The Functional Fitness 

MOT programme 

Impact  
assessment 

July 2014 
   

1
Summary of learning so far…
The Functional Fitness MOT training programme has to-date reached over 350
physical activity, health, exercise and fitness and active ageing professionals
across the UK in its first year (Summer 2013 – Summer 2014). 

A follow-up evaluation survey amongst 135 professionals indicates that 27% have
since organised an MOT event with the public (reach of over 600 older people), and
32% are planning to hold an MOT event in the next six months. Most MOT events
attract up to 20 people, but some local agencies have been successful in holding
events with as many as 90 participants in one day. 

The findings and materials for the day’s training are also being used for CPD
amongst Active Ageing teams. Fifty-four per cent of those attending report using
the functional fitness messages for inclusion/redesign of local programmes and 28%
report changes to public facing materials (eg, leaflets, posters, and programme
fliers). Professionals are using the training to deliver Functional Fitness
assessments in a variety of settings, including sheltered and supported
accommodation, GP practices, hospitals, universities and community and leisure
centres. 

Although no detailed statistical analysis has been possible, it is very clear from
these events that there is a lack of awareness of the UK CMO (Chief Medical
Officers’) physical activity guidelines for older adults (65+ years), even amongst
exercise and fitness professionals. It has become clear how few professionals fully
understand the concepts of strength, balance and minimising sedentary behaviour
or indeed which activities actually make a difference to the different components
of fitness (or which do not). Many of those who attend Functional Fitness MOT
training events rarely indulge in strength or balance activities themselves as
evidenced by their own poor strength and balance abilities when they were
assessed using the MOT. 

Some local programmes are using their local Functional Fitness MOT events and
activities to attract additional funding to initiate both research activities and new
physical activity programmes. Contrary to guidance offered to participants, the
assessments are being used to measure improvement in functional fitness. This
indicates the need for professionals to be trained to use validated tools to measure
functional fitness programmes and interventions. 

Follow up enquiries have identified the need for an adapted version of the
Functional Fitness MOT for use in residential and nursing homes and with disabled
people. 

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Introduction
Since 2011, Glasgow Caledonian University (GCU), the BHF National Centre for
Physical Activity and Health (BHFNC) at Loughborough University and Later Life
Training (LLT) have been collaborating to promote the use of the Functional
Fitness MOT.  

This tool was designed at GCU in 2011 to highlight the different components of
fitness necessary for older people to maintain independent living. It was also
created to help highlight the importance of physical and mental health and raises
awareness of the 2011 CMO physical activity guidelines for older adults (65+ years). 

What is an MOT for older people? 

The framework of the Functional Fitness MOT was established as a means of

translating research into practice. The MOT meets the reported needs of older
people in the following ways:  

• personal attention through one-to-one interviewing 

• time to understand different components of fitness 
• time to discuss barriers, motivators and solutions to initiate behaviour
change 
• using normal data sets from large studies for comparison to peers 
• personalised (tailored) information to take away, digest and take action 
• follow-up information (local) on how they can find out more. 

What a Functional Fitness MOT is not

• A research tool
• An evaluation tool
• An alternative for a pre-exercise assessment or PARQ
• An alternative to offering a tailored exercise programme.

The Functional Fitness MOT training programme was initiated in June 2011 at the
Glasgow Science Festival, run in Govan Shopping Centre and the ARC Leisure
Centre with GCU physiotherapy students and lecturers. It ran again at the Science
Festival in June 2011 and then was fully launched in August 2012 at the 8th World
Congress on Active Ageing, jointly hosted in Glasgow by GCU and the BHFNC.  

The BHFNC has identified the MOTs as priority training aligned with its role of
disseminating the key components of the UK 2011 CMO guidelines on physical
activity for older adults (65+ years) to the active ageing professional audience.  

