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30 Seconds Sit To Stand Test

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Introduction

30-Second Sit-to-Stand Test

The 30-Second Chair-Stand Test (30CST), also known as the 30 Second Sit-to-Stand Test (STS30) was developed by Rikili and Jones as part of the Fullerton Functional Fitness Test Battery, also known as the Senior fitness test manual, to assess lower body strength in older adults.[1][2] The test measures the number of times an individual can rise from a seated position to a full standing position within 30 seconds with their arms in folding position across the chest.[3] It provides a simple, cost-effective and reliable method of assessing functional lower extremity strength, which is essential for everyday activities.[1] Altough initially developed for older adults, it may also be relevant for younger adults.[4] This could be particularly interesting in sports and rehabilitation, as lower extremity strength contributes to athletic performance.[4]

Validity and Reliability

The 30 Second Sit to Stand Test, which is also known as the 30 Second Chair Stand Test (30CST), was designed for testing leg strength and endurance in older adults. It is part of the Fullerton Functional Fitness Test Battery. This test was developed to overcome the floor effect of the five or ten repetition sit to stand, a test in older adults.[5] There is also some consideration for its use as a physical performance test in younger adult and athletic populations, but further investigation may be necessary.

Intended Population

  • Adults 18-64 years
  • Older adults and geriatric care (65 years and above)
  • People with osteoarthritis

Method

Materials Needed

The items required to carry out the test are an armless chair with a seat height of 43,2 cm, placed against a wall, and a stopwatch.[1] During the test, the chair may be held steady to prevent it from tipping over.[1]

Performing the test

The person being tested is instructed to sit in the centre of the chair.[1] Their feet should be parallel and approximately a shoulder’s width apart.[1] Their arms should be crossed in front of their torso so that they cannot use them for support.[1] Another instruction is that both legs should be used equally.[4] They should then perform as many sit-to-stand cycles as possible at maximum effort, whilst ensuring safe execution.[1] The person should carry out a trial run before actually performing the exercise to get a feel for the movement.[1] The test subject should start on the command ‘Go’, and the examiner should start the stopwatch at the same time.[1] After 30 seconds, the number of cycles actually completed is recorded.[1]

[6]

Interpretation

A below-average number of stands for the patient’s age group indicates a high risk of falls. The table shows the average number of repetitions that should be completed. The number of stands was selected based on the 25th to 75th percentile range for the STS30.[7]

Age Women Men
60-64 12 - 17 14 - 19
65-69 11 - 16 12 - 18
70-74 10 - 15 12 - 17
75-79 10 - 15 11 - 17
80-84 9 - 14 10 - 15
85-89 8 - 13 8 - 14
90-94 4 - 11 7 - 12

Clinical Implications[3]

Community-dwelling Elderly Adults

Test/ Retest Reliability in Community-dwelling Elderly

  • Excellent test-retest reliability, total number of participants: r = 0.89 [95% Confidence Interval (CI) 0.79-0.93][1]

Inter-rater/Intra-rater Reliability in Community-dwelling Elderly

A pilot study using a subsample of 15 participants shows excellent interrater reliability: r = 0.95 (95% CI = 0.84-0.97)[1]

Criterion Validity: Predictive /Concurrent

  • Excellent criterion validity of the chair stand compared to weight-adjusted leg press performance for all participants: r = 0.77, 95% CI = 0.64-0.85
  • Excellent criterion validity of the chair stand compared to weight-adjusted leg press performance of men: r = 0.78, 95% CI = 0.63-0.88
  • Excellent criterion validity of the chair stand compared to weight-adjusted leg performance of women: r = 0.71, 95% CI = 0.53-0.84[1]

Osteoarthritis

Standard Error of Measurement (SEM) in Hip Osteoarthritis

Test/Retest Reliability in Hip and Knee OA

  • Established test-retest reliability between two administrations of the test on the same day by the same rater at three time points over 15 weeks in 40 patients awaiting total hip or knee replacement. Intraclass correlation coefficient (ICC) (1,1) values ranged from 0.97 (95% CI 0.94-0.98) to 0.98 (95% CI 0.97-0.99). [9]

Interrater/Intrarater Reliability in Hip and Knee OA

  • Established inter-rater reliability between two administrations of the same test by two different raters on the same day.  Reliability was assessed at three time points over 15 weeks in 42 patients awaiting total hip or knee replacement.  ICC (1,1) ranged from 0.93 (95% CI 0.87-0.96) to 0.98 (95% CI 0.96-0.99). [9]

Lower Limb Joint Replacement

Construct Validity in OA Individuals Awaiting Joint Replacement of the Hip or Knee

