Chair Stand Tests 07052013 4 PDF

CHAIR STAND Tests
This document reviews the one, five, and ten repetition timed sit to stand test, as well as those done in 30 seconds;
this test is also known as timed chair stands. Although most of the literature pertains to an adult population, a
section reviewing the test in a pediatric population is included in the One Time Sit to Stand section.
Type of test:
 Time to administer: 5 minutes or less

 Clinical Comments: Familiarity with stopwatch mechanism prior to administering test is important.
Placing chair against a wall or stable surface prior to beginning test improves patient safety. Rising from a
low chair may entail more than 100 degrees of knee flexion, 80 of hip flex and 25 degrees of ankle
dorsiflexion.1
Purpose/population for which tool was developed: The timed chair stand, with variations in directions given
to the subject has been referenced in literature more than 80 times since proposed by Csuka 2 as a simple measure of
lower extremity strength; there are multiple earlier, less validated references to sit to stand as a testing or exercise
technique. It has also been used to examine functional status 3-7 lower extremity muscle force/strength 8-14, 15 , 16, 17,
strength in subjects with CVA18-21 neuromuscular function 22-25 balance 26-29, vestibular dysfunction 30, and to
distinguish between fallers and non-fallers 22, 31-33 in an older population and a subpopulation of people with
Parkinson’s Disease (PD)34 and in chronic CVA18. Bohannon 200835 reports that the frequency of sit to stand is 43
to 49 times per day. Body weight (40%) is required of the knee extensors to stand without use of arm push-off.36, 37
When appropriate to use: This tool has been used to evaluate patients with LE proximal weakness,2
 patients with chronic low back pain 33, 38
 patients with knee osteoarthritis 6, 7, 16, 17, 39-43
 hip osteoarthritis 17, 43
 weight-bearing asymmetry 40
 rheumatoid arthritis, and other chronic diseases,8
 Parkinson’s Disease 34, 44
 and after arthroscopy.14, 29
 to compare methods of training, ,3, 45
 as an assessment of fitness,10 or
 frailty.46, 47,
 as measures of function , strength and balance in CVA 18-21
 as a tool to quantify the ability of people with balance disorders to perform transitional movements 48
 to measure effects of supplementation 41

 to help predict individuals with Parkinson’s Disease at risk of falling34.
 after total knee arthroplasty 49-51
Scaling: Results of the test are reported as a ratio data, either as the number of stands completed in (up to) 2
minutes or the time it took in seconds to complete 1, 5, or 10 chair stands. If a client cannot do the test without use
of hands, timed results may be reported incorporating the amount of assistance required or as nominal data (Unable).
For example, in a study of 1500 subjects in which 3 trials were allowed, 52 87% were able to rise without use of
hands on the first trial, 11% required use of hands which was allowed on the second trial, 1% required an assistive
device which was allowed on the third trial, and 1% were unable to stand without the assistance of a person.
Equipment needed:
 Stopwatch or clock with second hand

 Sturdy, straight-backed, armless chair with seat height to attain knee angle of 90 degrees when subject’s
feet are on the floor. Chair heights, if reported, have varied from 35.56 cm to 46 cm. Clinicians
monitoring change over time with a client need to use a consistent chair or chair height for reliability of
Compiled by Michele Stanley, Teresa Steffen, and numerous students. Thanks to Lina Prosser for
her help in formatting the outline. Do not copy without permission of the authors. Page 1
CHAIR STAND Tests
results. Rising from a low chair may entail more than 100 degrees of knee flexion, 80 degrees of hip
flexion and 25 degrees of ankle dorsiflexion1
Test variations: There are multiple variations of the sit to stand maneuver as a test including
 total number possible in 10 seconds, 7, 53-55
 total number possible in 30 seconds,42, 56-59
 total number in 1 minute,60, 61 or
 3 minutes.62
 Other reported versions allow use of hands for push-off or descent, alter foot placement, or do not time the
maneuver.63-69
 Another version records time to perform 3 sit to stands. 70
Clinically, the most common variations record time to perform one, five, or ten sit to stand repetitions. The
Center for Disease Control fall prevention task force, in the United States, included the 30 second sit to stand
test in the tool kit for health care providers. 71. Literature varies from no practice/test trials to a total of 3 trials
with best time recorded.72 5 total trials with 2 practice trials 3 test trials with the mean used for data analysis
20
two trials with the mean values for data analysis19
 An additional variation includes placing the hands on the ASIS rather than crossed over the chest 45
 Christiansen 2011 looked at weight-bearing asymmetry when subjects with knee osteoarthritis performed
5TSTS on a force plate.
 Akram 201173looked at movement of the body and stability with 1TST
Directions: The subject is to sit in the chair with arms crossed over his/her chest. Instruct the subject to stand up
as quickly as possible safely without using his/her arms (1, 5, or 10 times or 30 seconds) on the word “Go.” Begin
timing on the word “Go” and stop timing when the person comes to the last complete stand or sits after the last
stand. Record the time in seconds or number of completed stands for the 30 second version12, 16, 17, CDC 2013, 22, 33, 34, 39,
41, 43, 50, 55, 64
Ceiling or floor effect: People need to be able to rise independently from a chair for the test; thus it would not be
appropriate for very low functioning and dependent individuals.
Interpreting results: This test has been interpreted as a measure of one component of balance and as a measure
of strength of knee extensor and back muscles.
Other: In one study of persons with Alzheimer Disease 74, instructions were modified.
CHAIR STAND Tests
One Time Sit to Stand (1TSTS)
as quickly as possible safely without using his/her arms on the word “Go.” Begin timing on the word “Go” and stop
timing when the person comes to a complete stand. Record time in seconds.
Reliability:
Reference N= Sample Description Reliability Statistic
Intrarater Reliability: same rater within one session (or day)
Nevitt 1989 22 27 Community dwellers with 1 or more falls in ICC = .89 - .96
past 12 months
Interrater Reliability:
Nevitt 1989 22 27 Community dwellers with 1 or more falls in ICC = .93 - .99
past 12 months
Test-retest Reliability
Jette 1999 64 105 Frail community elders. Mean 14 days ICC = .25
between testing dates (range 0-132)
Validity
Construct/Concurrent Validity: It is difficult to always differentiate between these 2 types of validity. Evaluating
this property requires a “gold standard” measure with which to compare the test results. Such a “gold standard” is
often not available.
Population N= Support for Validity
Community-dwellers 50 Ratio of leg ext peak isometric torque to body wt
Age range 56 – 95 years13 explains 33% of time variance in multiple regression
model of 1TSTS performance; age and steadiness were
not predictive of 1TSTS.
Persons with chronic CVA23 22 Pearson correlations (p<0.05) between TSTS & paretic
ankle d-flex (-0.45), & knee ext (-0.72); greater weight-
bearing symmetry relates to faster TSTS
(-0.56) as well as to faster self-paced TSTS (-0.56)
Predictive Validity
Community dwellers31 761 Risk of falling predicted by inability to perform 1TSTS:
Female: relative risk 2.5 (1.5 -4.3 95% CI); Male:
relative risk 5.0 (95% CI = 2.1-10.9). Age controlled.
Community dwelling individuals, 13 No difference in muscle activation (Quadriceps Femoris
mean age 71.5years, with Stage II and Hamstrings) on EMG analysis, and no difference in
Hoehn and Yahr staging Parkinson’s peak force or kinematics on 1TSTS between individuals
Disease 44 with PD and matched population without. However,
significant within group differences were found for the
PD group with respect to peak torque and kinematics.
Community-dwellers with 1 or more 325 22% of subjects who were unable to complete 1TSTS in
falls in past 12 mos22 <2sec had 2 or more falls; Relative risk of falls 2.4
(95% CI =1.8 -3.2). Adjusted Odds Ratio 3.0 (95% CI
=1.2-7.2) as independent predictor of multiple falls
Responsiveness/Sensitivity to Change
Population N= Intervention Responsive Av change post intervention
Yes/No Significant differences?
Community dwelling 15 Exercise Intervention n = 15 Pre: 1.7 (0.7)s;Post:
adults 3x/wk x 8 week low to yes 1.3(0.4)s;
Age 66 – 97 years moderate intensity group ex 29% improvement
CHAIR STAND Tests
75
No difference on 1 year
follow-up of 9 subjects
Community dwelling 52 Exercise (EX) intervention yes Ex Pre: 2.50s
adults with Parkinson’s (n= 19) consisting of 20 Ex Post:2.28s
Disease average minutes, 3x/ week/ 4 weeks.
Hoehne and Yahr AV Pre: 2.80s
Staging 2.7 45 Cued task specific AV Post:2.10s
audiovisual (AV) training
(n= 19) consisting of 45 Control Pre: 2.40s
minutes, 2x / week for 4 Control Post: 2.41s
weeks.
Exercise and AV group
Control: no treatment (n=14) significant improvement over
control (p<0.05 and 0.01
respectively).Maintained
gains at 2 week follow up.
Community dwelling Subjects Baseline= 6 weeks pre-THA; yes CI (.95)
adults with cemented 30 male Intervention = 6 months Pre: 3.0 (2.8-3.2)s
post-lateral THA, post-THA Post: 2.6 (2.5-2.8)s
Age 60.3 (13)years Controls Control = healthy P<0.0001
BMI 26.4(3.4) 11 male 0.375s change p<0.0001
Controls 60.3(12.9); 20 computerized random Dependent t test
BMI 25.3(3.3) chair rises in own Controls 2.3(2.2-2.5)s
76
environment from morning P < 0.001
until dark Independent t test
effect size large .85,
6mo post op to control p=.001
one-tailed calculated by CP
Ceiling or floor effect:

