chair stand tests

CHAIR STAND Tests

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.

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 Csuka2 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

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 20two trials with the mean values for data analysis19

An additional variation includes placing the hands on the ASIS rather than crossed over the chest45

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

past 12 months

ICC = .89 - .96

Interrater Reliability:

Nevitt 1989 22 27 Community dwellers with 1 or more falls in

past 12 months

ICC = .93 - .99

Test-retest Reliability

Jette 1999 64 105 Frail community elders. Mean 14 days

between testing dates (range 0-132)

ICC = .25

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

Age range 56 – 95 years13

50 Ratio of leg ext peak isometric torque to body wt

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,

mean age 71.5years, with Stage II

Hoehn and Yahr staging Parkinson’s

Disease 44

13 No difference in muscle activation (Quadriceps Femoris

and Hamstrings) on EMG analysis, and no difference in

peak force or kinematics on 1TSTS between individuals

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

falls in past 12 mos22

325 22% of subjects who were unable to complete 1TSTS in

<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

Yes/No

Av change post intervention

Significant differences?

Community dwelling

adults

Age 66 – 97 years

15 Exercise Intervention n = 15

3x/wk x 8 week low to

moderate intensity group ex

yes

Pre: 1.7 (0.7)s;Post:

1.3(0.4)s;

29% improvement

CHAIR STAND Tests


75 No difference on 1 year

follow-up of 9 subjects

Community dwelling

adults with Parkinson’s

Disease average

Hoehne and Yahr

Staging 2.7 45

52 Exercise (EX) intervention

(n= 19) consisting of 20

minutes, 3x/ week/ 4 weeks.

Cued task specific

audiovisual (AV) training

(n= 19) consisting of 45

minutes, 2x / week for 4

weeks.

Control: no treatment (n=14)

yes Ex Pre: 2.50s

Ex Post:2.28s

AV Pre: 2.80s

AV Post:2.10s

Control Pre: 2.40s

Control Post: 2.41s

Exercise and AV group

significant improvement over

control (p<0.05 and 0.01

respectively).Maintained

gains at 2 week follow up.

Community dwelling

adults with cemented

post-lateral THA,

Age 60.3 (13)years

BMI 26.4(3.4)

Controls 60.3(12.9);

BMI 25.3(3.3) 76

Subjects

30 male

Controls

11 male

Baseline= 6 weeks pre-THA;

Intervention = 6 months

post-THA

Control = healthy

20 computerized random

chair rises in own

environment from morning

until dark

yes CI (.95)

Pre: 3.0 (2.8-3.2)s

Post: 2.6 (2.5-2.8)s

P<0.0001

0.375s change p<0.0001

Dependent t test

Controls 2.3(2.2-2.5)s

P < 0.001

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

(2.8)years 25

47

20males

2.04(0.39) seconds 1.30—3.18 seconds

Healthy subjects, mean age

60.1(12.9) years

years BMI: 26.4 + 3.4 76

30

Male

2.3 (2.2-2.5) seconds

CI (.95) p = 0.001

CHAIR STAND Tests


Other: Untimed 1TSTS

Population Descriptor N= Results

Non-fallers in community (23-

92yrs) Fallers in a care facility (63-

92years) 32

23

22

Rate of rising (as measured by force/time) identified 17 out of

21 fallers and 1 out of 23 non-fallers; retrospective study

Residents of an intermediate care

facility 47

79 25/79 were repeat fallers; 20% of the fallers but none of the

non-fallers had difficulty with arising; mean times not given.

Elderly persons with balance

impairment 26

14 TSTS correlates with 15 other balance test items; total

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

w/diplegic cerebral palsy (CP)

(mean age 48.9+15.9 months)

P < .05 Children with CP compared

with normal children

Normal children

(mean age 47.7 +7.9 months)79

15

Real time 5 phases of sit to stand ; Mean +SD seconds

Right side Left side

Trunk hip flexion .64 +.15 .69+.19

Max hip flexion .21 + .12 .16 + .18

Knee ext ankle DF -.10 +.12 -.05+ .08

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

21 Trunk hip flexion .32±.08

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

With hemiplegic or diplegic CP

Mean age 4.5 – 15.7 years

and

Without disabilities

Mean age 4.3 -11.8 years

Low bench height (measured in

prone): distance from bottom of heel

to popliteal crease, neutral ankle, 90o

knee flexion. High bench height:

120% of low bench height 80

20

10

10

Phase duration (seconds) Ave from low and high position measures

Mean (+SD)

With CP.

Mean (+SD)

Non disabled

Signif-

icance

Flexion momentum 64 (.13) .54 (.12) NS

Momentum transfer 22 (.94) .21 (.14) NS

Extension phase .85 (.28) .45 (.14) P<.05

Total STS time 1.71 (.36) 1.24 (.18) P<.05

Seat height had significant effect on duration of extension phase(F=19.64)

Extension Phase of STS was significantly longer for children with CP (.85s )

compared to children without disabilities (.45s ),

Children with CP took significantly longer to perform STS ( 1.71s ) than

children without disabilities ( 1.24s )

1

5

High STS 1RM: 11.3(3.6)kg. Ascending time mean with high resistance

1.7 sec as measured on reported x-y graph

CHAIR STAND Tests


Children (with mean +SD weighted

vest in kg based on max weight -

1RM (reliability ICC = .88-.97)

With CP (Mean age 8.5 +2.2 years)

Without CP(Mean age 8.9+ 1.7) 81

Ascending time compared to control significantly different(more time)

with High STS 1RM t =3.1, p=.004

1

5

High STS 1RM 26.1(5.0)kg. Ascending time mean with high resistance

1.25 seconds as measured on reported x-y graph

Critical Review of STS in children

with CP: 9 studies in which the N

ranged from 19-562,mean

91.77(176,86). Three of the studies

characterized STS movement in

children with CP. 82

CONCLUSIONs

Need to select standardized inclusion criteria

STS movement can be considered to better understand health conditions in

children with CP

Definitions of STS movement phases lack standardization

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: Reference N= Sample Description Reliability Statistic


Ostchega 200094

392 Community dwellers >age 60 ICC = 0.64

Blake 2004108 24 End stage renal dialysis patients and

healthy matched controls

ICC = 0.98

Mong et al 201020 36 12 subjects with chronic stroke, 12 healthy

elderly subjects and 12 young subjects

ICC=.970-.976

Interrater Reliability Ostchega 2000 94

392 Community dwellers > age 60 ICC =0.71

Duncan 2011 34 82 Community dwelling individuals with

idiopathic PD

ICC(1,1) = 0.99

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

weeks

ICC = 0.73

Duncan 2011 34 82 Community dwelling individuals with

idiopathic PD

ICC (2,1) = 0.76

Hoeymans, 199793

99 Men born between 1900 – 1920 & living in

Zutphen, Netherlands, 2 weeks

r = 0.82

Jette, 199964 89 Frail elders from community, 2 weeks ICC = .67

CHAIR STAND Tests


Schaubert, 200591 10 Ambulatory community dwellers, mean

age 76(6) yrs (6 & 12 week intervals)

