A novel upper-extremity-based performance test for sarcopenia: reliability and clinical utility of the elbow performance test

Abstract

Background Given the limitations of gait speed tests for sarcopenia assessment, this study evaluated the Elbow Performance Test (EPT), a simple upper-extremity alternative. Aims This study aimed to evaluate the test-retest reliability of the EPT and its ability to distinguish between older adults with sarcopenia and healthy young controls. Methods This cross-sectional study included 96 male participants: 43 older adults with sarcopenia (≥60 years) and 53 healthy young controls (≤40 years). Assessments covered muscle strength, mass, and physical performance, including 4-meter gait speed, the Short Physical Performance Battery (SPPB), and Timed Up and Go (TUG). The EPT required 30 self-paced elbow flexion-extension repetitions with a 1-kg weight. Test-retest reliability was assessed after 7–10 days using intraclass correlation coefficients (ICCs). Results All performance test scores differed significantly between the sarcopenia and control groups (p < 0.01). The EPT showed excellent test–retest reliability in both the control (ICC = 0.932; 95% CI:0.885–0.960) and sarcopenia (ICC = 0.905; 95% CI:0.831–0.947) groups. In terms of reliability, the EPT outperformed gait speed and SPPB in both groups and was comparable to the TUG test in the sarcopenic group. Conclusions The EPT demonstrated excellent reliability and effectively distinguished between older adults with sarcopenia and healthy controls. Given its simplicity, high repeatability, and minimal equipment needs, the EPT may serve as a practical tool for assessing upper-extremity muscle performance, particularly in settings where traditional lower-extremity-based tests are less feasible. Further studies are warranted to confirm its broader clinical utility across diverse populations. Clinical trial registration This trial was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07065448) on July 03, 2025.