In a community-based prospective study of 761 adults over age 70, 90 women and 34 men were unable to perform a
single TSTS; of these 50 women and 19 men were identified as fallers. 31
In a study of 32 community dwelling individuals with PD, with stage II Hoehn and Yahr staging (Mean age not
given), failure to complete the sit to stand maneuver (backward fall to chair) was due to poor timing of peak forward
velocity of Center of Mass (COM) in relation to hip height off the chair. 77
Interpreting results: This test has been interpreted as a measure of one aspect of balance and as a measure of
strength of knee extensor and back muscles.
Reference Data
Subjects N= Timed Chair Stand Scores
Mean (SD) Range
Healthy PT students; mean age 20.1 47 2.04(0.39) seconds 1.30—3.18 seconds
(2.8)years 25 20males
Healthy subjects, mean age 30 2.3 (2.2-2.5) seconds
60.1(12.9) years Male CI (.95) p = 0.001
years BMI: 26.4 + 3.4
76
CHAIR STAND Tests
Other:
Untimed 1TSTS
Population Descriptor N= Results
Non-fallers in community (23- 23 Rate of rising (as measured by force/time) identified 17 out of
92yrs) Fallers in a care facility (63- 21 fallers and 1 out of 23 non-fallers; retrospective study
92years) 32 22
Residents of an intermediate care 79 25/79 were repeat fallers; 20% of the fallers but none of the
facility 47 non-fallers had difficulty with arising; mean times not given.
Elderly persons with balance 14 TSTS correlates with 15 other balance test items; total
impairment 26 correlations of 0.90.
Pediatric Studies of 1TSTS
Cahill et.al. (1999)78 reported that healthy children exhibit more variability in STS patterns than adults with the
greatest variability seen in children < 5 years of age. By 9-10 years of age the STS patterns were similar to those of
healthy adults. Characteristics of sit-stand transfer in children with CP (time to stand through different phases, effect
of bench height, weight resistance) STS from neutral ankle and knee flex at 90º (low) and at 120º of this (high), 3
phases measured78
Population Descriptor N= Results
Children 15 Real time 5 phases of sit to stand ; Mean +SD seconds
w/diplegic cerebral palsy (CP) Right side Left side
(mean age 48.9+15.9 months) Trunk hip flexion .64 +.15 .69+.19
Max hip flexion .21 + .12 .16 + .18
P < .05 Children with CP compared Knee ext ankle DF -.10 +.12 -.05+ .08
with normal children Max ankle DF/just stand 1.21+ .22 1.23+.24
Just stand/stable stand .45+ .19 .46+ .17
Total time 2.41 2.49
Plegic Sound
Trunk hip flexion .62 + .18 .70 + .30
Max hip flexion .18 +.22 .15+.09
Knee ext ankle DF .22+.76 .05 + .16
Max ankle DF /just stand .69 + .63 .89 +.46
Just stand/stable stand .37+.33 .30+.33
Total time 2.08 2.09
Normal children 21 Trunk hip flexion .32±.08
(mean age 47.7 +7.9 months)79 Max hip flexion .05±.07
Knee ext ankle DF .10±.12
Max ankle DF/just stand .38 +.14
Just stand/stable stand .27 + .06
Total time 1.12
Children 20 Phase duration (seconds) Ave from low and high position measures
With hemiplegic or diplegic CP 10 Mean (+SD) Mean (+SD) Signif-
Mean age 4.5 – 15.7 years With CP. Non disabled icance
and Flexion momentum 64 (.13) .54 (.12) NS
Without disabilities 10 Momentum transfer 22 (.94) .21 (.14) NS
Mean age 4.3 -11.8 years Extension phase .85 (.28) .45 (.14) P<.05
Low bench height (measured in Total STS time 1.71 (.36) 1.24 (.18) P<.05
prone): distance from bottom of heel Seat height had significant effect on duration of extension phase(F=19.64)
to popliteal crease, neutral ankle, 90o Extension Phase of STS was significantly longer for children with CP (.85s )
knee flexion. High bench height: compared to children without disabilities (.45s ),
120% of low bench height 80 Children with CP took significantly longer to perform STS ( 1.71s ) than
children without disabilities ( 1.24s )
1 High STS 1RM: 11.3(3.6)kg. Ascending time mean with high resistance
5 1.7 sec as measured on reported x-y graph
CHAIR STAND Tests
Children (with mean +SD weighted Ascending time compared to control significantly different(more time)
vest in kg based on max weight - with High STS 1RM t =3.1, p=.004
1RM (reliability ICC = .88-.97) 1 High STS 1RM 26.1(5.0)kg. Ascending time mean with high resistance
With CP (Mean age 8.5 +2.2 years) 5 1.25 seconds as measured on reported x-y graph
Without CP(Mean age 8.9+ 1.7) 81

Critical Review of STS in children CONCLUSIONs
with CP: 9 studies in which the N Need to select standardized inclusion criteria
ranged from 19-562,mean STS movement can be considered to better understand health conditions in
91.77(176,86). Three of the studies children with CP
characterized STS movement in Definitions of STS movement phases lack standardization
children with CP. 82 Analysis of STS movement enables further exploration of functionality
through biomechanical analysis of movement and effectiveness of
intervention protocols
Analysis methods of STS movement needs standardization
Decrease in% of children able to perform STS with increase in external
support according to following types: unilateral spastic; ataxic; bilateral
spastic; dyskinetic
Suggested that children with CP be divided into 4 groups based on
movement characteristics: 1) greater trunk forward movement 2)buttocks
movement forward along seat 3)buttocks forward movement to shift center
of mass forward 4)early knee extension presented
Children with CP took longer than controls to perform STS
Variations in STS similar to controls
Increased final pelvic tilting and obliquity angles, greater maximum flexion
of the hip joints and greater maximum ankle dorsi flexion was found in
children with CP
Maximum power of the hip and knee extensors and maximum moments of
the knee joint where significantly reduced in children with CP
Children with CP exhibit muscle weakness, poor postural control and
disturbances in balance
STS duration was shortened in CP children with the use of hinged AFO
There were improvements in kinematic variables involving increased initial
knee flexion and ankle dorsi flexion with AFO use
There were increased extension phase duration, maximal horizontal and
vertical velocity of the head and maximal vertical ground reaction force
when both normal and CP children stood from low seat heights
Children with CP took longer with STS from low seat height compared to
control
CP children had lower agonist contraction (vastus lateralus) when the load
was high
Extrinsic factors of STS can be modified to either facilitate or complicate
STS movement in CP children
STS can be incorporated into rehab protocols and to measure effect of
interventions in CP children
CHAIR STAND Tests
Five Times Sit to Stand Test (5TSTS or FRSTST)
as quickly as possible safely five times without using his/her arms on the word “Go.” Begin timing on the word
“Go” and stop timing when the person sits after the fifth complete stand .16-21, 33, 34, 39-41, 48, 55, 83-92
Some authors stop the test when the person completes the 5th stand 43, 93-98
Others do not specify end point.6, 17, 18, 30, 38, 99-107
Other authors score 3 trials, with rests between, and include only best trial.72
In the 5TSTS portion of the Life Space Assessment (LSA) 89 ordinal scores are assigned based on time to complete:
0 = Unable to do; 1 = > 16.7 seconds; 2 = 13.7 – 16.6 s; 3 = 11.2 – 13.6 s; 4 = < 11.1s.
In the FTSTS of the Intervention of Fit and Strong Study (Hughes, 2004) 17, time was measured to nearest tenth of a
second and raw scores were transformed into rate per minute in order to accurately assess change in those who were
unable to perform the test at any point.
Choose reference data that matches your directions on when to end the test. Time is recorded in seconds.
Reliability:
Ostchega 200094 392 Community dwellers >age 60 ICC = 0.64
Blake 2004108 24 End stage renal dialysis patients and ICC = 0.98
healthy matched controls
Mong et al 201020 36 12 subjects with chronic stroke, 12 healthy ICC=.970-.976

elderly subjects and 12 young subjects
Interrater Reliability
Ostchega 2000 94 392 Community dwellers > age 60 ICC =0.71
Duncan 2011 34 82
Community dwelling individuals with ICC(1,1) = 0.99
idiopathic PD
Mong et al 201020 36 12 subjects with chronic stroke , 12 healthy ICC=.999
Test-Retest Reliability The reported range on test-retest reliability was .64 to .99; the current MDC is 2.3 and
1.6 and 1.24 (same day) seconds. It would be best to use 2 seconds as the MDC.
109
McCarthy, 2004 47
Community dwellers age 65 (3) 5TSTS 11(2) sec
r = .95
MDC (95) 1.24 sec
Seeman, 199484 1192 Subset of EPESE study, age 70-79, 2 ICC = 0.73
weeks
Duncan 2011 34 82 Community dwelling individuals with ICC (2,1) = 0.76
idiopathic PD
Hoeymans, 199793 99 Men born between 1900 – 1920 & living in r = 0.82
Zutphen, Netherlands, 2 weeks
Jette, 199964 89 Frail elders from community, 2 weeks ICC = .67
CHAIR STAND Tests
Schaubert, 200591 10 Ambulatory community dwellers, mean ICC = .81