ICC = .81

Lord, 200299 30 Community dwellers ICC = .89

Sherrington, 2005110

27 Community dwellers, mean 11 days after

ORIF hip fracture; retests done at 3 and 6

weeks

ICC(3,1) =.92

Tiedmann, 2008107 362 Community dwelling elderly age 74-98 ICC(3,1) =.89

Kim, 201133

43 cm height and barefoot

30 Lumbar spinal stenosis patients waiting for

surgery and matched bilateral knee

osteoarthritis patients waiting for surgery,

ICC= .95

Lin, Y-C, 2001, chair

height 44.5 cm, ending in

standing position.43

106 Sedentary community dwellers with hip or

knee OA

ICC=.96

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)

684 OLDER(75-98)

ICC=0.89

95% CI =.79,.95

Bohannon, 2007111 94 Nondisabled community dwelling adults

aged 19-84

ICC = .96

Bohannon, 2011112 Summarizing 10 studies Mean ICC = 0.81

Schaubert, 2005 91 113 21 Community dwelling adults aged 65-85

seen at baseline 6 and 12 weeks

ICC = .82

Validity: Body weight, BMI, knee extensor (quadriceps) strength and age all seem to correlate with FTSTS -

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


often not available

Population N Support for Validity

Ambulatory, community-dwelling

people with chronic stroke 92

50 On stepwise regression analysis, composite muscle strength

measured by 5TSTS accounted for 43% of the variance in BBS,

64% of TUG variance.

Community dwelling, ambulatory

persons with single ischemic CVA,

6-24 mos since CVA98

31 Failed to find significant relationship between knee extensor

power or strength with 5TSTS time. In regression analysis,

self-perceived ability did predict 43% of 5TSTS.

People with Rheumatoid Arthritis,

age 62(10)101

135 Knee strength inversely correlated with 5TSTS ( -0.47).

Subjects 3 months post TKA for OA 102

14 Subjects shifted weight away from the operated leg during

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,

community dwellers with

bone mineral density BMD 95

2928 5TSTS and knee strength (–.0.26), 6MWT (-0.36), 400m walk

(0.35) & standing balance (-0.16). Correlations controlled for

age, sex, race, bone site, height and weight.

Persons with and without balance or

vestibular disorders48

174 5TSTS scores correlated inversely both with DGI test scores (-

0.68) & ABC (-0.58)

Age> 65, ind ambulatory (58%

w/assist device) living in community

or CBRF97

179 Correlations between 5TSTS and time to complete 3600 turn

(0.26) and walking speed (-0.23)

Community dwelling adults age 65 –

9315

139 Correlations of 5TSTS with self-reported limitation in stair

flights climbed ; one flight (0.38), several flights (0.26)

Non-disabled community-dwelling

women, age range 60-90114

104 Pearson correlations of 5TSTS with waist circum (0.34), W/H

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,

ambulatory w/o AD115

176 5TSTS time associated with high visual acuity (0.23), reaction

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;

mean age 76(6) years 91

10 5TSTS correlates with TUG (0.73 – 0.92) and inversely with

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

stable adults, age 75 -889

16 Significant relationship between 5TSTS & combined hip

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

with idiopathic PD34 82 Correlation Coefficients Between FTSTS Test

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

adults on hemodialysis, age 22-87104

46 Correlation with gait speed (-.071), and stair climbing 12 steps,

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

measuring asymmetry in weight

bearing pre and post-op for TKA.

Age=63.4±7.740

53

36 with

knee OA

to

undergo

unilateral

TKA

17 healthy

people

Greatest asymmetry in weight-bearing with sit to stand is at one

month post-op (r=-.33), returned to pre-op levels at 3 months

post-op(r=-.26), more symmetrical at 6 months post-op than at

pre-op(r=-.31).

at one month post-op=11.3 seconds

at three months post-op=8.8 seconds

at six months post-op=9.4 seconds

Greater symmetry with weight bearing during STS associated

with increased quad strength symmetry (range, .26-.39).

People with Balance disorders age

23-9048

93 The Spearman rho between the 5TSTS and the DGI was -.68

Between 5TSTS and ABC was -.58

CHAIR STAND Tests


Community dwelling adults aged

19-84111

94 Greater age (.53), weight (.28), and BMI (.34) were

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,

mean age 68(8)116

684 5TSTS time does not predict or correlate with testosterone

hormone levels

Community dwellers in Netherlands 96

1262 Apolipoprotein E e4 polymorphism associated with poor

5TSTS time, age and sex adjusted OR 1.94

Healthy post-menopausal women;

mean age 68(7)88 116 5TSTS time doesn’t predict or correlate with bone mineral

density at any skeletal site.


adults on hemodialysis, age range

22-87, mean age 52104

46 Univariate association among predictor variables and 5TSTS.

Decline in performance associated with age (0.51). Improved

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)(r2=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

age 50-69 (mean 59).6

54 5TSTS is significantly correlated with all WOMAC subscales

and composite scores r = .485 to .529; muscle strength r = --

.620 for knee extension; r = -.638 for knee flexion.

Subjects with lumbar spinal stenosis

mean age 63(7) 33

40 No significant correlation of 5TSTS with the Oswestry

Disability Index

People with unilateral knee pain

from Osteoarthritis Initiative Study39

1344 Pearson correlation between isometric quad strength and

FTSTS= -.36. FTSTS not correlated with pain.

People with unilateral knee OA

recruited from an orthopedic clinic40

67 N=50 with knee OA

N=17 healthy people

Pearson correlation between weight-bearing asymmetry and

FTSTS=-.44

Subjects of varied age 20-39 and 75-

98 and disability including RA and

CVA height of chair 43 cm and

barefoot 21

734

CVA=48

NoCVA=

636

OA=283

No CVA=

401

Significant age related difference in performance were found

with older women performing longer than older men

Median (IQR) sit to stand test scores

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)

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)

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-

20.6)

Times for FRSTS by subject’s medical diagnosis (seconds)

OA No OA CVA No CVA

12.5(10.3-

15.9)

11.0(9.2-13.1) 12.1(10.6-14.7) 11.5(9.5-14.2)

CHAIR STAND Tests


Males with osteoarthritis of the knee

age 50-69 (mean 59).6

54 5TSTS is significantly correlated with all WOMAC subscales

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

height 43 cm 109

47 Low level of relative importance in explaining STS

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 disability117

Population N Results

Ambulatory, community-dwelling

people with chronic stroke92

50 5TSTS scores were not predictive of non-fallers or fallers;

5TSTS explains 64% of the variance of the TUG.

