1. Quality assurance for the handgrip strength and chair stand tests

2. Based on EHES Manual, Part B. Fieldwork Procedures, 2nd edition (2016)
Available at:
These slides can be used freely, translated and adapted to national use (e.g. concerning the national QA practices).

3. Quality assurance of handgrip strength and chair stand measurements
Adequate training: theory and practice
Understanding the difference between clinical practice and survey fieldwork
Competence and commitment to follow protocols carefully
Checking the equipment and regular calibration of the devices (handgrip strength)
Auditing
Adherence to the protocol
Evaluation of data during the fieldwork

4. Training of personnel Theory providing information about
Why it is important to measure handgrip strength and carry out chair stand tests
Why the measurements need to be standardized
What implications differences in the protocol have to survey results
Practical training, ideally with several different persons with a wide range of physical capability
Supervision and feedback

5. Checking the equipment and regular calibration
Protocols for daily and weekly equipment checks recorded in a log book
Calibration of used handgrip strength dynamometer before starting the fieldwork
If fieldwork lasts longer than a year or the number of daily measurements is high, re-calibration may be needed in between

6. Audit visits Regular audit visits and observations to
ensure that protocol is followed correctly: evaluate adherence to the standard protocol
supervise the flow of the survey
ensure that the protocol is followed correctly
Support and encourage the field personnel

7. Additional training
If the survey is prolonged or any deviations from the protocol are observed, refresher sessions about conducting the tests should be organized when needed or at three month intervals
Katso referenssi

8. Evaluation of measurement data
Data should be checked regularly for
Missing data and recorded reasons for that
Mean and standard deviation for hand grip strength and chair stand test time
Values which are possible but rare
Separately for each measurer (nurse)
If deviations in data are detected, the reasons for this need to be traced, e.g. if due to measurement protocol and/or equipment

9. Missing data and reasons for that
If handgrip strength or timed chair stand test cannot be measured, a reason for that should be recorded
It is important to notice that the single chair stand test should be conducted to all participants and the exclusion criteria concerns the repeated (timed) chair stand test
Frequency of reasons for exclusion by measurer
E.g. if some measurer has a lot of missing information and refusals for the measurement, this may reveal that she/he is not properly introducing the measurement for the participants or not following the protocol properly

10. Acknowledgements
Slides prepared by: Heini Wennman, Päivi Sainio, Päivikki Koponen, Hanna Tolonen
Photographs: Hanna Tolonen
Demonstrations by voluntary participants
Experiences and feedback from the EHES network have been utilized in the preparation of these slides
Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in through SANCO/2008/C2/02-SI EHES and Grand Agreement number , and in through Grand Agreement number /BRIDGE Health

11. Disclaimer
The views expressed here are those of the authors and they do not represent the Commission’s official position.