What does the 5 times sit to stand test measure?

According to research published in the journal Neurospine, the five-repetition sit-to-stand test (5R-STS) is a reliable and objective measure of functional impairment. This article will delve into the critical question: what does the 5 times sit to stand test measure and what are its implications for healthy aging?

Quick Summary

The 5 times sit to stand test measures functional lower extremity strength, dynamic balance, and assesses fall risk. The time it takes to complete five repetitions reveals a person's mobility, muscle power, and postural control, providing valuable insight into their physical independence.

Key Points

• Measures Functional Strength: The FTSST primarily measures the strength and power of the lower body muscles, crucial for daily activities.

• Assesses Dynamic Balance: The repetitive standing and sitting motion evaluates a person's dynamic balance and postural control during transitional movements.

• Predicts Fall Risk: Performance times are strongly correlated with fall risk, with slower times indicating a higher likelihood of falls.

• Indicates Functional Independence: The test can predict a person's potential for functional decline, hospitalization, and the need for caregiver support.

• Reveals Movement Patterns: Clinicians observe not just the time, but also the quality of the movement, such as leaning or use of hands, to identify specific deficits.

• Useful for Diverse Populations: While primarily used in geriatric care, the test is also valuable for individuals recovering from stroke, or those with vestibular disorders.

Understanding the Purpose of the FTSST

The Five Times Sit to Stand Test (FTSST) is a simple, yet highly effective clinical assessment widely used by healthcare professionals. It evaluates a person's ability to perform the fundamental movement of transitioning from a seated to a standing position, a key component of daily life. The test quantifies several aspects of physical function, making it a valuable tool for monitoring age-related decline or recovery from injury or illness.

Core Physical Functions Measured

The FTSST provides critical data on several interconnected areas of physical health:

• Functional Lower Extremity Strength: The test directly measures the power and endurance of the major muscle groups in the legs, including the quadriceps, hamstrings, and glutes. These muscles are essential for performing daily activities, and a faster time indicates better functional strength.
• Dynamic Balance: The repetitive motion of standing and sitting requires constant adjustments to maintain balance. The test assesses a person’s postural control and stability throughout these transitional movements.
• Transitional Movements: The FTSST is a practical assessment of a person's ability to move between different positions. The quality of these movements, observed during the test, can highlight any compensatory strategies, asymmetry, or difficulty.

How the Test Is Performed

The FTSST is simple to administer and requires minimal equipment. Here's a breakdown of the standard procedure:

1. Preparation: The individual sits on a standard, firm chair (approximately 16 inches high) with their arms folded across their chest.
2. Instructions: The tester provides clear instructions, such as: "Please stand up and sit down 5 times as quickly as you can, without stopping. Keep your arms folded across your chest." A practice trial is often given.
3. Execution: Timing begins on the command "Go" and ends when the individual's buttocks makes contact with the chair after the fifth repetition.
4. Observation: The tester observes the individual for any difficulty, loss of balance, or the need to use their hands for support. Inability to complete the test without using hands is noted as a failure.

Interpreting the Results and Predicting Fall Risk

The time it takes to complete the FTSST is the primary result, but a healthcare provider will consider multiple factors for a comprehensive interpretation, including age, gender, and underlying conditions.

Interpreting Scores and Normative Data

Performance is compared against normative data for different age groups. Faster times are associated with better functional strength and lower fall risk. The following table provides examples of normative data for healthy adults, demonstrating the expected decrease in performance with age:

Age Group (years)	Male (Mean Time ± SD)	Female (Mean Time ± SD)
60-69	8.4 ± 0.0 sec	12.7 ± 1.8 sec
70-79	11.6 ± 3.4 sec	13.0 ± 4.8 sec
80-89	16.7 ± 4.5 sec	17.2 ± 5.5 sec
90+	19.5 ± 2.3 sec	22.9 ± 9.6 sec

Clinical Interpretation of Results

• Risk of Falls: A score of 16 seconds or more is often used as a cut-off to indicate an increased risk of falling in older adults. Slower times also correlate with a higher risk of recurrent falls.
• Functional Decline: For older adults, longer test times are associated with increased disability and morbidity. The test can identify individuals at risk of functional decline, hospitalization, or needing caregiver assistance.
• Qualitative Assessment: Beyond the timed score, clinicians observe the quality of the movement. Hesitation, leaning, or relying on hands for support can indicate specific balance or strength deficits that require targeted interventions.

Comparing the FTSST to Other Mobility Tests

While the FTSST is an excellent tool, it is one of several functional assessments. Here is how it compares to a few others:

Feature	Five Times Sit to Stand Test (FTSST)	30-Second Sit to Stand Test	Timed Up and Go (TUG) Test
Primary Measure	Time to complete 5 repetitions	Number of repetitions in 30 seconds	Time to stand, walk 3 meters, turn, and sit
Focus	Functional lower body strength and balance during transitions	Lower body strength endurance	Overall functional mobility, gait, and balance
Interpretation	Slower time indicates lower strength and higher fall risk	Fewer repetitions indicate lower strength	Slower time indicates greater fall risk
Best For	Isolating strength and balance in sit-to-stand motion	Measuring lower body endurance	Comprehensive mobility assessment incorporating gait

For a deeper dive into optimal procedures for geriatric care, the National Institutes of Health provides excellent resources, such as the systematic review on the topic available at Optimal procedure and characteristics in using five times sit to stand test in older adults.

Conclusion: Why the FTSST Matters

The FTSST is a quick, easy-to-administer, and highly reliable test that provides invaluable insights into a person's physical health, particularly in the context of healthy aging. By measuring functional lower body strength, dynamic balance, and mobility, it helps healthcare providers accurately assess fall risk and predict future disability. The results empower clinicians to develop targeted rehabilitation strategies and monitor progress, ultimately helping seniors maintain independence and quality of life for as long as possible. Anyone concerned about their mobility or balance can benefit from this simple yet powerful assessment.

Frequently Asked Questions

What is considered a poor score on the 5 times sit to stand test?

For older adults, a score of 16 seconds or more is often considered poor and may indicate an increased risk of falls. In general, slower times compared to age-matched norms suggest lower functional strength and balance.

Is the 5 times sit to stand test a measure of balance?

Yes, while the FTSST is known for measuring functional leg strength, it also assesses dynamic balance. Performing the test requires continuous adjustments to maintain stability, especially during the transition between sitting and standing.

What equipment is needed for the 5 times sit to stand test?

The test requires minimal equipment: a standard height chair (approximately 16 inches high) with a straight back and a stopwatch. The individual should also be instructed to cross their arms over their chest during the test.

How can I improve my 5 times sit to stand test score?

Improving your score typically involves strengthening the muscles of your lower body and practicing balance exercises. Regular strength training that targets the quadriceps, hamstrings, and glutes, combined with balance-focused activities, can lead to improvements.

How do physical therapists use the results of the FTSST?

Physical therapists use the FTSST results to establish a baseline measure of a patient's functional mobility, assess their risk of falling, and monitor their progress during rehabilitation. They also use qualitative observations to tailor specific intervention strategies.

Can people of all ages take the 5 times sit to stand test?

Yes, the FTSST has been studied and used across a wide age range, from younger adults to those over 90. However, the interpretation of the score is relative to age-specific normative data to account for natural variations in mobility and strength.

What if a person cannot complete the 5 times sit to stand test?

If a person is unable to complete the five repetitions or must use their hands for support, it is considered a test failure. This is a significant indicator of high fall risk and functional impairment, signaling a need for immediate intervention and additional assessment.