Healthy, community dwellers over

age 65118

189 No significant difference between non-fallers, one time

fallers, and multi-fallers

Community dwellers

(mean age 72)119

257 Increased 5TSTS times predictor of falls with OR 1.13.

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

in rural Japan community 103

402 5TSTS time increased with age (0.44); Time decreased with

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

over age 71; prospective study117

(Note: Same scoring used in

another study of elderly persons) 100

1122 Increased 5TSTS scores predictor of mobility related

disability within 4 years: > 16.7 sec , relative risk 4.1

4 year Predictors (p<0.001) Chi-Square Test

Scores: No Disability Mobility Dis ADL Dis

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 %


elderly age 74-98107

362 5TSTS, when combined with the alternate step test (AST)

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

community18

27 STS was less accurate at predicting falls than the ABC and

the SIS-16

Chronic Hemi-paretic community

dwellers 19

68 Results show that balance ability is an independent predictor

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

65 living in France. 120

999 Twice as likely to be recurrent fallers in those that were

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

Identifying Balance

Disorders

<age 60

>age 60

Entire group

79

95

174

48

10.0 seconds

14.2 seconds

13.0 seconds

Sensitivity 87%, specificity 84%



Identifying individuals

who fall in a population of

community dwellers with

idiopathic PD

82 34 >16 seconds Sensitivity 0.75 specificity 0.68

Identifying Multiple fallers 362 107 ≥12 sec Sensitivity 66%, specificity 55%

Ambulatory community

dwelling adults on

hemodialysis, age range

22-87

46 104 Separate multivariate

regression analysis performed

using physical activity arbitrary

units

No significant improvement in model

of the 5TSTS. r=0.68, r2=0.46N

Subjects, age 18-65 with

chronic low back pain

178 38

14.1 seconds


Discriminatory between

young

healthy elderly

stroke

12

12

12

20

9.4 seconds

10seconds

12 seconds

Sensitivity 83% Specificity 75%

Chronic CVA 27 18 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

Yes/No

Average change post

intervention

Clients with Central

vestibular

dysfunction at

hospital-based

rehab center

12 30 custom designed Vestibular

PT; 5 visits over 5 months;

retrospective study

Yes 6.8 (6.)

Persons with cerebellar

disorders had least

improvement (n=2)

Community

dwelling renal

dialysis patients

12

(12

healthy

controls)

108

1 time comparison testing, age

& sex matched controls

Yes Dialysis: 10.1(1.6) s

Control: 7.3(1.1) s

(P<0.001)

Older adults

without cognitive or

physical disabilities

2450 121

longitudinal analysis over 4

years; mean age 74 . Persons

w/severe MRI white matter

hypersensitivity had slower

5TSTS (13.7 vs 14.6 s)

Yes Persons w/severe MRI

white matter

hypersensitivity had inc

rate of decline (mean

change =0.3 s/yr vs

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.

Community

dwellers > 75

620 122 2x/wk x 12 months Yes EIG group:

pre 13.7(6.4)sec

CHAIR STAND Tests


Extensive Intervention Group

EIG; individualized

interventions comprising ex

and strategies for max vision

and sensation

Minimal Intervention Group

MIG: brief advice

Control CG

no feedback until 12 mos

post 11.7(4.6)

Post-hoc test differences

between EIG – CG

&MIG-CG:

No significant differences

between

EIG and MIG

Healthy, not active

Community-

dwelling, age 60 -

92

108 903x/week x 16 weeks

Cobblestone mat walking

group n=54

Conventional walking group;

Yes Mean difference

1.21(0.32)

Community

dwellers,

Age 65-79

53 7224 weeks 3 sets of 8 ex

EX 1 n=14,: 1x/week

EX 2, n=14: 2x/week

EX 3, n=11: 3x/week

Control, n=14: no exercise

Yes 5TSTS times decreased

for all exercise groups, no

sig. change in control

improved 5TSTS assoc

w/% quad strength

increase (-0.4): leg press (-

0.39)

Community

dwelling adults

Age 66 – 97 years

15 753x/week x 8 week low to

moderate intensity group

exercise

Yes

Pre: 19.3(7.9)

Post: 14.5(4.2);

27% improvement. No

difference 1 year follow-

up

Community

Dwelling frail

Elderly awaiting

THA mean age 76

+ 4 years

From7/07- 11/08

21

10

Treatment

11

Usual care

123

Exercise intervention n=10

2x/wk x 60 min x 3-6 wks pre-

op 91% participation

Control group n=11

1 group information session

Yes Exercise:

Baseline 18.5 + 13.5s

Pre-op 15.0 +5.8s

Control:

Baseline 17.1 + 6.4s

Pre-op 17.4 + 5.9s

Between Group

d = -2.9(-6.2-0.4)s CI(.95)

ANCOVA effect size 0.43;

medium effect

Adults undergoing

THA or TKA

Age 61.8 + 11.2

years

80 124

Intervention

Total hip arthroplasty

n = 36

Total knee arthroplasty

n= 44

pre-op, 3 and 6 month post-op

measured with Activity

Monitor (AM)

Yes p = 0.05

Pre-op (t0):

Total group 18.3(7.7-

35.7)s

THA 18.5 (7.7-32.7)s

TKA 17.5(8.9-35.7)s

3 month post-op(t3):

THA 16.0 (5.6-32.8)s

TKA 16.7 (10.4-35.3)s

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 Ambulatory

community

dwelling adults on

hemodialysis, age

range 22-87

46 104 Separate multivariate

regression analysis performed

using physical activity

arbitrary units

No No significant

improvement in model of

the 5TSTS. r=0.68, r2=0.46

CHAIR STAND Tests


Community

dwelling adults on

hemodialysis, age

40-70

79 1253 month supervised LE

resistive exercise program,

3x/week during hemodialysis

Yes No improvement in any of

the groups.2-way repeated

ANOVA comparing

baseline & outcome, 2-

tailed <.05. P ND=0.38,

EX 0.30

Ambulatory

community

dwelling adults

with end-stage renal

disease on

hemodialysis, age

range 31-71

33 1063 month supervised

moderate level aerobic training

on a cycle ergometer, 3x/week

Yes Significant improvement

pre-post for ex group (14.7

± 6.2 to 11.0 ±3.3) vs

control group (12.8 ± 4.4

to 12.7 ± 4.8) sec with f =

10.4 and p =0.003

Lumbar spinal

stenosis patients

waiting for surgery

40 331 time comparison testing

age and sex matched subjects

with bilateral knee

osteoarthritis

Yes Lumbar spinal stenosis:

15.76(1.44) s

Knee osteoarthritis:

14.37 (2.25)s

(p<.001)

Males with

osteoarthritis of the

knee age 50-69

(mean 59)

54 61 time comparison testing

age and sex matched controls

Yes Mean difference between

groups 19%-26% in STS,

timed up and go, and

straight line walking

(p<.001). Specific values

not given per test.

