30 Seconds Sit To Stand Test

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Objective

The 30 Second Sit to Stand Test is also known as 30 second chair stand test ( 30CST), is 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 5 or 10 repetition sit to stand test in older adults.[1]

Intended Population

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

Method of Use

  • The 30-Second Chair Test is administered using a folding chair without arms, with seat height of 17 inches (43.2 cm). The chair, with rubber tips on the legs, is placed against a wall to prevent it from moving.
  • The participant is 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. Arms are crossed at the wrists and held against the chest.
  • Demonstrate the task both slowly and quickly.
  • Have the patient practice a repetition or 2 before completing the test.
  • If a patient must use their arms to complete the test they are scored 0.
  • The participant is encouraged to complete as many full stands as possible within 30 seconds. The participant is instructed to fully sit between each stand.
  • While monitoring the participant’s performance to ensure proper form, the tester silently counts the completion of each correct stand.  The score is the total number of stands within 30 seconds (more than halfway up at the end of 30 seconds counts as a full stand). Incorrectly executed stands are not counted.
  • The 30-second chair stand involves recording the number of stands a person can complete in 30 seconds rather then the amount of time it takes to complete a pre-determined number of repetitions. That way, it is possible to assess a wide variety of ability levels with scores ranging from 0 for those who can not complete 1 stand to greater then 20 for more fit individuals.[1]

Evidence

Test/ Retest Reliability in community dwelling Elderly

  • Excellent test-retest reliability total number of participants: r = 0.89 (95% Confidence interval 0.79-0.93)[2]

Interrater/Intrarater 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)[2]

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[2]

Reliability in Community Dwelling Sexagenarian Women

  • Adequate validity when compared to hip extensor isokinetic strength: r = 0.33
  • Adequate validity when compared to hip flexor isokinetic strength: r = 0.47
  • Adequate validity when compared to knee extensor isokinetic strength: r = 0.44
  • Adequate validity when compared to knee flexor isokinetic strength: r = 0.33
  • Adequate validity when compared to ankle plantar flexor isokinetic strength: r = 0.52
  • Poor validity when compared to ankle dorsiflexion isokinetic strength: r = 0.21 [3]

Responsiveness of the Test among Community Dwelling Elderly 

  • Effect sizes for high vs. low activity level means = 0.83; p < 0.0001
  • Effect sizes for the 60’s to 70’s age group comparisons = 0.38
  • Effect sizes for the 70’s to 80’s age group comparisons = 0.30 [4]

Standard Error of Measurement (SEM) in Hip Osteoarthritis

Test/Retest Reliability ( Hip and Knee OA)

  • Established test-retest reliability between 2 administrations of the test on the same day by the same rater at 3 time points over 15 weeks in 40 patients awaiting total hip or knee replacement.  ICC (1,1) values ranged from 0.97 (95% CI 0.94-0.98) to 0.98 (95% CI 0.97-0.99). [6]

Interrater/Intrarater Reliability( Hip and Knee OA)

  • Established inter-rater reliability between 2 administrations of the same test by 2 different raters on the same day.  Reliability was assessed at 3 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). [6]

Construct Validity (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 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) [7] 

Responsiveness (OA Individuals Awaiting Joint Replacement of the Hip or Knee)

  • Significantly higher scores for individuals who did not ambulate with gait aide compared to individuals who did ambulate with gait aid: p = 0.00, Effect size = 0.64 (95% CI 0.32-0.95)
  • Standardized Response Mean (SRM) = 0.84 (95% CI 0.61-1.07)
  • Guyatt’s Responsiveness Index (GRI) = 0.98 (95% CI 0.73-1.22) [7]

References

  1. 1.0 1.1 https://www.sralab.org/rehabilitation-measures/30-second-sit-stand-test (last accessed 17th May 2019)
  2. 2.0 2.1 2.2 Rikli, R.E. and Jones, C.J., 1999. Development and validation of a functional fitness test for community-residing older adults. Journal of aging and physical activity7(2), pp.129-161.
  3. McCarthy, E.K., Horvat, M.A., Holtsberg, P.A. and Wisenbaker, J.M., 2004. Repeated chair stands as a measure of lower limb strength in sexagenarian women. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences59(11), pp.1207-1212.
  4. Jones, C.J., Rikli, R.E. and Beam, W.C., 1999. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Research quarterly for exercise and sport70(2), pp.113-119.
  5. Wright, A. A., Cook, C. E., et al. 2011. "A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis." J Orthop Sports Phys Ther 41(5): 319-327.
  6. 6.0 6.1 Gill, S. and McBurney, H., 2008. Reliability of performance‐based measures in people awaiting joint replacement surgery of the hip or knee. Physiotherapy Research International13(3), pp.141-152.
  7. 7.0 7.1 Gill, S.D., de Morton, N.A. and Mc Burney, H., 2012. An investigation of the validity of six measures of physical function in people awaiting joint replacement surgery of the hip or knee. Clinical rehabilitation26(10), pp.945-951.