age 76(6) yrs (6 & 12 week intervals)
Lord, 200299 30 Community dwellers ICC = .89
Sherrington, 2005110 27 Community dwellers, mean 11 days after ICC(3,1) =.92
ORIF hip fracture; retests done at 3 and 6
weeks
Tiedmann, 2008107 362 Community dwelling elderly age 74-98 ICC(3,1) =.89
Kim, 201133 30 Lumbar spinal stenosis patients waiting for ICC= .95
43 cm height and barefoot surgery and matched bilateral knee
osteoarthritis patients waiting for surgery,
Lin, Y-C, 2001, chair 106 Sedentary community dwellers with hip or ICC=.96
height 44.5 cm, ending in knee OA
standing position.43
Mong et al 201020 36 12 subjects with chronic stroke , 12 healthy ICC=.989-.999
Butler et al 200921 734 50 young subjects (20-39) ICC=0.89
684 OLDER(75-98) 95% CI =.79,.95
Bohannon, 2007111 94 Nondisabled community dwelling adults ICC = .96
aged 19-84
Bohannon, 2011112 Summarizing 10 studies Mean ICC = 0.81
Schaubert, 2005 91 113 21 Community dwelling adults aged 65-85 ICC = .82
seen at baseline 6 and 12 weeks
Validity: Body weight, BMI, knee extensor (quadriceps) strength and age all seem to correlate with FTSTS -
often not available
Population N Support for Validity
Ambulatory, community-dwelling 50 On stepwise regression analysis, composite muscle strength
people with chronic stroke 92 measured by 5TSTS accounted for 43% of the variance in BBS,
64% of TUG variance.
Community dwelling, ambulatory 31 Failed to find significant relationship between knee extensor
persons with single ischemic CVA, power or strength with 5TSTS time. In regression analysis,
6-24 mos since CVA98 self-perceived ability did predict 43% of 5TSTS.
People with Rheumatoid Arthritis, 135 Knee strength inversely correlated with 5TSTS ( -0.47).
age 62(10)101
Subjects 3 months post TKA for OA 14 Subjects shifted weight away from the operated leg during
102
5TSTS. Asymmetry in weight bearing and uninvolved hip
extension moment during 5TSTS are related to amount of quad
asymmetry (0.56)
Well-functioning, age 70-79, 2928 5TSTS and knee strength (–.0.26), 6MWT (-0.36), 400m walk
community dwellers with (0.35) & standing balance (-0.16). Correlations controlled for
bone mineral density BMD 95 age, sex, race, bone site, height and weight.
Persons with and without balance or 174 5TSTS scores correlated inversely both with DGI test scores (-
vestibular disorders48 0.68) & ABC (-0.58)
Age> 65, ind ambulatory (58% 179 Correlations between 5TSTS and time to complete 3600 turn
w/assist device) living in community (0.26) and walking speed (-0.23)
or CBRF97
Community dwelling adults age 65 – 139 Correlations of 5TSTS with self-reported limitation in stair
9315 flights climbed ; one flight (0.38), several flights (0.26)
Non-disabled community-dwelling 104 Pearson correlations of 5TSTS with waist circum (0.34), W/H
women, age range 60-90114 ratio(0.28), BMI(0.40), & 25’ walk time(0.56); inversely
CHAIR STAND Tests
correlates w/one leg stance time (-0.29) &Phys FuncSF-36(-

0.29). BMI is a predictor of 5TSTS time.
Residents of a retirement village, 176 5TSTS time associated with high visual acuity (0.23), reaction
ambulatory w/o AD115 time (0.36), proprioception (0.27), and inversely associated
with visual contrast sensitivity (-0.31), ankle dorsiflexor (-0.49)
and knee extensor strength (-0.51). In regression analysis of
5TSTS Betas with ankle flexibility (-0.51), knee ex strength (-
0.39), age(0.19), hallux grip (-0.16) contrast sensitivity (-0.13)
Ambulatory, community dwellers; 10 5TSTS correlates with TUG (0.73 – 0.92) and inversely with
mean age 76(6) years 91 gait speed for 3 testing sessions (-0.78 to -0.94)
Community dwelling > 65 89 1000 Correlation with Life Space Assessment, LSA, (0.51)
Community dwelling Age > 75 99 642 Visual contrast sensitivity, LE proprioception, tactile
sensitivity, foot reaction time, postural sway, body wt, pain
report, anxiety, & vitality, &strength of knee ext, flex, &
ankle DF are all significant, ind. predictors of 5TSTS times
(R2 = 35%). Knee ext strength (corrected for body wt)
accounted for the largest Beta in the 5TSTS regression
analysis.
Community dwelling, medically 16 Significant relationship between 5TSTS & combined hip
stable adults, age 75 -889 extension, knee extension, & plantar flexion strength when
chair ht 14”(0.64) but non-significant relationship from 18”
chair (-0.34). Non-significant associations observed between
5TSTS and individual muscles.
Community dwelling individuals 82 Correlation Coefficients Between FTSTS Test
with idiopathic PD34 Variable Correlation P
Age .37 .001