Knee osteoarthritis

subjects (OA) age=

63+/- 10 years

80 16Exercise intervention (knee

OA subjects) n = 40 3- 4 x/wk

x 8 wk exercise program for

hip abductors HEP and booklet

Control group(age and sex

matched normals) n=40

Regular daily activity

Yes Initial testing (95%CI)

OA: 15.2 (12.6-17.9)

Control: 10.1 (9.2-11.0)

Final testing 8 week

(95%CI)

OA: 12.5 (10.6-14.4)

Control: 9.3(8.4-10.2)

Between group

comparison of

improvement: F=5.55

p=.021

Community

dwellers >60 y.o

with hip or knee

OA defined by

Altman

170 17Exercise intervention n=80

3x/week for 90 minutes/8

weeks, resistance training,

walking for 30 minutes, 30

minutes of education to

promote exercise adherence

Control group n=70 on wait

list for surgery

No No significant difference

between groups

Subjects with OA

of knee average age

65.3 years.

39 4139 subjects underwent course

of PT, evaluating therapist

determined treatment based on

signs and symptoms.

No Effect size=.36(small)

Chronic non-

specific low back

pain subjects

134 38Chronic non-specific low

back pain subjects

10 week exercise program

Yes 9.8seconds for

improvement.

CHAIR STAND Tests


Subjects scheduled

for TKA measuring

asymmetry in

weight bearing pre

and post-op for

TKA.

Age=63.4±7.740

53

36 with

knee OA

pre/post

unilateral

TKA

17 healthy

people

1 month post-op=11.3 sec

3 months post-op=8.8 sec

6 months post-op=9.4 sec

Greater symmetry with weight

bearing during sit to stand was

associated with increased quad

strength symmetry (range, .26-

.39).

Yes Greatest asymmetry in

weight-bearing with sit to

stand is at one month post-

op (r=-.33), returned to

pre-op levels at 3 months

post-op(r=-.26), more

symmetrical at 6 months

post-op than at pre-op(r=-

.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

& CT (EPESE Study)83

Ends with sit.

5097 13.2 sec Age 71-79

15.9 sec Age 80+

14.4 sec Age 71-79

16.1 sec Age 80+

Community dwellers 99

Ends with stand.

642 75-79 12.1(5.4)

80-84 12.9(5.5)

85-89 13.7(7.2)

90+ 17.2(5.9)

Total 12.8(5.9)

12.2(4.1)

13.4(5.6)

14.1(6.5)

15.1(6.5)

12.9(5.1)

Community dwellers > age 60

NHW (Non-Hispanic White)

NHB(Non-Hispanic Black)

MA (Mexican American)

Men faster than women (P<0.001)

NHW faster than MA females,

NHB males and female s (p<0.001)

Ends with sit.94

Total:5403

2592 Males

60-69 12.65(.24) s

70-79 13.35(.29)

80+ 14.70(.25)

13.22(.22)sec

14.19(.29)

16.58(.30)

NHW 13.08(.20)

NHB 14.49(.26)

MA 12.96(.27)

Overall

mean 13.11(.19)

13.7 (.22)

16.52(.48)

15.27(.30)

14.05(.72)

Community Dwellers (EPESE

study)84 Ends with sit

1192 Age 70-79. 45% male

Mean time 12.3(2.9) with range 5.0 – 20.4 sec

Community dwelling adults15

Ends with sit.

139 Age 65 – 93, men (n=32)

Mean time 11.7(3.8) with range 5.5 – 27.0 sec

Healthy older (>60) women living in

rural Japan community103

Ends with stand.

402 Time increased with fallers:

Fallers (n=85)10.8(4.0) sec;

non-fallers(n=317)9.9(3.1) s.

Community dwelling individuals

with idiopathic PD34

82 Average age 67(9) years. Mean time to complete 5TSTS

20.25 (14) sec

Non-disabled community dwelling

females 114

Ends with sit.

104 Ages 60 -90 Mean time 11.5(4.1) range 6.0 – 34.5 sec

CHAIR STAND Tests


Massachusetts Male Aging Study116

Ends with sit

659 Mean age 68(8)

3.4(1.2)sec

Ambulatory w/o assist device,

residents of a retirement village115

Ends with stand

176 Mean age 80(6); men (n = 56)

Mean time 19.32(10.72), range 6.09 – 46.02 sec

Well-functioning, age 70-79,

community dwellers

Measured bone mineral density

BMD 95 Ends with stand.

2928 Adjusted for age, ht, wt, bone site by ANCOVA time

difference in 5TSTS by race: Wh Fe 15.0(0.2), Bl Fe

15.9(0.2); Wh Male 12.4(0.2) vs Bl Male 14.3(0.2).


adults on hemodialysis, age range

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

46 31 male and 15 females

mean time for 5TSTS 16.6 (9.5) sec

Community dwelling adults on

hemodialysis, University based

dialysis unit 105 End not specified

79

49 males and 30 females, age 40-70 with mean age 55

5TSTS Mean time 16.3, range 6.3 – 29.4 sec


adults with end-stage renal disease

on hemodialysis,, age range 31-71106

End test position not specified

33

exercise n=18

mean age =

57.3

control n=15

mean age 50.5

No indication of number of males/females.

Mean age 54.

Mean time (sec) 14.7 with range 8.4-20.9

Community dwellers with chronic

Hemiparesis 19ends with sit

68 Average time 17.9 +/- 9.6 (8.41-54.6)sec

Community dwelling adults 19-84 111

Ends with sit

94 Measurement (n) Mean ± SD Minimum-Maximum

Trial 1: all ages (94) 7.8 ( 2.8) 4.0–16.3

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 119 Ends with sit.

All (257)

Mean age72 Non-Fallers

(n = 129)

Occasional

fallers (n=76)

Frequent falls

(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

(all of these groupings are times

significantly different than the

Bohannon 2006 data) 127

Age N Score SD

50-59 78 6.7 sec (1.9)

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-

98 and disability including RA and

CVA height of chair 43 cm and

barefoot21

734

CVA=48

No CVA=

636

OA=283

No OA=

401

Significant age related difference in performance were found

with older women performing longer than older men

Median (IQR) sit to stand test scores 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)

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)

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-

20.6)

Times for FRSTS by subject’s medical diagnosis (seconds)

OA No OA CVA No CVA

12.5(10.3-

15.9)

11.0(9.2-13.1) 12.1(10.6-14.7) 11.5(9.5-14.2)

Independently ambulatory, with

and without use of assistive

device, community dwelling

adults87 Ends with sit.

