Mingxing Yang

Background: The 6 min walk test (6MWT) is the gold standard for field-based functional assessment, yet the 3 min walk test (3MWT) offers a time-efficient alternative. However, a lack of localised normative reference values (NRV) and an over-reliance on simple 6 min extrapolation limit its clinical utility. Objectives: To establish the NRV and reference equations for the 3MWT in a healthy cohort and investigate the physiological relationship between 3 min performance and 6 min predictions. Methods: This cross-sectional study recruited healthy community-dwelling adults (aged 20 to 80, BMI < 27.5 kg/m²). Participants performed two 3MWT trials on a 30 m indoor course. Primary outcomes included the best 3MWT and physiological parameters. Reference equations were derived using multiple linear regression. Results: In total, 240 participants were recruited with an overall median 3MWT of 290 metres (m) (IQR 257.0–323.0). Males walked significantly farther than females (p = 0.002). While 3MWT remained stable across age decades in males (p = 0.225), females’ performance declined with age (p = 0.005). Older adults maintained walking distances comparable to younger cohorts by operating at a higher relative percentage of their predicted maximum heart rate and exhibiting prolonged recovery profiles. Doubling the 3MWT significantly overestimated 6 min capacity (p < 0.001), highlighting non-linear pacing strategies. Conclusions: This study provides the first age- and gender-specific NRV for the 3MWT in Singapore, supporting its use as a rapid functional walking assessment tool in healthy adults. The findings suggest that the 3MWT should not be interpreted as a direct linear surrogate for the 6MWT. Further research is required to validate these reference equations externally and determine their clinical sensitivity in disease populations.

Objectives: Gait speed indicates the individual’s functional status and predicts overall health. This study aims to determine (1) the intra- and inter-rater and test–retest reliability of the dynamic 4 m gait speed test protocol; (2) establish the normative reference values of habitual and fast gait speeds in community-dwelling healthy Singaporean adults aged 21 to 80; and (3) explore the association of age, gender, height, weight, and body mass index (BMI) on gait speed. Methods: This prospective cross-sectional study recruited healthy ambulatory community-dwelling Singaporeans aged 21 to 80 who could ambulate independently without aid. Participants were excluded if they required walking aids; were pregnant; or had physical, medical, or cognitive conditions that may affect gait. Each participant completed at least two habitual and fast gait speed test trials via a 4 m walkway with a dynamic start. The data were analysed by descriptive statistics, the Mann–Whitney test, the Spearman coefficient, and the interclass correlation coefficient (ICC). Results: In total, 178 males and 201 females were included in the data analysis. The median age was 45.0 years [interquartile range (IQR) 26.2–59.0], and the median height was 1.64 metres (m) (IQR 1.58–1.70). The median habitual gait speed was 1.08 metre/second (m/s) (IQR 0.97–1.22), and the fast gait speed was 1.55 m/s (IQR 1.40–1.70). The ICC for reliability ranged from 0.84 to 0.99, indicating that the 4 m gait speed test had good-to-excellent reliability. Conclusions: Gait speeds were not influenced by gender but declined with age advancement. Age and height and age and BMI were weakly correlated to habitual and fast gait speed, respectively. We established the norm values for the 4 m gait speeds in Singapore and proved it to be a reliable gait speed assessment ready for immediate community applications.

The “Timed-Up-and-Go” test (TUG) is a standard assessment tool for functional mobility as it assesses several functional components, including balance, gait, and lower-extremity strength. It has good reliability and validity and is cost-effective and safe, making it an ideal screening tool for falls in various populations, such as older adults or various conditions. However, TUG interpretation relies on comparisons against local normative reference values (NRV), which few studies established for the Asian or younger population. Hence, this study aims to: (1) establish the normative reference values NRV for the population aged 21 to 85 years; (2) determine demographic and anthropometric variables that influence the TUG results; and (3) establish the regression equation of the TUG. A prospective, convenience sampling cross-sectional study recruited subjects aged 21–85 from the community to complete two TUG trials in various parts of Singapore. Variables collected include gender, age, height (meters, m), weight (kilograms, kg), and hand grip strength (HGS) (kg). The intraclass correlation coefficient (ICC) and 95% confidence interval (95% CI) determined test-retest, intra- and inter-rater reliabilities. TUG and variables were analyzed with descriptive statistics and multiple linear regression. p < 0.05 was accepted as statistical significance. Further, 838 subjects (542 females, 296 males) completed the data collection. The mean TUG time was 9.16 s (95% CI 9.01–9.3). Slower TUG was observed with advanced age and female gender. Multiple linear regression analysis demonstrated that age, height, and weight were the best variables to predict TUG scores. The regression formula presented as: TUG (second) = 9.11 + 0.063 (Age, years)—3.19 (Height, meters) + 0.026 (Weight, Kilograms) (R² = 0.374, p < 0.001). This study provided the TUG NRV and regression formula for healthy Asian adults aged 21 to 85. The information may provide a quick reference for the physical function to interpret assessment findings and guide decision-making in various health and healthcare settings.