  • Excellent correlation to the 50 ft. walk test: ICC = -0.64(95% CI = -0.75 to -0.49)
  • Poor correlation to the Patient Specific Function Scale (PSFS): ICC = 0.26 (95% CI 0.04-0.45)
  • Adequate correlation to the 36-Item Short Form Survey (SF-36) Physical Function (SF-36 PF): ICC = 0.39 (95% CI 0.19-0.56)
  • Adequate correlation to the SF-36 Physical Component Summary (SF-36 PCS): ICC = 0.35 (0.14-0.53)
  • Excellent correlation to the Western Ontario and McMaster Universities Arthritis Index (WOMAC): ICC = -0.62 (95% CI -0.74 to -0.47)
  • Adequate correlation to the SF-36 Mental Health (SF-36 MH): ICC = 0.33 (95% CI 0.12-0.51) [10] 

Responsiveness in OA Individuals Awaiting Joint Replacement of the Hip or Knee

  • Significantly higher scores for individuals who did not ambulate with gait aid compared to individuals who did ambulate with gait aid: p = 0.00, Effect size = 0.64 (95% CI 0.32-0.95)
  • Standardised Response Mean (SRM) = 0.84 (95% CI 0.61-1.07)
  • Guyatt’s Responsiveness Index (GRI) = 0.98 (95% CI 0.73-1.22) [10]

Hemodialysis Patients

  • The STS-30 demonstrated excellent test-retest reliability (ICC > 0.90)[11]
  • There was a significant strong correlation between STS-30 with exercise capacity (r = 0.724; p < 0.001)[11]
  • The 30-second Sit-to-Stand Test is reliable for identifying hemodialysis patients with exercise capacity impairment.

Physical Performance Testing

  • 81 participants between 18 and 35 years of age averaged 33.0±5.4 repetitions during the 30CST [12]
  • There was excellent test-retest reliability between 2 30CST trials in this group (ICC = 0.93) [12]
  • Significant, strong negative correlation between 30CST repetitions and time to complete the 5 Times Sit to Stand (r = -0.78; p = 0.01); significant, strong positive correlations with the Lateral Step-Up Test (r = 0.51; p = 0.01)[12]
  • Individuals identified as sufficiently active (according to Physical Activity Guidelines for Americans) performed a statistically significantly greater number of repetitions than those in the insufficiently active group (mean difference = [t (2,79) = 2.09; p = 0.04][12]
  • Due to its strong psychometric properties, the 30CST may be a useful tool to assess functional LE in young adults, and for use as a physical performance test for athletes

Safety Considerations

Conclusion

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70(2):113-9.
  2. ↑ Rikli RE, Jones CJ. Senior fitness test manual. Champaign (IL): Human Kinetics; 2001.
  3. ↑ 3.0 3.1 Rikli R, Jones C, Functional fitness normative scores for community-residing older adults, ages 60-94. J Aging Phys Activity 1999;7(2):162-81.Available from: https://bpac.org.nz/falls/docs/The_30-Second_Chair_Stand_Test.pdf (accessed 26 November 2023).
  4. ↑ 4.0 4.1 4.2 Lein DH Jr, Alotaibi M, Almutairi M, Singh H. Normative reference values and validity for the 30-second chair-stand test in healthy young adults. Int J Sports Phys Ther. 2022;17(5):907-14.
  5. ↑ Shirley Ryan Ability Lab. 30 Second Sit to Stand Test. Available from: https://www.sralab.org/rehabilitation-measures/30-second-sit-stand-test (accessed 26 November 2023).
  6. ↑ Centers for Disease Control and Prevention. 30-Second Chair Stand Test. Available from: https://www.youtube.com/watch?v=qkV0UvjXgcs (accessed 26 November 2023).
  7. ↑ Rikli RE, Jones CJ. Functional fitness normative scores for community-residing older adults, ages 60–94. J Aging Phys Act. 1999;7(2):162-81.
  8. ↑ Wright AA, Cook CE, Baxter GD, Dockerty JD, Abbott JH. A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis. Journal of Orthopaedic & Sports Physical Therapy. 2011;41(5):319-27.
  9. ↑ 9.0 9.1 Gill S, McBurney H. Reliability of performance‐based measures in people awaiting joint replacement surgery of the hip or knee. Physiotherapy Research International. 2008 Sep;13(3):141-52.
  10. ↑ 10.0 10.1 Gill SD, de Morton NA, McBurney H. An investigation of the validity of six measures of physical function in people awaiting joint replacement surgery of the hip or knee. Clinical rehabilitation. 2012 Oct;26(10):945-51.
  11. ↑ 11.0 11.1 Figueiredo PH, de Souza Veloso LR, Lima MM, Vieira CF, Alves FL, Lacerda AC, Lima VP, Rodrigues VG, Maciel EH, Costa HS. The reliability and validity of the 30-seconds sit-to-stand test and its capacity for assessment of the functional status of hemodialysis patients. Journal of Bodywork and Movement Therapies. 2021 Jul 1;27:157-64.
  12. ↑ 12.0 12.1 12.2 12.3 Lein DH, Alotaibi M, Almutairi M, Singh H. Normative Reference Values and Validity for the 30-Second Chair-Stand Test in Healthy Young Adults. Int J Sports Phys Ther. 2022;17(5):907–14.
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