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The Functional Fitness MOT
The Functional Fitness MOT is a person-centered tool that uses a number of
different physical function assessments to give older people an idea of how their
physical function compares to that of their peers. A Function Fitness MOT takes
approximately 60 minutes to complete per older person and contains the following
nine elements: 

Table 1 – Functional Fitness MOT components 

An assessment of…  Indicator of… 

Lower limb strength and Independent living,

30 second chair rise 
power  morbidity and mortality 

Mobility, agility related to

Timed 8ft up and go  Risk of falls 
walking ability and balance 

Six minute timed walk  Mobility   Aerobic Endurance 

Single leg stance  Balance  Risk of fall 

Hand grip strength  Wrist strength  Risk of fall 

Chair sit and reach  Hamstring flexibility  Walking ability 

Back scratch  Shoulder flexibility  Everyday tasks 

Physical activity Current physical activity Current levels and type

questionnaire  participation  of physical activity 

Height and weight  Optional 

 
The results of these assessments are used to discuss the different components of
fitness and highlight individuals’ strengths and weaknesses. It can also be used to:
 
• highlight the key components of strength and balance and their importance
in the maintenance of health and independence to older people 
• provide a means of assisting professionals with opportunities to engage older
people in a personalised physical function assessment  
• disseminate the UK 2011 CMO guidelines on physical activity for older adults
65+ to professionals working with older people.  
The Functional Fitness MOT has also been promoted as a potential community
Active Ageing engagement event as part of the annual Department for Work and
Pensions annual UK Day for Older People (October 1st). 

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 Bespoke Functional Fitness Training event in Dingwall, Highlands, Scotland 

The training day

Following the initial launch in August 2012, the BHFNC and LLT developed a one-
day hands-on training course for professionals on how to run Functional Fitness
MOTs for older adults.  

Each training event provides: 

• an introduction to functional fitness and the UK CMO physical activity
guidelines for older adults (65+ years) 
• a practical session where participants take part in the Functional Fitness
MOT 
• guidance on interpreting the results and how to encourage the individual to
take action 
• advice on organising and promoting Functional Fitness MOT events.  

As part of the training event, participants are provided with a course handbook
and have access to the Functional Fitness MOT Toolkit, containing the following
items: 
• a presentation on the Functional Fitness MOT for use as an awareness raising
tool 
• a template hand-out that can be personalised with local opportunities and
programmes in a local area 
• a set of protocols for the assessments that can be used 
• a set of circuit cards for use to set up your awareness raising event 
• an example of a poster to advertise a local event. 
 
Since June 2013, 90 Active Ageing For more details on upcoming events or
professionals in Scotland and a further 242 how to book a bespoke course, visit
across the UK have undergone this training. www.bhfactive.org.uk/older-adults-
Training is organised by the BHFNC on an training-and-events 
open basis or offered as closed bespoke
training to individual organisations.  

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Table 2 - Functional Fitness MOT training events summer 2013 - spring 2014 
Location  Date  Attendance  Type 

London  June 2013  25  Open 

Glasgow, Scotland  June 2013  35  Open 

Nottingham  June 2013  33  Open 

Sale  July 2013  32  Open 

Dingwall, Scotland  August 2013  30  Bespoke 

Cambridge  October 2013  18  Open 

Perth, Scotland  October 2013  15  Open 

South Oxfordshire  December 2013  32  Bespoke 

Greenwich, South
January 2014  25  Bespoke 
London 

Lisburn, Northern
March 2014  35  Bespoke 
Ireland 

Stroud  February 2014  22  Open 

Newport, Wales  March 2014  25  Open 

 
End of training day evaluation

The Functional Fitness MOT training days attracted a variety of professionals,

including:  
• active ageing professionals (18%) 
• health promotion/wellbeing (12%) 
• exercise teachers and instructors (23%) 
• local authority physical activity/sports development (26%) 
• adult/social care worker (7%) 
• exercise referral specialist (5%) 
• health trainers (4%) 
• physiotherapists and assistants (5%). 

