi R.. (2024). Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. Journal of Health, Population and Nutrition, 43:7
2.       Maki, B. E., Holliday, P. J., & Topper, A. K. (2004). A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. Journal of the American Geriatrics Society, 42(7), 734-740.
3.       Michikawa T, Nishiwaki Y, Takebayashi T, Toyama Y. (2009). One-leg standing test for elderly populations. J Orthop Sci., 14(5):675-685
4.       Bohannon RW. (1995). Sit-to-Stand Test for Measuring Performance of Lower Extremity Muscles. Perceptual and Motor Skills, 80(1), 163-166.
5.       Bergland, A., & Laake, K. (2005). Concurrent and predictive validity of “getting up from lying on the floor”. Aging clinical and experimental research, 17(3), 181-185.
6.       de Brito, Leonardo Barbosa Barreto, et al. “Ability to sit and rise from the floor as a predictor of all-cause mortality.” European journal of preventive cardiology 21.7 (2014): 892-898.
7.       Leong, D. P., et al. (2015). Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet, 386(9990), 266-273.
8.       Garcia-Hermoso, A., et al. (2020). Association of grip strength with cardiovascular risk markers. European Journal of Preventive Cardiology, 27(4), 356-364.
9.       Cruz-Jentoft, A. J., et al. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16-31.