PASE .38 .001
PDQ-Mobility .58 .001
FOGQ .44 .001
PDQ-SI .38 .001
ABC .54 .001
Mini-BEST .71 .001
Quadriceps MVIC .33 .003
9HPT .55 .001
6MWT .60 .001
Ambulatory community dwelling 46 Correlation with gait speed (-.071), and stair climbing 12 steps,
adults on hemodialysis, age 22-87104 7 inches tall (.059)(p<0.0001)
Subjects with Chronic Hemiparesis20 36 5TSST test scores had significant negative correlation after
Bonferroni correction with affected ( p= -.753;p=.005) and
unaffected (p=-.830;p=.001) knee flexors of subjects with
stroke. No significant association found between 5TSST score
with BBS and LOS performance in subjects with stroke
Subjects scheduled for TKA 53 Greatest asymmetry in weight-bearing with sit to stand is at one
measuring asymmetry in weight 36 with month post-op (r=-.33), returned to pre-op levels at 3 months
bearing pre and post-op for TKA. knee OA post-op(r=-.26), more symmetrical at 6 months post-op than at
Age=63.4±7.740 to pre-op(r=-.31).
undergo at one month post-op=11.3 seconds
unilateral at three months post-op=8.8 seconds
TKA at six months post-op=9.4 seconds
17 healthy Greater symmetry with weight bearing during STS associated
people with increased quad strength symmetry (range, .26-.39).
People with Balance disorders age 93 The Spearman rho between the 5TSTS and the DGI was -.68
23-9048 Between 5TSTS and ABC was -.58
CHAIR STAND Tests
Community dwelling adults aged 94 Greater age (.53), weight (.28), and BMI (.34) were
19-84111 significantly correlated with longer STS time. STS time had
fair correlation with physical functioning (-.47) as reported on
the physical functioning subscale of the SF-36.
Subjects in MA Male Aging Study, 684 5TSTS time does not predict or correlate with testosterone
mean age 68(8)116 hormone levels
Community dwellers in Netherlands 1262 Apolipoprotein E e4 polymorphism associated with poor
96
5TSTS time, age and sex adjusted OR 1.94
Healthy post-menopausal women; 116 5TSTS time doesn’t predict or correlate with bone mineral
mean age 68(7)88 density at any skeletal site.
Ambulatory community dwelling 46 Univariate association among predictor variables and 5TSTS.
adults on hemodialysis, age range Decline in performance associated with age (0.51). Improved
22-87, mean age 52104 performance associated with a higher value for serum albumin
concentration g/dL (-.43), phase angle degree (-0.40), serum
creatinine concentration mg/dL (-0.29), and adequacy of
dialysis dose (Kt/V) (-0.23) (p<0.13).
Multivariate regression analysis performed using physical
performance as the outcome variable. Adequacy of dialysis
dose (Kt/V)(-11.9) and albumin g/dL (-7.1) significant in
predicting performance measures (r=0.68)(r 2=0.46).table 3
Multivariate regression analysis with physical performance as
the outcome variable and physical activity level (arbitrary
units) as an additional predictor. Physical activity level did not
significantly improve the model for rising from a chair.
(r=.70)(r2=0.49) page 1588 and page 1589 table 4
Males with osteoarthritis of the knee 54 5TSTS is significantly correlated with all WOMAC subscales
age 50-69 (mean 59).6 and composite scores r = .485 to .529; muscle strength r = --
.620 for knee extension; r = -.638 for knee flexion.
Subjects with lumbar spinal stenosis 40 No significant correlation of 5TSTS with the Oswestry
mean age 63(7) 33 Disability Index
People with unilateral knee pain 1344 Pearson correlation between isometric quad strength and
from Osteoarthritis Initiative Study39 FTSTS= -.36. FTSTS not correlated with pain.
People with unilateral knee OA 67 N=50 with knee OA
recruited from an orthopedic clinic40 N=17 healthy people
Pearson correlation between weight-bearing asymmetry and
FTSTS=-.44
Subjects of varied age 20-39 and 75- 734 Significant age related difference in performance were found
98 and disability including RA and with older women performing longer than older men
CVA height of chair 43 cm and CVA=48 Median (IQR) sit to stand test scores
barefoot 21 AGE Male/N Female/N Total
20-39 7.9(6.9-9.4) 8.0(6.4-9.0) 7.9(6.5-9)
NoCVA=
636 75-79 10.3(9 -12.9) 11.5(9.3-13.6) 11.2(9.1 -
13.4)
80-84 11.5(9.4-14.5) 12 (10.5-15) 11.9(9.7-14.7)
OA=283 85-59 11.7(9.8-14.7) 12.1(10.2-15) 12(10.2-14.9)
90+ 14.5(9.7-30) 14.6(10.7-15.2)
14.5(10.5-
No CVA= 20.6)
401 Times for FRSTS by subject’s medical diagnosis (seconds)
OA No OA CVA No CVA
12.5(10.3- 11.0(9.2-13.1) 12.1(10.6-14.7) 11.5(9.5-14.2)
15.9)
CHAIR STAND Tests
Males with osteoarthritis of the knee 54 5TSTS is significantly correlated with all WOMAC subscales
age 50-69 (mean 59).6 and composite scores r = .485 to .529; muscle strength r = --
.620 for knee extension; r = -.638 for knee flexion.
Community dwelling age 65(3), seat 47 Low level of relative importance in explaining STS
height 43 cm 109 performance. The 30 sec test is highly correlated to the 5TSTS
(.83) Regression results using all 6 lower limb strength
variables explained 48% and 35% of the variance in 5TSTS
and 30 sec chair stand scores, respectively. These results
suggest that variables other than hip, knee, and ankle joint
strength influence sit to stand performance
Predictive Validity: With a cut-off time of 12 seconds,5TSTS may be a predictor of falls during transitional
movements but it doesn’t generalize to ambulation. It may be a better predictor of general disability 117
Population N Results
Ambulatory, community-dwelling 50 5TSTS scores were not predictive of non-fallers or fallers;
people with chronic stroke92 5TSTS explains 64% of the variance of the TUG.
Healthy, community dwellers over 189 No significant difference between non-fallers, one time
age 65118 fallers, and multi-fallers
Community dwellers 257 Increased 5TSTS times predictor of falls with OR 1.13.
(mean age 72)119
Persons with Balance Disorders48 174 65% of all subjects correctly identified for balance disorders
with 5TSTS on univariate and multivariate discriminant
models
Healthy older (>60) women living 402 5TSTS time increased with age (0.44); Time decreased with
in rural Japan community 103 higher physical activity index (0.14).
Time increased with fallers: Fallers (n=85)10.8+ 4.0 sec;
non-fallers(n=317)9.9+ 3.1.
Non-disabled community dwellers 1122 Increased 5TSTS scores predictor of mobility related
over age 71; prospective study117 disability within 4 years: > 16.7 sec , relative risk 4.1
4 year Predictors (p<0.001) Chi-Square Test
(Note: Same scoring used in Scores: No Disability Mobility Dis ADL Dis
another study of elderly persons) 100 16.7s 60% 25 % 15%
13.7 – 16.6 s 67% 22 % 11%
11.2 – 13.6 s 75% 16 % 9%
< 11.1s 79% 14 % 7%
Ambulatory community dwelling 362 5TSTS, when combined with the alternate step test (AST)
elderly age 74-98107 and the six-metre-walk tests (SMWT) demonstrate reasonable
sensitivity and specificity in identifying multiple fallers. Poor
performance in 2 mobility tests increased risk of multiple
falls, more than poor performance on one test alone.
People with chronic CVA in the 27 STS was less accurate at predicting falls than the ABC and
community18 the SIS-16
Chronic Hemi-paretic community 68 Results show that balance ability is an independent predictor
dwellers 19 of 5TSST scores in people with chronic stroke
Mean 5TSST score of the client with stroke (17.9+/-1.2 sec)
was consistent with those reported for clients with a stroke
with mild to moderate residual disability (17.9-19.3 sec) but
slower than those of the age matched healthy subjects( 11.3
+/-2.4 sec) but comparable with the average times reported
for elderly subjects with balance disorders (16.4 +/-4.4) sec
Community dweller over the age of 999 Twice as likely to be recurrent fallers in those that were
65 living in France. 120 classified as moderate fall risk, p=.003, 15 sec cut-off score
Sensitivity/specificity: 12 seconds is usually used for a cut-off but sensitivity and specificity are not impressive as
a fall risk predictor: sensitivity is 66% for general community dwellers, 83% for those who have had a CVA. If using
CHAIR STAND Tests
16 seconds cut-off in people with Parkinson disease the sensitivity is75%. Overall it appears it is not a good test for
predicting falls when used alone.
Population N= Cutoff Score/Description Results
48
Identifying Balance
Disorders
<age 60 79 10.0 seconds Sensitivity 87%, specificity 84%
>age 60 95 14.2 seconds Sensitivity 61%, specificity 59%
Entire group 174 13.0 seconds Sensitivity 66%, specificity 67%
34
Identifying individuals 82 >16 seconds Sensitivity 0.75 specificity 0.68
who fall in a population of
community dwellers with
idiopathic PD
Identifying Multiple fallers 362 107
≥12 sec Sensitivity 66%, specificity 55%
104
Ambulatory community 46 Separate multivariate No significant improvement in model
dwelling adults on regression analysis performed of the 5TSTS. r=0.68, r2=0.46N
hemodialysis, age range using physical activity arbitrary
22-87 units
38
Subjects, age 18-65 with 178 Sensitivity 73%, specificity 70%
chronic low back pain 14.1 seconds
20
Discriminatory between
young 12 9.4 seconds Sensitivity 83% Specificity 75%
healthy elderly 12 10seconds
stroke 12 12 seconds
18
Chronic CVA 27 17.9 seconds Sensitivity 67%, Specificity 72%
Responsiveness/Sensitivity to Change: Clinically, the responsiveness of this test to interventions may be the
most important utility. The test is applicable to almost all patient populations and sit to stand is indicated for a
functional goal when time is >12 seconds. If the person is unable to arise independently, they may use their hands
initially (norms do not then apply) with goals adjusted to reach the “12 second time with no hands”.
Population N= Reference and Intervention Responsive Average change post
Yes/No intervention
30
Clients with Central 12 custom designed Vestibular Yes 6.8 (6.)
vestibular PT; 5 visits over 5 months; Persons with cerebellar
dysfunction at retrospective study disorders had least
hospital-based improvement (n=2)
rehab center
108
Community 12 Yes Dialysis: 10.1(1.6) s
dwelling renal (12 1 time comparison testing, age Control: 7.3(1.1) s
dialysis patients healthy & sex matched controls (P<0.001)
controls)
121
Older adults 2450 Yes Persons w/severe MRI
without cognitive or longitudinal analysis over 4 white matter
physical disabilities years; mean age 74 . Persons hypersensitivity had inc
w/severe MRI white matter rate of decline (mean
hypersensitivity had slower change =0.3 s/yr vs
5TSTS (13.7 vs 14.6 s) 0.5s/yr,). Rate of decline
inc w/basal ganglia infarct
(mean change = 0.3s/yr vs
0.4s/yr) all ind of
demographics, risk factors,
CVD, and baseline
performance.
122
Community 620 2x/wk x 12 months Yes EIG group:
dwellers > 75 pre 13.7(6.4)sec
CHAIR STAND Tests
Extensive Intervention Group post 11.7(4.6)

