The relationship between upper extremity strength and instrumental activities of daily living performance among elderly women

The purpose of this study was to assess the relationship between upper extremity strength and the ability to perform instrumental activities of daily living (IADL) independently and to explore how therapists might interpret the results of upper extremity strength evaluations among elderly women. Participants included 29 women (68 to 84 years old) who resided in assisted living facilities. Daily living performance was assessed using five subscales of the Multilevel Assessment Instrument. Grip, lateral pinch, and the strength of selected muscles of the elbow and the shoulder in the dominant upper extremity were tested. Shoulder abductor and external rotator strength were moderately correlated (r_s = 0.50 and r_s = 0.51, respectively) with IADL function. Shoulder external rotator strength was moderately correlated (r_s = 0.55) and elbow extensor strength was fairly correlated (r_s = 0.49) with participants' ability to grocery shop. Upper extremity strength measurements within normal limits are not necessarily predictive of IADL independence for elderly women, but measurements below normal limits may indicate IADL limitation. A positive screening result for shoulder weakness or upper extremity strength of more than two standard deviations below norms may warrant in-depth assessment of IADL performance. Alternatively, self-reported limitation in IADL independence may support the need for assessment of upper extremity strength.