All participants who attended one of the 12 Functional Fitness MOT training days
were asked to complete end of day evaluation forms. Reponses indicated that:  
• 94% would recommend this course to a colleague 
• 90% said after the training day they felt confident to use the information
presented in the training  
• 85% rated this course as useful or very useful to their professional role  

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Impact on knowledge and understanding
As part of the training, attendees were asked to record their individual key
learning at three points during the day. The following prompt was provided: what’s
the most important new learning for you during this session?  

Responses to this question suggest that there is a lack of awareness of the UK CMO
guidelines for physical activity in older adults, even amongst exercise and fitness
professionals.  

The following comments are just a few examples of the new learning that
professionals said they were taking away from the Functional Fitness MOT training
day:  
• the importance of strength and balance for older people 
• significance of breaking up sedentary behaviour 
• loss of muscle strength over time 
• standing activity instead of seated exercise 
• three months to replace 20 years lost strength and function 
• the importance of grip strength 
• other benefits of muscle strength, body temperature, resistance to
infection, cognition 
• UK 2011 CMO physical activity guidelines. 

Reflections for local delivering

Participants also highlighted a number of key learnings to think about when
delivering Functional Fitness MOTs locally, including:  
• the need to quality assure local physical activity opportunities  
• need to review quality and content of our own local public facing materials 
• ease of application and accessibility of MOT, eg, no PARQ required 
• the flexibility of the MOT and how it can be used/adapted/applied in
different situations 
• use of Functional MOT to generate ‘the conversation’ rather than being a
stand-alone test, a starting point to engage older people in physical activity  
• the importance of treating each person as an individual and taking time to
build a rapport rather than just treating older people as though they’re all
the same. 

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 Functional Fitness Training event in London 
 
Follow-up survey
Participants from the first cohort of open training sessions (summer 2013) were
offered the chance to give feedback on what they had done with their learning
since the training event. This opportunity was offered to the 120 participants who
attended training events in London, Glasgow, Nottingham and Sale.  

Participants were provided with a link to an online survey via email five months
after their initial training day. This survey was used to capture information on
subsequent activities undertaken by participants after the training day. About a
quarter of participants (26%) responded to the survey.  

Key findings
Ninety-three per cent of respondents shared the information learned during the
day either during meetings with other staff members (52%) or during informal
conversations (48%)  

Sixty-two per cent of respondents indicated sharing the information contained in

the UK CMO physical activity guidelines:  
• 14% used the information to help inform design and content of local
promotional materials  
• 57% used the information to change content of local programmes or
interventions  
• 32% included the information in education or training events with other
professionals.  

Twenty-seven per cent indicated they had organised a Functional Fitness MOT
event since attending the training day. MOT events were most frequently held in
town halls or sports centres. Table 3 provides information on the attendance and
structure of the events hosted. Of those who hadn’t organised an event, 81% were
still considering this as an option. 

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Table 3 – Number and duration of Functional Fitness MOT events 

Number of reported participants at MOT events  % reporting 

1-20  36 

21-30  36 

40+  28 

Length of MOT event 

60 - 120 minutes  42 

120 - 180 minutes  49 

180+  9 
 
Fifty per cent of respondents highlighted that they were using the information and
MOT activities in other areas of their work. Examples of how respondents were
using the information and activities included:  
• inclusion of the activities as part of an exercise class  
• within a GP referral consultation activity  
• on a one-to-one basis with individual patients 
• within university exercise and sports science courses.  

A number of respondents also reported greater use of motivational activities or

techniques with older people. 
 

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Case studies
The following case studies illustrate the different ways in which Functional Fitness
MOTs activities can be used to suit local programmes and partnerships. 

Case Study – Glasgow Caledonian University students delivering

Awareness Raising, Glasgow

In Scotland, over the past three years, 420 older people participated in a
Functional Fitness MOT, provided by Glasgow Caledonian University staff and
students. MOTs have been hosted in a variety of settings and have been aimed to
reach those hardest to reach (sheltered housing, shopping centres in
socioeconomically deprived areas).  

Photos from the ARC Leisure Centre, Glasgow.  