EIG; individualized Post-hoc test differences
interventions comprising ex between EIG – CG
and strategies for max vision &MIG-CG:
and sensation No significant differences
Minimal Intervention Group between
MIG: brief advice EIG and MIG
Control CG
no feedback until 12 mos
90
Healthy, not active 108 3x/week x 16 weeks Yes Mean difference
Community- Cobblestone mat walking 1.21(0.32)
dwelling, age 60 - group n=54
92 Conventional walking group;
72
Community 53 24 weeks 3 sets of 8 ex Yes 5TSTS times decreased
dwellers, EX 1 n=14,: 1x/week for all exercise groups, no
Age 65-79 EX 2, n=14: 2x/week sig. change in control
EX 3, n=11: 3x/week improved 5TSTS assoc
Control, n=14: no exercise w/% quad strength
increase (-0.4): leg press (-
0.39)
75
Community 15 3x/week x 8 week low to Pre: 19.3(7.9)
dwelling adults moderate intensity group Yes Post: 14.5(4.2);
Age 66 – 97 years exercise 27% improvement. No
difference 1 year follow-
up
123
Community 21 Yes Exercise:
Dwelling frail Exercise intervention n=10 Baseline 18.5 + 13.5s
Elderly awaiting 10 2x/wk x 60 min x 3-6 wks pre- Pre-op 15.0 +5.8s
THA mean age 76 Treatment op 91% participation Control:
+ 4 years 11 Baseline 17.1 + 6.4s
From7/07- 11/08 Usual care Control group n=11 Pre-op 17.4 + 5.9s
1 group information session Between Group
d = -2.9(-6.2-0.4)s CI(.95)
ANCOVA effect size 0.43;
medium effect
124
Adults undergoing 80 Yes p = 0.05
THA or TKA Intervention Pre-op (t0):
Age 61.8 + 11.2 Total hip arthroplasty Total group 18.3(7.7-
years n = 36 35.7)s
THA 18.5 (7.7-32.7)s
Total knee arthroplasty TKA 17.5(8.9-35.7)s
n= 44 3 month post-op(t3):
pre-op, 3 and 6 month post-op THA 16.0 (5.6-32.8)s
measured with Activity TKA 16.7 (10.4-35.3)s
Monitor (AM) 6month post-op (t6):
THA 13.4(5.0-23.0)
TKA 15.6 (10.0-33.0)
Total p value delta
Scores t3-t0/t6-t0=
0.44/0.03s
104
Ambulatory 46 Separate multivariate No No significant
community regression analysis performed improvement in model of
dwelling adults on using physical activity the 5TSTS. r=0.68, r2=0.46
hemodialysis, age arbitrary units
range 22-87
CHAIR STAND Tests
125
Community 79 3 month supervised LE Yes No improvement in any of
dwelling adults on resistive exercise program, the groups.2-way repeated
hemodialysis, age 3x/week during hemodialysis ANOVA comparing
40-70 baseline & outcome, 2-
tailed <.05. P ND=0.38,
EX 0.30
106
Ambulatory 33 3 month supervised Yes Significant improvement
community moderate level aerobic training pre-post for ex group (14.7
dwelling adults on a cycle ergometer, 3x/week ± 6.2 to 11.0 ±3.3) vs
with end-stage renal control group (12.8 ± 4.4
disease on to 12.7 ± 4.8) sec with f =
hemodialysis, age 10.4 and p =0.003
range 31-71
33
Lumbar spinal 40 1 time comparison testing Yes Lumbar spinal stenosis:
stenosis patients age and sex matched subjects 15.76(1.44) s
waiting for surgery with bilateral knee Knee osteoarthritis:
osteoarthritis 14.37 (2.25)s
(p<.001)
6
Males with 54 1 time comparison testing Yes Mean difference between
osteoarthritis of the age and sex matched controls groups 19%-26% in STS,
knee age 50-69 timed up and go, and
(mean 59) straight line walking
(p<.001). Specific values
not given per test.
16
Knee osteoarthritis 80 Exercise intervention (knee Yes Initial testing (95%CI)
subjects (OA) age= OA subjects) n = 40 3- 4 x/wk OA: 15.2 (12.6-17.9)
63+/- 10 years x 8 wk exercise program for Control: 10.1 (9.2-11.0)
hip abductors HEP and booklet Final testing 8 week
Control group(age and sex (95%CI)
matched normals) n=40 OA: 12.5 (10.6-14.4)
Regular daily activity Control: 9.3(8.4-10.2)
Between group
comparison of
improvement: F=5.55
p=.021
17
Community 170 Exercise intervention n=80 No No significant difference
dwellers >60 y.o 3x/week for 90 minutes/8 between groups
with hip or knee weeks, resistance training,
OA defined by walking for 30 minutes, 30
Altman minutes of education to
promote exercise adherence
Control group n=70 on wait
list for surgery
41
Subjects with OA 39 39 subjects underwent course No Effect size=.36(small)
of knee average age of PT, evaluating therapist
65.3 years. determined treatment based on
signs and symptoms.
38
Chronic non- 134 Chronic non-specific low Yes 9.8seconds for
specific low back back pain subjects improvement.
pain subjects 10 week exercise program
CHAIR STAND Tests
Subjects scheduled 53 1 month post-op=11.3 sec Yes Greatest asymmetry in

for TKA measuring 36 with 3 months post-op=8.8 sec weight-bearing with sit to
asymmetry in knee OA 6 months post-op=9.4 sec stand is at one month post-
weight bearing pre pre/post op (r=-.33), returned to
and post-op for unilateral Greater symmetry with weight pre-op levels at 3 months
TKA. TKA bearing during sit to stand was post-op(r=-.26), more
Age=63.4±7.740 associated with increased quad symmetrical at 6 months
17 healthy strength symmetry (range, .26- post-op than at pre-op(r=-
people .39). .31).
Ceiling or floor effect: Floor effect, that is that persons were unable to complete five timed chair stands was
reported in two large studies of people over age 60 as 18% males, 24% females83 and 6% males, 9% females.94 In a
study of long term care residents only 83% were able to perform 5TSTS. 85 Sixty seven patients with unilateral knee
OA recruited from an orthopedic clinic. Eighteen of the fifty (36%) participants in OA group could not perform STS
test without upper extremity assistance.40 If clients cannot do a chair stand without use of arms, the test may be
performed as a baseline measure with arm support BUT do not compare it to normative data below.
Interpreting results: This test has been interpreted as a measure of balance and as a measure of strength of knee
extensor and back muscles. Univariate relationships between serum creatinine, phase angle and physical
performance test results among individuals on hemodialysis suggest muscle strength is important in the performance
of activities such as chair-rising time. 104
Reference Data (Note that how the test is administered makes a big difference in interpretation; ie, always ending
in sit or stand but staying consistent)
Subjects N Av Time Men Av Time Women
People age> 65 living in MA, Iowa 5097 13.2 sec Age 71-79 14.4 sec Age 71-79
& CT (EPESE Study)83 15.9 sec Age 80+ 16.1 sec Age 80+
Ends with sit.
Community dwellers 99 642 75-79 12.1(5.4) 12.2(4.1)
Ends with stand. 80-84 12.9(5.5) 13.4(5.6)
85-89 13.7(7.2) 14.1(6.5)
90+ 17.2(5.9) 15.1(6.5)
Total 12.8(5.9) 12.9(5.1)
Community dwellers > age 60 Total:5403 60-69 12.65(.24) s 13.22(.22)sec
NHW (Non-Hispanic White) 70-79 13.35(.29) 14.19(.29)
NHB(Non-Hispanic Black) 2592 Males 80+ 14.70(.25) 16.58(.30)
MA (Mexican American) NHW 13.08(.20) 13.7 (.22)
Men faster than women (P<0.001) NHB 14.49(.26) 16.52(.48)
NHW faster than MA females, MA 12.96(.27) 15.27(.30)
NHB males and female s (p<0.001) Overall
Ends with sit.94 mean 13.11(.19) 14.05(.72)
Community Dwellers (EPESE 1192 Age 70-79. 45% male
study)84 Ends with sit Mean time 12.3(2.9) with range 5.0 – 20.4 sec
Community dwelling adults15 139 Age 65 – 93, men (n=32)
Ends with sit. Mean time 11.7(3.8) with range 5.5 – 27.0 sec
Healthy older (>60) women living in 402 Time increased with fallers:
rural Japan community103 Fallers (n=85)10.8(4.0) sec;
Ends with stand. non-fallers(n=317)9.9(3.1) s.
Community dwelling individuals 82 Average age 67(9) years. Mean time to complete 5TSTS
with idiopathic PD34 20.25 (14) sec
Non-disabled community dwelling 104 Ages 60 -90
females 114 Mean time 11.5(4.1) range 6.0 – 34.5 sec
Ends with sit.
CHAIR STAND Tests
Massachusetts Male Aging Study116 659 Mean age 68(8)

Ends with sit 3.4(1.2)sec
Ambulatory w/o assist device, 176 Mean age 80(6); men (n = 56)
residents of a retirement village115 Mean time 19.32(10.72), range 6.09 – 46.02 sec
Ends with stand
Well-functioning, age 70-79, 2928 Adjusted for age, ht, wt, bone site by ANCOVA time
community dwellers difference in 5TSTS by race: Wh Fe 15.0(0.2), Bl Fe
Measured bone mineral density 15.9(0.2); Wh Male 12.4(0.2) vs Bl Male 14.3(0.2).
BMD 95 Ends with stand.
Ambulatory community dwelling 46 31 male and 15 females
adults on hemodialysis, age range mean time for 5TSTS 16.6 (9.5) sec
22-87. Mean age 52, capable of
walking 50 feet with or/without an
assistive device. Two trials
performed with the faster of the two
recorded to the nearest 10th of a
second.104 End not specified
Community dwelling adults on 79 49 males and 30 females, age 40-70 with mean age 55
hemodialysis, University based 5TSTS Mean time 16.3, range 6.3 – 29.4 sec
dialysis unit 105 End not specified
Ambulatory community dwelling 33 No indication of number of males/females.
adults with end-stage renal disease exercise n=18 Mean age 54.
on hemodialysis,, age range 31-71106 mean age = Mean time (sec) 14.7 with range 8.4-20.9
End test position not specified 57.3
control n=15
mean age 50.5
Community dwellers with chronic 68 Average time 17.9 +/- 9.6 (8.41-54.6)sec
Hemiparesis 19ends with sit
Community dwelling adults 19-84 94 Measurement (n) Mean ± SD Minimum-Maximum
111
Trial 1: all ages (94) 7.8 ( 2.8) 4.0–16.3
Ends with sit Trial 2: all ages (94) 7.5 ± 2.8 4.0–17.0
Mean: all ages (94) 7.6 ± 2.7 4.0–16.0
Mean: 19–49y (39) 6.2 ± 1.3 4.1–11.5
Mean: 50–59y (15) 7.1 ± 1.5 4.4–9.1
Mean: 60–69y (18) 8.1 ± 3.1 4.0–15.1
Mean: 70–79 y (16) 10.0 ± 3.1 4.5–15.5
Mean: 80–89 years (6) 10.6 ± 3.4 7. 8–16.0
Community dwellers All (257) Non-Fallers Occasional Frequent falls
119
Ends with sit. Mean age72 (n = 129) fallers (n=76) (n = 52)
13.51(5.37)s 12.23(3.08)s 14.86(6.87)s 14.69(6.58)s
Senior Athletes126 Ends with sit Age N Score SD
(all of these groupings are times 50-59 78 6.7 sec (1.9)

