Reliability of the Short Physical Performance Battery (SPPB): a systematic review with meta-analysis

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Clinical Biomechanics

Background:

• The Short Physical Performance Battery (SPPB) is a widely used tool for assessing physical performance in various adult populations.
• Reliability of the SPPB is crucial for accurate assessment and monitoring of physical function.
• Understanding the measurement error of the SPPB is essential for interpreting changes in performance over time.

Purpose of the Study:

• To systematically review and meta-analyze the reliability and measurement error of the SPPB in adult patients.
• To evaluate both intra-rater and inter-rater reliability across different SPPB components.
• To assess the quality of evidence for SPPB reliability studies.

Main Methods:

• A systematic literature search was conducted across five databases until March 2025.
• Studies assessing SPPB intra- and inter-rater reliability and measurement error were included.
• Random effects meta-analyses were performed on data from at least two studies for comparable properties.

Main Results:

• The SPPB total score demonstrated sufficient intra-rater (ICC=0.88) and inter-rater (ICC=0.86) reliability with high quality of evidence (QoE).
• Measurement error for the total score (MDC=1.90) was rated as insufficient with high QoE.
• Subscale reliability varied, with balance showing inconsistent results (ICC=0.69-0.77) and higher measurement error compared to the total score.

Conclusions:

• The SPPB exhibits supported intra- and inter-rater reliability for assessing physical performance in diverse adult populations.
• Measurement error is generally higher for SPPB subscales than for the total score.
• The findings support the use of the SPPB total score in clinical practice for its superior reliability.