AGE

N

76

Group Mean

(sec)

SD 95% CI

60-69 1

5

6

Male

Female

Overall

8.4

12.7

12.0

--

1.8

2.4

-3.6—20.5

7.3—18.1

9.5—14.4

70-79 9

10

19

Male

Female

Overall

11.6

13.0

12.3

3.4

4.8

4.2

7.6—15.6

9.2—16.8

10.3—14.3

80-89 10

24

24

10

34

Male

Female

NoDevice

Device

Overall

16.7

17.2

16.0

19.8

17.1

4.5

5.5

4.9

4.9

5.2

12.9—20.5

14.8—19.7

13.7—18.2

16.3—23.3

15.3—18.9

90-101 2

15

7

10

17

Male

Female

NoDevice

Device

Overall

19.5

22.9

18.0

25.7

22.5

2.3

9.6

7.0

9.2

9.0

11.0—28.0

19.8—26.0

13.8—22.2

22.2—29.2

17.9—27.2


elderly,107 Ends with sit

362

age

range

74-98

N

Group Mean

(sec)

SD Rel. Risk

(95% CI)

282 Single

fallers

12 4.8 2.0

(1.3, 3.0)

80 Multiple

fallers

15 6.2

Community dwellers, with and

without known balance

dysfunction

48Ends with sit.

Controls

Age 41(11)

(n = 32)

With Balance

Dysfunction

Age 48(10)

(n = 47)

Older Controls

Age 73(5)

(n = 49)

Older Balance

Dysfunction

Age 75(7)

(n=46)

8.2(1.7) 15.3(7.6) 13.4(2.8) 16.4(4.4)

Healthy, community dwellers118

Ends with stand

189

AGE > 65 Non-fallers

(n = 132)

1x Fallers

(n = 38)

Multi-fallers

(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:

Reference N= Sample Description Reliability Statistic


Suzuki 20015 34 Community-dwelling females,

mean age 75(5); evaluated 2x in one session

ICC = 0.71

Hammaren 20054 6 Men ages 31-61 with Myotonia Congenita

(MC)

ICC = 0.87 rest

ICC = 0.94 warm-up

Segura-Orti 201161 37 Community dwelling individuals on

hemodialysis with adequate dialysis dose or

delivery (Kt/V greater or equal to 1.2) 1

tester. Mean age=24 (10.4). Testing occurred

twice over a one to two week interval, before

the second hemodialysis session of the week.

ICC=0.88

SEM=3.6

MDC90=8.4 sec

MDC95=10 sec

(calculated)

Interrater Reliability

Netz 199710 41 Volunteers, Mean Age 72 (6).

2 sessions, 2 raters each session

ICC = 0.88

Test/retest Reliability

Newcomer 19938 16 Persons with RA tested twice, 10 week

intervals; number of testers not specified

r = 0.88

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


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

chronic diseases8

147 10TSTS correlates with 50’ walk (0.66), LE MMT

(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

11men mean age 74(2.8) and 17 women

age 73.1( 5.7) years.129

28 No correlation between trunk flexion angle and knee

extensor (r= -.02) or trunk extensor muscle strength

(r=.02)

Community dwelling, healthy women

with a mean age of 72.2 +/- 6.4130

49 No correlation between max peak torque of knee

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)

Responsiveness/Sensitivity to Change Population Descriptor N= Reference and Intervention Responsive

Yes/No

Average Change post

intervention. Group

Differences significant?

Females with post-

menopausal &

idiopathic osteoporosis

50 1316 mos retest, weekly calls

Experimental Group=25

Self-management classes

1x/week x 5 weeks

Control Group = 25

Maintain sedentary lifestyle

Yes Pre-intervention time:

30.1(8.1)s; 5 wk:

22.5(6.1)s; 6 mos post-

intervention: 21.1(5.9)s.

Control group no

significant change

Men with Myotonia

Congenita

6 410TSTS tested at rest, after

warm-up, with & without

medication

Yes

Warming up effect 56%;

effect of medication 19%

Independent

ambulators, with self-

reported disability

30

Females >

65 years

33x/week x 16 weeks

Leg presses; knee extension

High velocity resistance =15

“as fast as possible”

Low velocity resistance

YES –with

training

NO—with

type of

Exercise

10 -13% improvement

after 16 weeks both groups

People with

Osteoarthritis (OA)

of the knee

36

71(79)yrs

67%

female

11Stationary cycling 3x/wk

x10 wks, speed variance

High intensity (n =19)

70% heart rate reserve

low-intensity (n=20)

40% heart rate reserve

Yes –with

training

NO—with

intensity

No differences between

groups

Pre-intervention time:

23.3 2(9.1)s

Post-intervention time:

19.11(6.62)s.

Identifying persons

with arthritis vs. other

chronic diseases

147

males

8No intervention Yes Arthritis: 31.0 (12.9)s

Control: 24.2 (10.1)s

Community dwelling

individuals with end

stage renal disease

(ESRD) on

hemodialysis. Mean age

42.8 (4.4); average time

on maintenance

hemodialysis 42 (19)

months. Used standard

44-cm straight-back

chair with no arm rests.

Ends with sit.

10 1252x /wk x12 weeks

supervised resistance training.

1x /wk x12 weeks

nonsupervised with theraband.

10 TSTS completed on 4

separate occasions over 12

weeks on nondialysis days.

The first 6 weeks were a

control period. Scores

compared with predicted

normal scores.

Yes- with

resistance

exercise

training

An improvement in time to

complete the 10 TSTS

(sec) baseline for the

control period=21(2) sec

compared to end of 12

week period=18(2) sec.

good

Individuals on dialysis

at least 3 months

Age Intervention group

56(15)

Non Intervention

group 53(17). Specify

protocol used by Csuka

and McCarty 2

111 132Exercise Intervention

n=111

Individualized exercise

program x8 weeks; followed

by in clinic cycling x8 weeks

NonIntervention group n=109

Yes Intervention group

Baseline 29.3(12.5)sec

Increased from 14% (37%)

of normal to 38% (37%) of

normal values *based on

predicted values.

NonIntervention group

Remained at 23%(66%) of

normal values

CHAIR STAND Tests


People with ESRD on

hemodialysis

Mean age 42.8(4.4);

average time on

maintenance

hemodialysis 41.6

moths. Plus –or- minus

19 months.

10 1252x/wk x12 weeks

supervised resistance-training

1x/wk x12 weeks

nonsupervised with theraband.

10 TSTS completed on 4

separate occasions over 12

weeks on nondialysis days.