significantly different than the
Bohannon 2006 data) 127 60-69 106 7.3 (4.1)
70-79 68 8.1 (1.9)
80-89 21 9.2 (2.9)
CHAIR STAND Tests
Subjects of varied age 20-39 and 75- 734 Significant age related difference in performance were found
98 and disability including RA and with older women performing longer than older men
CVA height of chair 43 cm and CVA=48 Median (IQR) sit to stand test scores
barefoot21 AGE Male/N Female/N Total
20-39 7.9(6.9-9.4) 8.0(6.4-9.0) 7.9(6.5-9)
No CVA=
636 75-79 10.3(9 -12.9) 11.5(9.3-13.6) 11.2(9.1 -13.4)
80-84 11.5(9.4-14.5) 12 (10.5-15) 11.9(9.7-14.7)
OA=283 85-59 11.7(9.8-14.7) 12.1(10.2-15) 12(10.2-14.9)
90+ 14.5(9.7-30) 14.6(10.7-15.2)
14.5(10.5-
No OA= 20.6)
401
Times for FRSTS by subject’s medical diagnosis (seconds)
OA No OA CVA No CVA
12.5(10.3- 11.0(9.2-13.1) 12.1(10.6-14.7) 11.5(9.5-14.2)
15.9)
Independently ambulatory, with AGE N Group Mean SD 95% CI
and without use of assistive 76 (sec)
device, community dwelling 60-69 1 Male 8.4 -- -3.6—20.5
adults87 Ends with sit. 5 Female 12.7 1.8 7.3—18.1
6 Overall 12.0 2.4 9.5—14.4
70-79 9 Male 11.6 3.4 7.6—15.6
10 Female 13.0 4.8 9.2—16.8
19 Overall 12.3 4.2 10.3—14.3
80-89 10 Male 16.7 4.5 12.9—20.5
24 Female 17.2 5.5 14.8—19.7
24 NoDevice 16.0 4.9 13.7—18.2
10 Device 19.8 4.9 16.3—23.3
34 Overall 17.1 5.2 15.3—18.9
90-101 2 Male 19.5 2.3 11.0—28.0
15 Female 22.9 9.6 19.8—26.0
7 NoDevice 18.0 7.0 13.8—22.2
10 Device 25.7 9.2 22.2—29.2
17 Overall 22.5 9.0 17.9—27.2
Ambulatory community dwelling 362 N Group Mean SD Rel. Risk
elderly,107 Ends with sit (sec) (95% CI)
age 282 Single 12 4.8 2.0
range fallers (1.3, 3.0)
74-98 80 Multiple 15 6.2
fallers
Community dwellers, with and Controls With Balance Older Controls Older Balance
without known balance Age 41(11) Dysfunction Age 73(5) Dysfunction
dysfunction (n = 32) Age 48(10) (n = 49) Age 75(7)
(n = 47) (n=46)
48
Ends with sit. 8.2(1.7) 15.3(7.6) 13.4(2.8) 16.4(4.4)
Healthy, community dwellers118 189 Non-fallers 1x Fallers Multi-fallers

Ends with stand AGE > 65 (n = 132) (n = 38) (n = 19)
15.2(4.8) s 14.7(3.3)s 14.6(4.3)s
Other:
CHAIR STAND Tests
Sometimes 5TSTS is combined with other timed-tests for an overall physical performance measure as in the
Longitudinal Aging Study of Amsterdam, in which serum Vitamin D levels were associated with 5TSTS
performance of 1234 participants age> 65.128
CHAIR STAND Tests
Ten Chair Stands (10TSTS or TTSTST)
and sit down ten times as quickly as safely possible without using his/her arms on the word “Go.” Begin timing on
the word “Go” and stop timing when the person comes to a complete stand. Record the time in seconds.
Reliability:
Suzuki 20015 34 Community-dwelling females, ICC = 0.71
mean age 75(5); evaluated 2x in one session
Hammaren 20054 6 Men ages 31-61 with Myotonia Congenita ICC = 0.87 rest
(MC) ICC = 0.94 warm-up
Segura-Orti 201161 37 Community dwelling individuals on ICC=0.88
hemodialysis with adequate dialysis dose or SEM=3.6
delivery (Kt/V greater or equal to 1.2) 1 MDC90=8.4 sec
tester. Mean age=24 (10.4). Testing occurred MDC95=10 sec
twice over a one to two week interval, before (calculated)
the second hemodialysis session of the week.
Netz 199710 41 Volunteers, Mean Age 72 (6). ICC = 0.88
2 sessions, 2 raters each session
Test/retest Reliability
Newcomer 19938 16 Persons with RA tested twice, 10 week r = 0.88
intervals; number of testers not specified
Validity:
often not available.
Community dwelling, age 63-9046 48 10TST correlates with Strawbridge Frailty score (0.5),
TUG (0.37), mean grip strength (r = 0.40), mean
bimanual dexterity ( 0.34); it also correlates with
reported arm weakness ( 0.45), reported leg weakness
(0.34) but not with dizziness.
Community dwelling elderly10 122 10TSTS correlates with self-reported health .(0.41) and
self-report daily function (0.49)
Males, age>50 with arthritis vs other 147 10TSTS correlates with 50’ walk (0.66), LE MMT
chronic diseases8 (0.47), Arthritis Impact Measurement Scale (AIMS)
pain scale (0.36), AIMS physical activity scale (0.33), &
tender joint count (0.33) in RA patients. 10TSTS
correlates with 50’ walk (0.46), LE MMT (0.60), &
AIMS composite physical function score (0.63) control
group without RA.
Healthy older Community dwellers 28 No correlation between trunk flexion angle and knee
11men mean age 74(2.8) and 17 women extensor (r= -.02) or trunk extensor muscle strength
age 73.1( 5.7) years.129 (r=.02)
Community dwelling, healthy women 49 No correlation between max peak torque of knee
with a mean age of 72.2 +/- 6.4130 extensors (-.02) or knee extensor muscular endurance (-
.11) using 30 rep isokinetic testing at 180deg/ sec and 10
TSTS. There was a moderate correlation between 10
TSTS, peak VO2 (-.38), and age(.34)
Predictive Validity:
CHAIR STAND Tests
Population N= Results
Older females, community dwelling5 34 Univariate association between 10TSTS & peak power
of ankle dorsi-flexors ( 0.50) and of physical
functioning on MOS SF36 ( 0.58)
Population Descriptor N= Reference and Intervention Responsive Average Change post
Yes/No intervention. Group
Differences significant?
131
Females with post- 50 6 mos retest, weekly calls Yes Pre-intervention time:
menopausal & Experimental Group=25 30.1(8.1)s; 5 wk:
idiopathic osteoporosis Self-management classes 22.5(6.1)s; 6 mos post-
1x/week x 5 weeks intervention: 21.1(5.9)s.
Control Group = 25 Control group no
Maintain sedentary lifestyle significant change
4
Men with Myotonia 6 10TSTS tested at rest, after Yes Warming up effect 56%;
Congenita warm-up, with & without effect of medication 19%
medication
Independent 30 3
3x/week x 16 weeks YES –with 10 -13% improvement
ambulators, with self- Females > Leg presses; knee extension training after 16 weeks both groups
reported disability 65 years High velocity resistance =15 NO—with
“as fast as possible” type of
Low velocity resistance Exercise
People with 36 11
Stationary cycling 3x/wk Yes –with No differences between
Osteoarthritis (OA) 71(79)yrs x10 wks, speed variance training groups
of the knee 67% High intensity (n =19) NO—with Pre-intervention time:
female 70% heart rate reserve intensity 23.3 2(9.1)s
low-intensity (n=20) Post-intervention time:
40% heart rate reserve 19.11(6.62)s.
8
Identifying persons 147 No intervention Yes Arthritis: 31.0 (12.9)s
with arthritis vs. other males Control: 24.2 (10.1)s
chronic diseases
125
Community dwelling 10 2x /wk x12 weeks Yes- with An improvement in time to
individuals with end supervised resistance training. resistance complete the 10 TSTS
stage renal disease 1x /wk x12 weeks exercise (sec) baseline for the
(ESRD) on nonsupervised with theraband. training control period=21(2) sec
hemodialysis. Mean age 10 TSTS completed on 4 compared to end of 12
42.8 (4.4); average time separate occasions over 12 week period=18(2) sec.
on maintenance weeks on nondialysis days. good
hemodialysis 42 (19) The first 6 weeks were a
months. Used standard control period. Scores
44-cm straight-back compared with predicted
chair with no arm rests. normal scores.
Ends with sit.
132
Individuals on dialysis 111 Exercise Intervention Yes Intervention group
at least 3 months n=111 Baseline 29.3(12.5)sec
Age Intervention group Individualized exercise Increased from 14% (37%)
56(15) program x8 weeks; followed of normal to 38% (37%) of
Non Intervention by in clinic cycling x8 weeks normal values *based on
group 53(17). Specify NonIntervention group n=109 predicted values.
protocol used by Csuka NonIntervention group
and McCarty 2 Remained at 23%(66%) of
normal values
CHAIR STAND Tests
125
People with ESRD on 10 2x/wk x12 weeks Yes-with Initial test 58% slower in
hemodialysis supervised resistance-training resistance dialysis patients compared
Mean age 42.8(4.4); 1x/wk x12 weeks exercise with age-predicted normal
average time on nonsupervised with theraband. training values.
maintenance 10 TSTS completed on 4
hemodialysis 41.6 separate occasions over 12 At completion of 12 wks of
moths. Plus –or- minus weeks on nondialysis days. training the time was
19 months. The first 6 weeks were a 36.8% slower compared to
control period. Scores age predicted normal
compared with predicted values
normal scores
7
People with 50 4 and 8 week follow up No Mean difference between
osteoarthritis of the Age: 75 Experimental group n=25 groups at 4 weeks: -.40 s
knee (5) Education and supervised (95%CI -14.6 to 6.61) p>
26% male exercise 1 day/week for 45 .05
minutes x 4 week plus HEP Mean difference between
Control group n=25 diathermy groups at 8 weeks: -5.5 s
treatment 1 day /week x4 (95%CI
week -11.3 to 0.03) p> .05
125
Community dwelling Supervised exercises done Delta score for treatment
adults on hemodialysis 25 3x/wk. Pre-post test design Yes group -5.4 ±10.6 sec. with
Experimental Group = 17 decrease time 22.2%
18 males PRE’s (p<.05). Low level aerobic
7 females Control Group = 8 exercisers time decreased
Low level aerobic exercise 6.4% (NS)
51
Persons 2-6 months s/p 35 N=18 received functional No Both groups had >20%
TKA training alone decrease in 5TSTS with
Mean age=68±8. N=17 received functional mean between group
training and balance exercise change of -0.6 seconds at
program 6 month follow up.
Both groups had 12 sessions Effect size= small (.035)
over 6 weeks
Community dwelling Trial 1 Trial 2 61No intervention. Yes Delta score trial 1=11(0-
individuals on N=38 N=37 10TSTS tested in 1-2- 43) trial 2=6 (-6 to 27)
hemodialysis week intervals p=.001
comparing heart rate Median HR
(bpm); systolic and N=31 N=29 Median SBP No Delta score trial 1=2(-23 to
diastolic blood 31); trial 2=2(-35 to
pressure (mmHg); 40)p=.682
Rating of perceived N=31 N=29 Median DBP No Delta score trial 1=-2(-18
exertion. to 9); trial 2=0(-19 to
13)p=.194
N=38 N=37 Median RPE No Delta score trial 1=11(7to
13); trial 2=11 (7-
17)p=.850
N=31 N=29 Median DBP(range) No Trial 1=-2(-18 to 9)mmHg;
Trial 2=0 (-19 to13)
mmHg
N=38 N=37 Rating of perceived No Trial 1=11(7-13)
exertion (range) Trial 2=11(7-17)
Ceiling or floor effect: People need to be able to repeatedly rise independently from a chair for the 10 TSTS test;
thus it would not be appropriate for very low functioning and dependent individuals.
CHAIR STAND Tests
Interpreting results: This test has been interpreted as a measure of one aspect of balance and as a measure of
strength of knee extensor and back muscles.
Reference Data:
Subjects N= Results
Community dwelling elderly, 252 Mean Times
identifying differences by age10 55 men Age 60 – 69: 19.4 (4.2) s
197 women Age 70 –79: 20.1 (5.7)s
Age 80 –89: 26.3(11.1)s
Healthy adults (subjects screened 139 Prediction Equations
for systemic disease; multiple 77 males Males : Time (s) = 4.9 + 0.19 x age
regression for age, height, 62 females Females: Time(s) = 7.6 +0.17 x age
weight, sex )2 Subjects by Age 10TSTS scores (seconds)
Group Female/Male Means
20 10.9/8.8
25 11.8/9.8
30 12.6/10.8
35 13.4/11.7
40 14.3/12.7
45 15.1/13.7
50 15.9/14.7
55 16.8/15.6
60 17.7/16.6
65 18.4/17.6
70 19.3/18.5
75 20.1/19.5
80 20.9/20.5
85 21.8/21.5
Community dwelling adults on 25
hemodialysis, recruited from 2 18 males Mean time 10TSTS 22 sec
dialysis clinics.133 7 females
CHAIR STAND Tests
30 Second Chair Stand Test
Directions:. The chair-stand test was administered using a folding chair without arms, with a seat
height of17 inches (43.2 cm). The chair, with rubber tips on the legs, was placed against a wall to prevent it from
moving during the test. The test began with the participant seated in the middle of the chair, back straight, feet
approximately shoulder-width apart and placed on the floor at an angle slightly back from the knees, with one foot
slightly in front of the other to help maintain balance when standing. Arms were crossed at the wrists and held
against the chest. At the signal "go," the participant rose to a full stand (body erect and straight) and then returned
back to the initial seated position. The participants were encouraged to complete as many full stands as possible
within a 30s time limit. The participant was instructed to be fully seated between each stand. While monitoring the
participant's performance to assure proper form, the tester silently counted the completion of each correct stand.
Following a demonstration by the tester, a practice trial of one repetition was given to check proper form, followed
by the 30s test trial. The score was the total number of stands executed correctly within 30s (more than halfway up
at the end of 30s counted as a full stand). Incorrectly executed stands were not counted. 134 This format is the one
often used and quoted.
In a recent study by Kuo (2013) the standard height of the chair was 43cm. He varied the height by 80 to 120 % and
found differences from the 43cm height 135
Two versions of the chair stand test, five time sit to stand (FTSTS) and 30-second chair stand tests have been most
often used with older adults. Although the movements required by each test are identical, the two tests differ in at
least one important aspect. The 5 Times STS test measures the time required to complete five movements, whereas
the other test measures the number of movements that can be completed in 30 seconds. Based on the amount of time
needed to complete 5 successive chair stands, the 5TSTS test may be a more appropriate functional lower limb
strength, speed, and power assessment instrument for older adults who have lower physical functional abilities (e.g.,
assisted living and nursing home residents and persons with joint replacement or hip, knee, or ankle joint
involvement). In contrast, the 30-second chair STS test may be a more appropriate functional lower limb endurance
assessment instrument for older adults categorized with higher physical functional abilities (e.g., persons residing in
the community who are independent, physically active, and experiencing no hip, knee, or ankle joint involvement).
109
Reliability