 

10
 

Photos from Govan Shopping Centre, Glasgow and the 8th World Congress on
Active Ageing, Glasgow. 
 
Case study - Link4Life Rochdale

Link4Life has used the Functional Fitness MOT as a guideline and starting point for
participants aged 60+, attending one of three ten-week functional fitness exercise
courses funded by the local Clinical Commissioning Group. 

Examples of impact on participants 

• Participant 1 – female, walked 195m on 6 minute walk test using her walking
stick, follow up she walked 226m without using her stick at all. 
• Participant 2 – female, walked 105m on 6 minute walk test with 2 rest stops,
follow up she walked 225m without any stop or rest. 
• Participant 3 – male, managed 3 sit to stands (with the help of a member of
staff) on 30 second sit to stand, follow up he managed 10 without any
support 
• Participant 4 – female, managed only 1 second on balance test and said she
could not do that as it was too painful, follow up she managed 42 seconds on
the same leg. 
• Participant 5 – female, can now change her duvet cover herself, something

she hadn’t done for ten years without her son’s help. 

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Using the MOT as a guideline and providing personal scores brings home to
participants how they can improve, how much more they can do and encourages
them to keep trying and working harder to improve. Participants from this course
now attend aqua aerobics, yoga and Zumba Gold sessions on a regular basis.

Case Study – Reaching Older Adults in Renfrewshire, Paisley,

Scotland

Twenty-seven older volunteers within the Reaching Older Adults in Renfrewshire

(ROAR) project underwent a Functional Fitness MOT facilitated by physiotherapy
students from Glasgow Caledonian University, in conjunction with a motivational
interview. Participants were followed-up three months after their original MOT and
showed improvements in the following functional tests: 
• Chair Sit to Stand - average 1 extra chair rise in 30 seconds 
• Timed Up and Go - average 2 seconds quicker 
• Walking distance in 6 minutes - average extra 30 yards 
• One leg stand ‐ average extra 15 seconds on each leg 
• Self-reported physical activity - this varied from individual to individual with
some suggesting they were doing more moderate activity (ie, walking) and
others concentrating on home-based balance exercises or tai chi groups.
This is to be expected as the advice was tailored to suggest activities that
would improve upon the needs of a participant’s particular area of weakness
as highlighted by the Functional Fitness MOT. 
• Sharing information – participants reported sharing their new knowledge
with their peers, their family and the sheltered housing residents they
worked as volunteers with. 

Photos from Functional Fitness MOTs delivered at ROAR (Reaching Older People in
Renfrewshire), Paisley 

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Case study Aberdeen City Council, Scotland

Aberdeen City Council has used the Town and County Hall to host a one day
prevention event to target those aged 60+, who are relatively fit, active and want
to remain as independent as possible. This Functional Fitness MOT event reached
40 people.

The Functional Fitness MOTs were included within a programme where participants
were invited to come and get advice about: 
• keeping eyes, feet and mind healthy 
• preventing falls 
• how technology can help keep independence 
• suitable exercise classes, social activities and events. 

The event used two rooms - the Functional Fitness tests/health MOTs performed in
one room and exhibitors in the connecting room. 

Once people had had a health check, they were passed onto the Functional Fitness
tests. After the assessment, the individual was signposted to exhibitors in the next
room who were promoting their local services and classes. 
NHS Healthpoint carried out the health checks – (height, weight, blood pressure). 
Wellbeing Co-ordinators (a qualified Occupational Therapist and a Personal
Trainer) carried out the functional fitness assessments. 

Exhibitors included Sport Aberdeen (promoting their OTAGO, Zumba, Aqua Zumba
and health walks), City Moves (a dance organisation promoting dance and arts
classes), NHS Falls Team, Alzheimer’s Scotland (promoting how diet and exercise
can help prevent dementia), NHS Healthpoint (promoting nutrition and weight
management), Podiatry services (promoting foot care), Aberdeen Sports Village
(promoting their Evergreens programme) and Telecare (promoting how to use
technology to help maintain independence). 