The first 6 weeks were a

control period. Scores

compared with predicted

normal scores

Yes-with

resistance

exercise

training

Initial test 58% slower in

dialysis patients compared

with age-predicted normal

values.

At completion of 12 wks of

training the time was

36.8% slower compared to

age predicted normal

values

People with

osteoarthritis of the

knee

50

Age: 75

(5)

26% male

74 and 8 week follow up

Experimental group n=25

Education and supervised

exercise 1 day/week for 45

minutes x 4 week plus HEP

Control group n=25 diathermy

treatment 1 day /week x4

week

No Mean difference between

groups at 4 weeks: -.40 s

(95%CI -14.6 to 6.61) p>

.05

Mean difference between

groups at 8 weeks: -5.5 s

(95%CI

-11.3 to 0.03) p> .05

Community dwelling

adults on hemodialysis

25

18 males

7 females

125Supervised exercises done

3x/wk. Pre-post test design

Experimental Group = 17

PRE’s

Control Group = 8

Low level aerobic exercise

Yes

Delta score for treatment

group -5.4 ±10.6 sec. with

decrease time 22.2%

(p<.05). Low level aerobic

exercisers time decreased

6.4% (NS)

Persons 2-6 months s/p

TKA

Mean age=68±8.

35 51N=18 received functional

training alone

N=17 received functional

training and balance exercise

program

Both groups had 12 sessions

over 6 weeks

No Both groups had >20%

decrease in 5TSTS with

mean between group

change of -0.6 seconds at

6 month follow up.

Effect size= small (.035)

Community dwelling

individuals on

hemodialysis

comparing heart rate

(bpm); systolic and

diastolic blood

pressure (mmHg);

Rating of perceived

exertion.

Trial 1

N=38

Trial 2

N=37

61No intervention.

10TSTS tested in 1-2-

week intervals

Median HR

Yes Delta score trial 1=11(0-

43) trial 2=6 (-6 to 27)

p=.001

N=31 N=29 Median SBP No Delta score trial 1=2(-23 to

31); trial 2=2(-35 to

40)p=.682

N=31 N=29 Median DBP No Delta score trial 1=-2(-18

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

exertion (range)

No Trial 1=11(7-13)

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,

identifying differences by age10

252

55 men

197 women

Mean Times

Age 60 – 69: 19.4 (4.2) s

Age 70 –79: 20.1 (5.7)s

Age 80 –89: 26.3(11.1)s

Healthy adults (subjects screened

for systemic disease; multiple

regression for age, height,

weight, sex )2

139

77 males

62 females

Prediction Equations

Males : Time (s) = 4.9 + 0.19 x age

Females: Time(s) = 7.6 +0.17 x age

Subjects by Age

Group

10TSTS scores (seconds)

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

hemodialysis, recruited from 2

dialysis clinics.133

25

18 males

7 females

Mean time 10TSTS 22 sec

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

Reference N= Sample Description Reliability Statistic

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

35 THA

47 TKA

Community dwelling Australians

awaiting hip or knee replacements not

actively in a PT program and not having

surgery within 6 weeks.

Age 70.3 (9.8) Sex51 female (63.4%)

THR 35 (42.7 %)

BMI 31.1 (5.6); 2 trials 30 sec CST at

baseline, 7 weeks, and 15 weeks with

30-45 min rest between

CI(.95)

Baseline n=40

ICC0.97(o.94-0.98)

7-wk assessment

n=47

ICC=0.97(0.95-0.98)

15-wk assessment n=37

ICC=0.98(0.97-0.99)

Practice effect noted at

baseline trial 109 McCarthy, 2004

47 Communitydwellers age 65 (3)

30 sec STS 14(3) reps done on

the same day

R =.93 MDC(95) 2.19 stands

Interrater Reliability 136Gill, 2008 82

35 THA

47 TKA





CI(.95)

Baseline n=42

ICC=0.93(0.87-0.96)

7-wk assessment

CHAIR STAND Tests


Age 70.3 (9.8) Sex51 female (63.4%)

THR 35 (42.7 %)




n=28

ICC=0.98(0.95-0.99)

15-wk assessment n=29

ICC=0.98(0.96-0.99)

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

35 THA

47 TKA





Age 70.3 (9.8) Sex51 female (63.4%)

THR 35 (42.7 %)




MDC(90)=1.64 stands at

time one or a MDC (95)

is 1.96 stands. These

were done in all the

same session not a week

apart.

134Jones, 1999 76 Community dwelling elderly average

age 70.5 . Tested 2-5 days apart with

seat height 43.2 cm

.84 for men

.92 for women

total .89 MDC (95) = 3.11

stands

137Alfonso-Rosa,

18 2013Older adults with type 2 NIDDM

(1 week apart)

ICC > or = .92 MDC(95)

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

TKA and at time of hospital discharge

to assess relationship of knee swelling

to loss of knee-extension strength and

functional ability.49 Mean age=66±7

24 Knee swelling correlation with 30 second chair stand

test (r=.08), knee extension strength correlation with

30 second chair stand test (r=-.09).

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

height 43 cm 109

47 Low level of relative importance in explaining STS

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

1038

Correlation with LE strength in .3-.4, hip strength is

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 140

39 30 sec chair stand was 9.6(5.2) 4 weeks after TKA and

correlated to leg press power .74 and knee extension.4

Predictive Validity

Population N= Results

Individuals scheduled for TKA

Age 62.7±7.5. 70% women.141

82 Flexion strength of the surgical knee had the highest

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

{Gill 2012}142

82

PSFS .26 ; WOMAC Function -0.62

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

elderly143

48 fallers

48 non

fallers

Fallers defined by 2 or more

falls in past 6 months.

No difference between the 2 groups

7.9(2.5) fallers and 8.5(2.6) for the non-

fallers.

Elderly people144 135 <14.5 to predict falls Sensitivity 88%

Specificity 70% Responsiveness/Sensitivity to Change

Population N= Intervention Responsive

Yes/No

Av change after

intervention. Group

differences significant?

26 people with prehabilitation

28 people with usual care

before TKA Topp, 2009145

54 Prehabilitation prior to

planned TKA: resistance

training, flexibility and

step training 3x/wk

13.04(7.5) sessions.