Intrarater Reliability: same rater within one session (or day) This test has nice reliability but not a lot has been
published.
136
Gill, 2008 82 Community dwelling Australians CI(.95)
35 THA awaiting hip or knee replacements not Baseline n=40
47 TKA actively in a PT program and not having ICC0.97(o.94-0.98)
surgery within 6 weeks. 7-wk assessment
Age 70.3 (9.8) Sex51 female (63.4%) n=47
THR 35 (42.7 %) ICC=0.97(0.95-0.98)
BMI 31.1 (5.6); 2 trials 30 sec CST at 15-wk assessment n=37
baseline, 7 weeks, and 15 weeks with ICC=0.98(0.97-0.99)
30-45 min rest between Practice effect noted at
baseline trial
109
McCarthy, 2004 47 Communitydwellers age 65 (3)
30 sec STS 14(3) reps done on R =.93 MDC(95) 2.19 stands
the same day
136
Gill, 2008 82 Community dwelling Australians CI(.95)
35 THA awaiting hip or knee replacements not Baseline n=42
47 TKA actively in a PT program and not having ICC=0.93(0.87-0.96)
surgery within 6 weeks. 7-wk assessment
CHAIR STAND Tests
Age 70.3 (9.8) Sex51 female (63.4%) n=28

THR 35 (42.7 %) ICC=0.98(0.95-0.99)
BMI 31.1 (5.6); 2 trials 30 sec CST at 15-wk assessment n=29
baseline, 7 weeks, and 15 weeks with ICC=0.98(0.96-0.99)
30-45 min rest between For baseline scores:
SEM=0.70stands
CV=11%
MDC=1.64 stands
Test-retest Reliability This gives a little information that the MDC(95) is between 2 and 3 stands for the 30
second sit to stand. In the same day testing it is 2 stands. (see above).
136
Gill, 2008 82 Community dwelling Australians MDC(90)=1.64 stands at
35 THA awaiting hip or knee replacements not time one or a MDC (95)
47 TKA actively in a PT program and not having is 1.96 stands. These
surgery within 6 weeks. were done in all the
Age 70.3 (9.8) Sex51 female (63.4%) same session not a week
THR 35 (42.7 %) apart.
BMI 31.1 (5.6); 2 trials 30 sec CST at
baseline, 7 weeks, and 15 weeks with
30-45 min rest between
134
Jones, 1999 76 Community dwelling elderly average .84 for men
age 70.5 . Tested 2-5 days apart with
seat height 43.2 cm .92 for women
total .89 MDC (95) = 3.11

stands
137
Alfonso-Rosa, 18 2013Older adults with type 2 NIDDM ICC > or = .92 MDC(95)
(1 week apart) 3.3
Validity
Construct/Concurrent Validity:: It is difficult to always differentiate between these 2 types of validity.