Aberdeen City Council has decided to make this a bi-annual event - spring and
autumn. 
   

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Sheffield Hallam University

Using their Functional Fitness laboratory and including the assessments from the
MOT programme, final year students studying the ‘Physical Activity Referral

Schemes’ module, undergo a Functional Fitness Assessment. However, the

assessment is undertaken wearing an age simulation suit GERT, which offers
students the opportunity to experience the potential impairments related to
ageing such as: 
• opacity of the eye lens 
• the narrowing of the visual field 
• high-frequency hearing loss 
• head mobility restrictions 
• joint stiffness, loss of strength, reduced grip ability 
• reduced co-ordination skills 

 
Age related simulation suits 

South Oxfordshire District Council

South Oxfordshire District Council has organised nine successful Functional Fitness
MOTs events, following up each MOT event with taster sessions to engage those
who currently do no physical activity. Each event has been arranged in partnership
with an existing community group, to aid promotion and provide local knowledge.
The nine events have attracted a total of 96 participants who were all introduced
to follow up taster days with local events including Pilates, Yoga, Nordic Walking,
table tennis, keep fit, Zumba, New Age Kurling and tai chi. 

A Pilates teacher and walk leader has now incorporated strength and balance work
into group activities. The majority of those who attended the Functional Fitness
MOTs were either Health Walkers or attended Pilates classes. Feedback has been

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very positive and many have indicated that they would welcome the opportunity to
repeat the assessments at a later date to see if there has been an improvement. 

This encouraged one lady, another health walker, who had just started to have
problems getting up off the floor to do these exercises on a daily basis – the result,
after three weeks was able to get up off the floor without difficulty. 

Another lady in her late 60s, discovered that her flexibility was low and she was
recommended to take up Pilates or Yoga. Having joined a Pilates class, she is
finding her range of movement improving especially in the arms and shoulders. 

Saturn Fitness club have incorporated Functional Fitness MOTs into their induction
programme with new senior members. 
 
Case study – Aberystwyth University

A joint collaboration between Age Cymru Ceredigion and the Department of Sport
and Exercise Science, Aberystwyth University. 

An inaugural Functional Fitness Testing workshop, organised to raise awareness of

the benefits of physical exercise and activity amongst the over 60s attracted
eighty people (aged 60 to 95) from the Ceredigion area. 

Planning included: 
• eighteen students from the University who were trained to undertake the
Functional Fitness assessments and also benefited from the
intergenerational opportunity of practical working with older people.  
• recruiting five volunteers from Age Cymru, Ceredigion who provided
assistance throughout the day.  
• the inclusion of scientific measurements of strength and balance including
body composition measurements in state of the art facilities at the
University. 

In order to follow up progress of individuals, participants agreed to complete an

additional record sheet with personal details. 
 

15
 Recognition and testimonials

20 new ideas from UK universities that will change the world

The theme of Universities week, (June 9th – 14th 2014) is Ideas for Life
and the relevance of university research and its everyday impact on
our lives. To this end, a survey commissioned for the annual event,
which is run by Universities UK with Research Councils UK, the Higher
Education Funding Council for England and the National Coordinating
Centre for Public Engagement, asked the general public about the
issues that they want university research to address. 

Thirty per cent said they wanted improved wellbeing in old age; just under half (47
per cent) wanted better treatments for the UK’s most deadly  

diseases; a quarter wanted technology that would improve people’s quality of life;
and 38 per cent said they cared about living in cities that are safe, enjoyable
places. 

With this in mind, 20 UK university research projects

that hope to tackle these issues have been
highlighted as part of the celebrations.  

The Function Fitness MOT was included as one of the

20 new ideas from UK universities that will change

Scotland Physical Activity and Health  

 
Alliance Awards (PAHA)

The Functional Fitness MOT programme was short

listed in the final three programmes under the
category “Raising Community Awareness” in the 2014
PAHA Annual Awards.