Yes at 1

week prior

to TKA and

one month

s/p TKA

Significant difference

within the prehab group 1

week before, 1 and 3

months after TKA to

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

OA

Neves, 2011 42

26 Intervention group n=13,

resistance training 3x/week

for 12 weeks combined

with creatine

supplementation

Control group n=13,

resistance training 3x/week

for 12 weeks 42

Yes intervention pre 15.0

(1.4) post 18.1 (1.8)

p=0.006

control pre 15.0 (1.8)

post 15.2(1.2)

creatinine vs placebo

P=0.004

Subjects tested 1 week prior

to TKA and at hospital

discharge; mean age

66(7)Holm, 201049

24 Examination of

relationship of knee

swelling to loss of knee

extension strength and

functional ability

Yes Pre: 30 s chair stand test

10.4(2.8)

Post (POD 2) 5.4(3.0)

P =<.001

Subjects after THA, Gill

2012142

82

Examination of

relationship in STS in

subjects who use a gait aid

(AD) or no gait aid

Yes

Significance

(2-tailed) =

0.00

No AD 7.3(2.8)

Gait Aid 4.5(3.3)

Mean difference (95%

CI)=2.8(1.4-4.1)

Effect size(95% CI) =

0.64(0.32 to 0.95)

Men with fibromyalgia

participating in Tai Chi, age

52(9). Carbonell-Baeza 2011 146

6 men 60 minutes, 3x/week for

16 weeks

Adherence 80%

No Initial 9(2)

Post 10(2)

Detraining 10(2)

Persons with hip and knee

OA

Shou, 2012147

34 6 weeks of programming

using GLA:D in Denmark

Yes

P<.012

Initial 13.8(3)

After 3 months 15.1(3)

Participants using Nintendo in

Denmark. Jorgensen 2013 148

58 28 treatment x 10 weeks

30 no treatment

Yes

P<.01

Rx: 11.5(3.8) initial

13.3(3.2) trained

NoRx: 11.2(3.8)

12.1(3.0)

Women in Brazil, av age 63

Hallage, 2010 149

13 Step aerobics 3x/week for

30-60 min x12 weeks

Yes

F value 14,

p<0.05

Initial 13.8(3.4)

12 week 16.9 (3.3)

1 mo post 15.3 (3.4)

18% change after 12

weeks, 10% decrease 1

mo post training


age 64 in Japan. Okamoto,

2007 150

45

men

155

female

64 step tests yes Men increased 5.9 stands

vs controls 2.6

Women increased 4.5

over 0.1 controls

Community dwellers in

Hungary, av age 67(5)

Plachy 2012 151

42 15 Pilates

15 Aqua-fitness

12 control

yes Final: Pilates 24(3)

Aqua-fitness 21(4)

Control 19(6) 152Blair 2013 Cancer 10 Chair stand (stands/30

seconds)

yes Median (min,max) Initial

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

2.1+0.5 days post-op unilateral

24

20 females

Score Pre-op: 9.8 (3.4) p = .01

Score Post-op at discharge 6.3(2.8) p= .01

CHAIR STAND Tests


THA; age 69(6.1) height

166.9(7.9)cm

Mass 75.9(11.8)kg

BMI 27.2(3.7)153

Change in Mean -36% from surgery


average age 70.5134

190 age N Chair stands

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

Standards for lower body strength154

2140 Age Female Male

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)

ranked against United States (US)

norms

MacFarlane 2006 139

US mean data and percentiles taken

from Rikli and Jones 2001154

1038 Group HK US HK mean as

US %

Fe 60-64 12.3(4.2) 15 25

Fe 65-69 11.3(3.5) 14 25

Fe 70-74 10.1(3.8) 13 25

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


1. Rodosky MW, Andriacchi TP Andersson GB. The influence of chair height on lower limb mechanics during rising. J Orthop Res. 1989;7:266-71.

2. Csuka MMcCarty D. Simple method for measurement of lower extremity muscle strength. Am J Med. 1985;78:77-81.

3. Sayers S, Bean J Cuoco A. Changes in functional and disability after resistance training: does velocity matter? A pilot study. Am J Phys Med Rehabil. 2003;82:605-613.

4. Hammaren E, KW G Lindberg C. Quantification of mobility impairment and self-assessment of stiffness in patients with myotonia congenita by the physiotherapist. Neuromuscul Disord. 2005;15:610-617.

5. Suzuki T, Bean J Fielding R. Muscle power of the ankle flexors predicts functional performance in community-dwelling older women. JAGS. 2001;49:1161-1167.

6. Liikavainio T, Lyytinen T, Tyrvainen E, Sipila S Arokoski JP. Physical function and properties of quadriceps femoris muscle in men with knee osteoarthritis. Arch Phys Med Rehabil. 2008;89:2185-94.

7. Bezalel T, Carmeli E Katz-Leurer M. The effect of a group education programme on pain and function through knowledge acquisition and home-based exercise among patients with knee osteoarthritis: a parallel randomised single-blind clinical trial. Physiotherapy. 2010;96:137-43.

8. Newcomer K, Krug H Mahowald M. Validity and reliability of the timed-stands test for patients with rheumatoid arthritis and other chronic diseases. J Rheumatol. 1993;20:21-27.

9. Brown M, Sinacore D Host H. The relationship of strength to function in the older adult. J Gerontology. 1995;50A:55-59.

10. Netz YArgov E. Assessment of functional fitness among independent older adults: A preliminary report. Percept Mot Skills. 1997;84:1059-1074.

11. Mangione K, McCully K, Gloviak A, et al. The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis. J Gerontol. 1999;54:M184-190.

12. VanSwearingen JBrach J. Making geriatric assessment work: Selecting useful measures. Phys Ther. 2001;81, Number 6:1233-1252.

13. Manini T, Baldwin S, Ordway N, RJ P-S LL P-S. Knee extensor isometric unsteadiness does not predict functional limitation in older adults. Am J Phys Med Rehabil. 2005;84:112-121.

14. Unver B, Karatosun V Bakirhan S. Ability to rise independently from a chair during 6-month follow-up after unilateral and bilateral total knee replacement. J Rehabil Med. 2005;37:385-387.

15. Bohannon RW, Brennan P, Pescatello L, et al. Relationships between perceived limitations in stair climbing and lower limb strength, body mass index, and self-reported stair climbing activity. Top Geriatr Rehabil. 2005;21:350-355.

16. Sled E, Khoja L, Deluzio K, Olney mS Gulham E. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: A clinical trial. Phys Ther. 2010;90:895-904.

17. Hughes SL, Seymour RB, Campbell R, et al. Impact of the fit and strong intervention on older adults with osteoarthritis. Gerontologist. 2004;44:217-28.

18. Beninato M, Portney LG Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89:816-25.

19. Ng S. Balance ability, not muscle strength and exercise endurance, determines the performance of hemiparetic subjects on the timed-sit-to-stand test. Am J Phys Med Rehabil. 2010;89:497-504.

CHAIR STAND Tests


20. Mong Y, Teo TW Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13.

21. Butler AA, Menant JC, Tiedemann AC Lord SR. Age and gender differences in seven tests of functional mobility. J Neuroeng Rehabil. 2009;6:31.