Evaluating this property requires a “gold standard” measure with which to compare the test results. Such a “gold
standard” is often not available
Persons examined one week prior to 24 Knee swelling correlation with 30 second chair stand
TKA and at time of hospital discharge test (r=.08), knee extension strength correlation with
to assess relationship of knee swelling 30 second chair stand test (r=-.09).
to loss of knee-extension strength and
functional ability.49 Mean age=66±7
Community dwelling elderly 134 66 Moderate correlation between chair stand and weight-
adjusted leg-press performance for all participants (r-
.77) and separate correlations for men (r=.78) and
women (r=.71)
Community dwelling age 65(3), seat 47 Low level of relative importance in explaining STS
height 43 cm 109 performance. The 30 sec test is highly correlated to the
5TSTS (.83) Regression results using all 6 lower limb
strength variables explained 48% and 35% of the
variance in 5TSTS and 30 sec chair stand scores,
CHAIR STAND Tests
respectively. These results suggest that variables other

than hip, knee, and ankle joint strength influence sit to
stand performance
Clients average age 76(7) 138 14 Demonstrated average power and peak power related
to the first 20s portion of the 30s test
Elderly in China 139 142 Correlation with LE strength in .3-.4, hip strength is
1038 more important than knee extensor strength in the
elderly during a chair stand test. Scores decrease with
increase in participant age
Subjects in Denmark tested after TKA 39 30 sec chair stand was 9.6(5.2) 4 weeks after TKA and
140
correlated to leg press power .74 and knee extension.4
Predictive Validity
Population N= Results
Individuals scheduled for TKA 82 Flexion strength of the surgical knee had the highest
Age 62.7±7.5. 70% women.141 correlation with 30 s sit to stand (.63)
Extension strength of surgical knee correlation (0.55)
with 30 s sit to stand
Flexion strength nonsurgical knee(.61)
Extension strength nonsurgical knee (.52)
Stepwise regression to predict sit to stand repetitions in

30 seconds found R2 to be .40 for flexion strength of
the surgical knee.
Subjects prior to hip replacement 82 PSFS .26 ; WOMAC Function -0.62

{Gill 2012}142 SF-36 PF 0.39 ; SF-36 PCS 0.35
SF-36 MH 0.33
Sensitivity/specificity:
Population N= Cutoff Score/Description Results
Brazil community 48 fallers Fallers defined by 2 or more No difference between the 2 groups
elderly143 48 non falls in past 6 months. 7.9(2.5) fallers and 8.5(2.6) for the non-
fallers fallers.
Elderly people144 135 <14.5 to predict falls Sensitivity 88%

Specificity 70%
Population N= Intervention Responsive Av change after

Yes/No intervention. Group
differences significant?
26 people with prehabilitation 54 Prehabilitation prior to Yes at 1 Significant difference
28 people with usual care planned TKA: resistance week prior within the prehab group 1
before TKA Topp, 2009145 training, flexibility and to TKA and week before, 1 and 3
step training 3x/wk one month months after TKA to
13.04(7.5) sessions. s/p TKA baseline. Significant
difference within control
group at 3 months after
TKA. Effect size at one
week prior to TKA= .54,
at one month after
TKA=.31, at three
months after TKA=.39
CHAIR STAND Tests
Women aged 50-65 with knee 26 Intervention group n=13, Yes intervention pre 15.0
OA resistance training 3x/week (1.4) post 18.1 (1.8)
Neves, 2011 42 for 12 weeks combined p=0.006
with creatine control pre 15.0 (1.8)
supplementation post 15.2(1.2)
Control group n=13, creatinine vs placebo
resistance training 3x/week P=0.004
for 12 weeks 42
Subjects tested 1 week prior 24 Examination of Yes Pre: 30 s chair stand test
to TKA and at hospital relationship of knee 10.4(2.8)
discharge; mean age swelling to loss of knee Post (POD 2) 5.4(3.0)
66(7)Holm, 201049 P =<.001
extension strength and
functional ability
Subjects after THA, Gill 82 Examination of Yes No AD 7.3(2.8)

2012142 relationship in STS in Significance Gait Aid 4.5(3.3)
subjects who use a gait aid (2-tailed) = Mean difference (95%
0.00 CI)=2.8(1.4-4.1)
(AD) or no gait aid
Effect size(95% CI) =
0.64(0.32 to 0.95)
Men with fibromyalgia 6 men 60 minutes, 3x/week for No Initial 9(2)
participating in Tai Chi, age 16 weeks Post 10(2)
52(9). Carbonell-Baeza 2011 Adherence 80% Detraining 10(2)
146
Persons with hip and knee 34 6 weeks of programming Yes Initial 13.8(3)
OA using GLA:D in Denmark P<.012 After 3 months 15.1(3)
Shou, 2012147
Participants using Nintendo in 58 28 treatment x 10 weeks Yes Rx: 11.5(3.8) initial
Denmark. Jorgensen 2013 148 30 no treatment P<.01 13.3(3.2) trained
NoRx: 11.2(3.8)
12.1(3.0)
Women in Brazil, av age 63 13 Step aerobics 3x/week for Yes Initial 13.8(3.4)
Hallage, 2010 149 30-60 min x12 weeks F value 14, 12 week 16.9 (3.3)
p<0.05 1 mo post 15.3 (3.4)
18% change after 12
weeks, 10% decrease 1
mo post training
Community dwelling elderly, 45 64 step tests yes Men increased 5.9 stands
age 64 in Japan. Okamoto, men vs controls 2.6
2007 150 155 Women increased 4.5
female over 0.1 controls
Community dwellers in 42 15 Pilates yes Final: Pilates 24(3)
Hungary, av age 67(5) 15 Aqua-fitness Aqua-fitness 21(4)
Plachy 2012 151 12 control Control 19(6)
152
Blair 2013 Cancer 10 Chair stand (stands/30 yes Median (min,max) Initial
seconds) 15.0 (12,18)
6 mo retest 17.0 (13, 22)
1 year later 17.5 (12,24)
Change 3.0 (-3.9)
Reference Data:
Subjects N= Results
Subjects tested 1 wk pre-op and 24 Score Pre-op: 9.8 (3.4) p = .01
2.1+0.5 days post-op unilateral 20 females Score Post-op at discharge 6.3(2.8) p= .01
CHAIR STAND Tests
THA; age 69(6.1) height Change in Mean -36% from surgery

166.9(7.9)cm
Mass 75.9(11.8)kg
BMI 27.2(3.7)153
Community dwelling elderly, 190 age N Chair stands
average age 70.5134
60-69 32 14 (2.4)
70-79 96 12.9(3.0)
80-89 62 11.9(3.6)
Activity Level
High 144 13.3(2..8)

Low 46 10.8(3.6)
Criterion Reference Fitness 2140 Age Female Male
Standards for lower body strength154
60-64 15 17
65-69 15 16
70-74 14 15
75-79 13 14
80-84 12 13
85-90 11 11
90-94 9 9
Elderly persons in Hong Kong (HK) 1038 Group HK US HK mean as
ranked against United States (US) US %
norms
MacFarlane 2006 139 Fe 60-64 12.3(4.2) 15 25
Fe 65-69 11.3(3.5) 14 25
US mean data and percentiles taken Fe 70-74 10.1(3.8) 13 25
from Rikli and Jones 2001154 Fe 75-79 9.4(3.4) 12 20
Fe 80-84 9.3(3.1) 11 25
Fe 85-89 8.3(2.4) 10 25
Fe 90+ 7.9(2.7) 8 50
Male 60-64 14.0(4.3) 16 25
Male 65-69 12.9(4.6) 15 30
Male 70-74 11.6(3.3) 14 25
Male 75-79 11.3(4.4) 14 25
Male 80-84 11.1(4.2) 12 35
Male 85-89 8.1(4.0) 11 25
Male 90+ 5.8(2.6) 10 15
Ceiling or floor effect: People need to be able to rise from a chair repeatedly for 30 seconds independently,
therefore, this would not be an appropriate test for those needing assist to rise from a chair or without the endurance
to complete the test.
Interpreting results: This test has been interpreted as a measure for functional ability145 and as a measure of
strength of the lower extremities. This test is often combined with other measures to get a better functional outlook
on a client
Other: May be used as a functional fitness measure with children and young adults
CHAIR STAND Tests
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CHAIR STAND Tests

 Time to administer: 5 minutes or less

 to measure effects of supplementation 41

 Stopwatch or clock with second hand

One Time Sit to Stand (1TSTS)

Ceiling or floor effect:

Without CP(Mean age 8.9+ 1.7) 81

Five Times Sit to Stand Test (5TSTS or FRSTST)

Mong et al 201020 36 12 subjects with chronic stroke, 12 healthy ICC=.970-.976

Schaubert, 200591 10 Ambulatory community dwellers, mean ICC = .81

correlates w/one leg stance time (-0.29) &Phys FuncSF-36(-

Age .37 .001

Extensive Intervention Group post 11.7(4.6)

Subjects scheduled 53 1 month post-op=11.3 sec Yes Greatest asymmetry in

Massachusetts Male Aging Study116 659 Mean age 68(8)

Senior Athletes126 Ends with sit Age N Score SD

(all of these groupings are times 50-59 78 6.7 sec (1.9)

70-79 68 8.1 (1.9)

80-89 21 9.2 (2.9)

Healthy, community dwellers118 189 Non-fallers 1x Fallers Multi-fallers

Ten Chair Stands (10TSTS or TTSTST)

30 Second Chair Stand Test

Reference N= Sample Description Reliability Statistic

Age 70.3 (9.8) Sex51 female (63.4%) n=28

total .89 MDC (95) = 3.11

Construct/Concurrent Validity:: It is difficult to always differentiate between these 2 types of validity.

respectively. These results suggest that variables other

Stepwise regression to predict sit to stand repetitions in

Subjects prior to hip replacement 82 PSFS .26 ; WOMAC Function -0.62

Elderly people144 135 <14.5 to predict falls Sensitivity 88%

Population N= Intervention Responsive Av change after

Subjects after THA, Gill 82 Examination of Yes No AD 7.3(2.8)

THA; age 69(6.1) height Change in Mean -36% from surgery

High 144 13.3(2..8)

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