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.

Objective: The objective of the present study was to describe stroke-related knowledge (risk factors, warning signs and emergency response), lifestyle behaviours and health beliefs among Singaporean Chinese, and to identify any factors associated with such knowledge, behaviours and beliefs.Design: This was a cross-sectional study design employing a non-probability sampling method.Setting: Participants were recruited from the community.Method: Singaporean Chinese aged 40–74 years completed an interviewer-administered questionnaire seeking demographic information, knowledge of stroke risk factors, warning signs and emergency response, lifestyle behaviours such as physical activity participation and dietary habits, and health beliefs.Results: A total of 411 questionnaires (42% men, average age 52.4 years ± 7.3) were analyzed. Most respondents were able to identify at least one correct risk factor and warning sign (88% and 78% respectively). But only 38% stated the correct emergency response. Mass media was the main source of their knowledge. Most respondents reported healthy lifestyle and have positive health beliefs, many of which were associated with age, gender, education, income, religion and whether having relatives suffering from a chronic illness.Conclusion: In conclusion, this survey identified areas for health education programmes to improve stroke-related knowledge and lifestyle behaviour change in different target groups.

Background: Frailty is a health condition linked to adverse health outcomes and lower life quality. The PRISMA-7, a 7-item questionnaire from the Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA), is a validated case-finding tool for frailty with good sensitivity and specificity. This study aimed to translate, culturally adapt, and validate the PRISMA-7 questionnaire for Chinese use. Methods: A prospective observational study with convenience sampling recruited bilingual adults aged 65 and over living in the community. The Functional Autonomy Measurement System (SMAF) was the gold standard benchmark. The English PRISMA-7 questionnaire was culturally adapted to Chinese using forward and backward translation. Intra- and inter-rater reliability were determined using the intraclass correlation coefficient (ICC). Face, content and criterion validity were determined. The Receiver Operator characteristic (ROC) curve determined the optimal cut-off score. Results: One-hundred-twenty participants (55 females and 65 males) were recruited. The Chinese PRISMA-7 questionnaire had excellent intra-rater and inter-rater reliability (ICC = 1.000). The rigorous forward and backward translation established the face and content validity. The moderately high correlations between the English PRISMA-7 with SMAF (r = − 0.655, p < 0.001) and Chinese PRISMA-7 with SMAF (r = − 0.653, p < 0.001) pairs established the criterion validity. An optimal cut-off score of three “Yes” responses was reported with 100% sensitivity and 85.3% specificity. Conclusion: This translation, cross-cultural adaptation, and validation study established the Chinese PRISMA-7 questionnaire. The preliminary results suggest adequate diagnostic test accuracy for frailty screening among the Chinese-literate community.

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.

Background: The validated Incremental Shuttle Walk Test (ISWT) is widely used for evaluating maximal exercise capacity, with the distance-walked (IWSD) as the primary outcome. However, there are no normative reference values (NRV) and reference equations to predict ISWD for the Singaporean population. Objectives: This study aims to establish the NRV and reference equations for ISWD in healthy Singaporeans aged 21 to 80 and investigate the determining variables during ISWT. Methods: This cross-sectional study recruited community-dwelling healthy subjects aged 21–80 from the community via convenience sampling. Each subject completed two trials of the ISWT according to the standard protocol. Variables measured during the trials included ISWD, pre-and post-test heart rate (HR), oxygen saturation, blood pressure (BP), modified Borg’s dyspnoea score and Borg’s rate of perceived exertion (RPE). Results: 199 healthy Singaporean (females = 114, males = 85) participated in the study. The overall median ISWD was 660.0 metres (m) [interquartile range (IQR):440.0–850.0]. The age-stratified mean ISWD ranged from 430.0 m (IQR:350.0–450.0) (aged 60–80) to 480.0 m (IQR:438.0–650.0) (aged 40–59) to 780.0 m (IQR:670.0–960.0) (aged 21–39). Gender, age, weight, height and HR change (highest post-test HR minus pre-test HR) were the most significant variables (p < 0.001). IWSD (m) = 651.4(Height, m) +89.7(Gender, male = 1; female = 0) –6.31(Age, years) –3.61(Weight, kilograms) +2.54(HR change, beats per minute); R² = 0.741. Previously published ISWT reference equations cannot accurately predict the ISWD in the Singaporean population. Conclusions: This study investigated the ISWD NRV and established reference equations for healthy Singaporeans aged 21–80. The information would be beneficial in setting performance benchmarks to guide physical assessment, intervention and rehabilitation.

Summary at a glance: The 6-min walk test (6MWT) is a widely used field walking test. This study reports the normative reference values (NRV) of distance walked during 6MWT (6MWD) in healthy Singaporeans (aged 21–80) and updates the 6MWD reference equations. This information may facilitate the interpretation of the 6MWD in clinical populations. Ethics approval: The Singapore Institute of Technology-Institutional Review Board (SIT-IRB Project Number: 2019099) approved this study to be carried out from June 2019 to January 2021. All participants gave written informed consent before data collection began. Background: The six-minute walk test (6MWT) is a widely adopted submaximal field-walking test to evaluate functional exercise capacity. This validated test is a reliable, safe, inexpensive, and straightforward assessment tool commonly used as an outcome measure, using the distance walked (6MWD) as the primary outcome. An earlier study has established the normative reference values (NRV) and equation in healthy Singaporeans — however, the small sample size and narrow age range curb adequate representation of the adult population profile. Objectives: This study aims to update the NRV and reference equations to predict the distance walked during 6MWT (6MWD) for healthy Singaporeans aged 21–80. Methods: This cross-sectional study recruited community-dwelling healthy subjects aged 21–80 via convenience sampling. Each subject completed two trials of 6MWT according to the standard protocol. Primary outcome measures included 6MWD, pre-and post-test heart rate (HR), oxygen saturation, and blood pressure (BP). Results: 172 healthy Singaporeans ($\mathrm{\text{females}}=90$ , $\mathrm{\text{males}}=82$ ) participated. The overall mean 6MWD was $578.00\pm 75.38$ metres. The age-stratified mean 6MWD ranged from $601.3\pm 71.79$ metres (aged 21–39) to $519.02\pm 55.42$ metres (aged 60–80). Age, gender, and percentage maximum HR predicted (%PredHRmax) were the most significant variables ($p<0.001$ ). 6MWD reference $\mathrm{\text{equation}}=288.282(\mathrm{\text{height}},\mathrm{\text{m}})+27.463\times \mathrm{\text{Gender}}$ $(\mathrm{\text{male}}=1;\mathrm{\text{female}}=0)+4.349(\%\mathrm{\text{predHRmax}})+1.191$ (HR reserve, bpm) $-185.431-1.343(\mathrm{\text{age}},\mathrm{\text{years}})-1.614$ (weight, kg), $R^2=58\%$ . Applying equations from other studies to the Singaporean population resulted in an overestimation of the 6MWD. Conclusion: This study updated the NRV and reference equations of 6MWD for healthy Singaporeans aged between 21–80 years. This update revises the local benchmarks of 6MWD in Singapore, a widely adopted outcome measure.