Skip to main content

Research Repository

Advanced Search

Normative reference values for strength and flexibility of 1,000 children and adults

McKay, Marnee J.; Baldwin, Jennifer N.; Ferreira, Paulo; Simic, Milena; Vanicek, Natalie; Burns, Joshua; For the 1000 Norms Project Consortium


Marnee J. McKay

Jennifer N. Baldwin

Paulo Ferreira

Milena Simic

Joshua Burns

For the 1000 Norms Project Consortium


Objectives: To establish reference values for isometric strength of 12 muscle groups and flexibility of 13 joint movements in 1000 children and adults, and investigate the influence of demographic and anthropometric factors. Methods: A standardized reliable protocol of hand-held and fixed dynamometry for isometric strength of ankle, knee, hip, elbow and shoulder musculature as well as goniometry for flexibility of the ankle, knee, hip, elbow, shoulder and cervical spine was performed in an observationa1 study investigating 1000 healthy males and females aged 3 to 101 years. Correlation and multiple regression analyses were performed to identify factors independently associated with strength and flexibility of children, adolescents, adults and older adults. Results: Normative reference values of 25 strength and flexibility measures were generated. Strong linear correlations between age and strength were identified in the first two decades of life. Muscle strength significantly decreased with age in older adults. Regression modelling identified increasing height as the most significant predictor of strength in children, higher body mass in adolescents and male gender in adults and older adults. Joint flexibility gradually decreased with age, with little gender difference. Waist circumference was a significant predictor of variability in joint flexibility in adolescents, adults and older adults. Conclusion: Reference values and associated age- and sex-stratified z-scores generated from this study can be used to determine the presence and extent of impairments associated with neuromuscular and other neurological disorders, monitor disease progression over time in natural history studies and evaluate the effect of new treatments in clinical trials.


McKay, M. J., Baldwin, J. N., Ferreira, P., Simic, M., Vanicek, N., Burns, J., & For the 1000 Norms Project Consortium, . (2017). Normative reference values for strength and flexibility of 1,000 children and adults. Neurology, 88(1), 36-43. doi:10.1212/WNL.0000000000003466

Journal Article Type Article
Acceptance Date Sep 22, 2016
Online Publication Date Nov 23, 2016
Publication Date Jan 3, 2017
Deposit Date Dec 19, 2016
Journal Neurology
Print ISSN 0028-3878
Electronic ISSN 1526-632X
Publisher American Academy of Neurology
Peer Reviewed Peer Reviewed
Volume 88
Issue 1
Pages 36-43
Public URL
Publisher URL
Additional Information This is a description of an article published in: Neurology, 2017, v.88, issue 1.