 
“I feel the course has made me feel more
confident with my mobility and ability and
that I am healthier and have stronger joints.
I have now joined the gym and attend the
yoga and aqua aerobics sessions which I
would not have done before going on this
course” 16
  
“I think functional fitness is an excellent idea,
wish there were more like it, it was fun and
interesting and I certainly enjoyed the MOT… I

found the session very useful.” 

 
"You spend more time with us than the doctor
does and a really nice atmosphere to get this
done in, loved the 50s and 60s music
throughout the day”. 
Male participant 72 Aberdeen

“We have decided to make this a bi-annual event in the spring and autumn.
“We have just run our first pilot of this session
We will also be hosting smaller events in which we signpost the activities
and have
rather had
than amazing
having results on-site.
exhibitors with ourOne is scheduled for a much deprived
participants,
area I really
in Aberdeen nextenjoyed
month the
withcourse and I
the community centre hosting the event
knowwill
and from
putexperience
on a healthythat this for
lunch sortparticipants
of sessions following the events. Thank
will be so
you for beneficial
providing theto so many
skills people” 
to help get people active again.” 
Physical Activity
Co-ordinator, Co-ordinator
Aberdeen North  West 
City Council

“The majority of those who attended the functional fitness MOT’s

were either Health Walkers or members of a Pilates classes. I have
spoken to the majority of those who attended and the feedback has
been very, very positive. Many have said that they would welcome
the opportunity to repeat the tests at a later date to see if they
have improved their physical function.” 
Walk Leader, Sonning Common, Oxfordshire 

17
Looking forward – shape of things to come

UK Day for Older People

The BHFNC and its partners Glasgow Caledonian University and Later Life Training
will again be promoting the use of the Functional Fitness MOT events as a
contribution to the 2014 October 1st UK Day for Older People. 

Applications to other population groups

In the summer of 2014, new work is beginning to look at the potential of the
Functional Fitness MOT model and its application to both frailer, older people (as a
model for use within residential care settings) and with disabled people. Older
people living within care settings are known to have far more functional
limitations, an increased risk of falls, sensory impairments and other conditions
including lower levels of cognition. However, the principles of the Functional
Fitness MOT (including awareness raising amongst staff and residents, person-
centred individual assessment and planning and the promotion of independence
and activities of daily living) still apply to this population group. 

Research into the use of the Functional Fitness MOTs

Lothian NHS has been successful in applying to the Edinburgh & Lothians Health
Foundation for a feasibility study to look at the effect of the Functional Fitness
MOT in engaging older patients of a physiotherapy service in increasing levels of
physical activity. The study will investigate whether the MOT is appealing to older
physiotherapy patients and can be delivered efficiently in a health centre setting.
Patient recruitment and retention rates and the extent to which outcome data will
be collected and will be measured with a view to planning a future pilot trial of
the MOT compared to the usual treatment provided. The study will start in
September 2014 and run for ten months. Gathering data on uptake, use and
change in behaviour after three months, the study will also involve interviews with
staff and older people involved to further understand its potential to measure and
change physical activity behaviour amongst older people. This may change the
advice given so far and suggest that the assessments can be used to measure
improvement in functional fitness. 

Inclusion of functional fitness within Intergenerational activities

There is emerging interest from universities and FE colleges in the way in which
younger and older people can be given opportunities for Intergenerational learning
and activities linked to functional fitness and physical activity promotion. 
 

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Further information
For more details of the Functional Fitness MOT resources visit 
www.laterlifetraining.co.uk/functional-fitness-mots-for-awareness-raising

For details of current courses visit 

www.bhfactive.org.uk/older-adults-training-and-events

For details of UK CMO Guidelines on Physical Activity visit 

www.bhfactive.org.uk/older-adults-guidelines

For further details about sedentary behavior and older people visit
http://www.gcu.ac.uk/seniorsusp

For details of the DWP Full of Life and UK Day for Older People visit  
www.olderpeoplesday.co.uk
 

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