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RehabMeasures Instrument

Modified Physical Performance Test

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The PPT is a direct observational test that assesses multiple dimensions of physical function (basic and complex activities of daily living [ADL]) with different levels of difficulty. The physical performance test (PPT) described by Reuben and Siu consists of seven or nine functional items that correlate well with degree of disability, loss of independence, and early mortality. Two other items from a battery of tests described by Guralnik and coworkers, the chair rise test and the Romberg test for balance, also correlate with nursing home placement and loss of independence. (Brown, 2000)

Acronym Modified PPT

Area of Assessment

Activities of Daily Living
Balance – Non-vestibular

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil


Not Free


  • Parkinson's Disease & Movement Disorders

Key Descriptions

  • The 9 functional items include:
  • 1. Book lift:
    A 7-lb book is lifted from waist height to a shelf 12 in above shoulder level. Scores are based on the time required to complete the task.
  • 2. Put on and take off a coat:
    Subjects put on and take off a standard lab coat of appropriate size as quickly as they are able. Scores are based on the time required to complete this item.
  • 3. Pick up a penny:
    Subjects pick up as quickly as possible a penny that is located 12 inches in front of the foot. Scores are based on the time required to complete the task
  • 4. Chair rise:
    Subjects sit in a chair that has a seat height of 16 inches. They then stand fully and sit back down, without using the hands, five times, as quickly as possible.
  • 5. Turn 360:
    Participants turn both clockwise and counterclockwise quickly but safely. They are subjectively graded on steadiness and ability to produce continuous turning movement.
  • 6. 50-foot walk:
    Subjects walk 25 feet in a straight line, turn, and return to the initial starting place as quickly as possible, safely
  • 7. One flight of stairs:
    The time required to ascend 10 steps
  • 8. Four flights of stairs:
    Participants climb four flights of stairs. One point is given for each flight of stairs completed.
  • 9. Progressive Romberg test:
    Subjects are scored according to their ability to maintain a reduced base of support: feet together, semi-tandem, and full tandem, for a maximum of 10 seconds.
  • Note: Maximum score is 36; 4 points per item. (Reuben and Siu, 1990) and Guralnik and coworkers (Brown, 2000).

Number of Items


Equipment Required

  • Penny
  • 7 pound book
  • Shelf 12” above shoulder level
  • Jacket (standard lab coat)
  • Standard height chair
  • Stopwatch
  • 25 foot walkway
  • 4 flights of stairs

Time to Administer

10-15 minutes

Required Training

Reading an Article/Manual

Age Ranges

Elderly Adult

65 +


Instrument Reviewers

Initially reviewed by Jeffrey Hoder, PT, DPT, NCS and the PD EDGE Task Force of the Neurology section of the APTA in 2013.

ICF Domain


Measurement Domain

Activities of Daily Living


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Parkinson's Disease

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Interrater/Intrarater Reliability

Parkinson’s Disease

(Tanji, 2008; n = 79 total; mean age = 65.5; Parkinson’s disease: HY stage I = 5, II = 47, III = 13, IV = 9, V = 5 ) 

  • High Interrater reliability (0.94-0.99)

Older Adults and Geriatric Care

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(Brown et al, 2000; n = 107 elderly subjects, >77 y.o.) 

  • Classification: Modified PPT: Not frail (32 - 36 points), mildly frail (25 - 31 points), or moderately frail (17 - 24 points)


Brown, M., Sinacore, D. R., et al. (2000). "Physical and performance measures for the identification of mild to moderate frailty." J Gerontol A Biol Sci Med Sci 55(6): M350-355.

Reuben, D. B. and Siu, A. L. (1990). "An objective measure of physical function of elderly outpatients. The Physical Performance Test." J Am Geriatr Soc 38(10): 1105-1112.

Tanji, H., Gruber-Baldini, A. L., et al. (2008). "A comparative study of physical performance measures in Parkinson's disease." Mov Disord 23(13): 1897-1905.