22. Nevitt M, Cummings S, Kidd S Black D. Risk factors for recurrent nonsyncopal falls. JAMA. 1989;261:2663-2668.

23. Lomaglio MEng J. Muscle strength and weight-bearing symmetry related to sit-to-stand performance in individuals with stroke. Gait Posture. 2005;22:126-131.

24. Shum G, Crosbie J Lee R. Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit. Spine. 2005;30:1998-2004.

25. Tully E, Fotoohabadi M Galea M. Sagittal spine and lower limb movement during sit-to-stand in healthy young subjects. Gait Posture. 2005;22:338-345.

26. Berg K, Wood-Dauphinee S, Williams J Gayton D. Measuring balance in elderly: Preliminary development of an instrument. Physiother Canada. 1989;41:304-311.

27. Carmeli E, Bar-Chad S Lotan M. Five clinical tests to assess balance following ball exercises and treadmill training in adult persons with intellectual disability. J Gerontol. 2003;58A:M767-M772.

28. Barnett A, Smith B, Lord S, Williams M Baumand A. Community-based group exericse improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Ageing. 2003;32:407-414.

29. Majewski M, Bischoff-Ferrari H, Gruneberg C, Dick W Allum J. Improvements in balance after total hip replacement. J Bone Joint Surg [Br]. 2005;87-B:1337-1343.

30. Brown K, Whitney S, Marchetti G, Wrisley D Furman J. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil. 2006;87:76-81.

31. Campbell A, Borrie M Spears G. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989;44:M112-117.

32. Fleming B, Wilson D Pendergast D. A portable, easily performed muscle power test and its association with falls by elderly persons. Arch Phys Med Rehabil. 1991;72:886-889.

33. Kim HJ, Chun HJ, Han CD, et al. The risk assessment of a fall in patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 2011;36:E588-92.

34. Duncan RP, Leddy AL Earhart GM. Five times sit-to-stand test performance in Parkinson's disease. Arch Phys Med Rehabil. 2011;92:1431-6.

35. Bohannon R, Barreca S, Shove M, et al. Documentation of daily sit-to-stands performed by community-dwelling adults. Physiother Theory Pract. 2008;24:437-42.

36. Eriksrud OBohannon RW. Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. Phys Ther. 2003;83:544-51.

37. Bohannon RW. Body weight-normalized knee extension strength explains sit-to-stand independence: a validation study. J Strength Cond Res. 2009;23:309-11.

38. Andersson EI, Lin CC Smeets RJ. Performance tests in people with chronic low back pain: responsiveness and minimal clinically important change. Spine (Phila Pa 1976). 2010;35:E1559-63.

39. Riddle DLStratford PW. Impact of pain reported during isometric quadriceps muscle strength testing in people with knee pain: data from the osteoarthritis initiative. Phys Ther. 2011;91:1478-89.

40. Christiansen CLStevens-Lapsley JE. Weight-bearing asymmetry in relation to measures of impairment and functional mobility for people with knee osteoarthritis. Arch Phys Med Rehabil. 2010;91:1524-8.

CHAIR STAND Tests


41. French HP, Fitzpatrick M FitzGerald O. Responsiveness of physical function outcomes following physiotherapy intervention for osteoarthritis of the knee: an outcome comparison study. Physiotherapy. 2011;97:302-8.

42. Neves M, Jr., Gualano B, Roschel H, et al. Beneficial effect of creatine supplementation in knee osteoarthritis. Med Sci Sports Exerc. 2011;43:1538-43.

43. Lin YC, Davey RC Cochrane T. Tests for physical function of the elderly with knee and hip osteoarthritis. Scand J Med Sci Sports. 2001;11:280-6.

44. Ramsey VK, Miszko TA Horvat M. Muscle activation and force production in Parkinson's patients during sit to stand transfers. Clin Biomech (Bristol, Avon). 2004;19:377-84.

45. Mak MKHui-Chan CW. Cued task-specific training is better than exercise in improving sit-to-stand in patients with Parkinson's disease: A randomized controlled trial. Mov Disord. 2008;23:501-9.

46. Matthews M, Lucas A, Boland R, et al. Use of a questionanaire to screen for fraility in the elderly: an exploratory study. Aging Clin Exp Res. 2004;16:34-40.

47. Tinetti M, Williams T Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med. 1986;80:429-434.

48. Whitney S, Wrisley D, Marchetti G, et al. Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the five-times-sit-to-stand test. Phys Ther. 2005;85:1034-1045.

49. Holm B, Kristensen MT, Bencke J, et al. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty. Arch Phys Med Rehabil. 2010;91:1770-6.

50. Christiansen CL, Bade MJ, Judd DL Stevens-Lapsley JE. Weight-bearing asymmetry during sit-stand transitions related to impairment and functional mobility after total knee arthroplasty. Arch Phys Med Rehabil. 2011;92:1624-9.

51. Piva S, Gil A, Almeida G, et al. A balance exercise program appears to improve function for patients with total knee arthroplasty: A randomized clinical trial. Phys Ther. 2010;90:880-894.

52. Judge J, Schechtman K Cress E. The relationship between physical performance measures and independence in instrumental activities of daily living. J Am Geriatr Soc. 1996;44:1332-1341.

53. Sterky EStegmayr B. Elderly patients on haemodialysis have 50% less functional capacity than gender- and age-matched healthy subjects. Scand J Urol Nephrol. 2005;39:423-430.

54. Kolbe-Alexander TL, Lambert EV Charlton KE. Effectiveness of a community basedlow intensity exercise program for older adults. J Nutr Health Aging. 2006;10:21-29.

55. Bohannon R. Alternatives for measuring knee extension strength of the elderly at home. Clin Rehabil. 1998;12:434-440.

56. Hruda K, Hicks A McCartney N. Training for muscle power in older adults: effects on functional abilities. Can J Appl Physiol. 2003;28(2):178-189.

57. Thapa P, Gideon P, Fought R, Kromicki M Ray W. Comparison of clinical and biomechanical measures of balance and mobility in elderly nursing home residents. JAGS. 1994;42:493-500.

58. Hakim R, DiCicco J, Burke J, Hoy T Roberts E. Differences in balance related measures among older adults participating in Tai Chi, structured exercise, or no exercise. J Geriatr Phys Ther. 2004;27:11-15.

59. Rikli RJones C. Functional fitness normative scores for community-residing older adults, ages 60-94. J Aging Phys Activity. 1999;7:162-181.

60. Ozalevli S, Ozden A, Itil O Akkoclu A. Comparison of the sit-to-stand test with 6 min walk test in patients with chronic obstructive pulmonary disease. Respir Med. 2007;101:286-293.

61. Segura-Orti EMartinez-Olmos FJ. Test-retest reliability and minimal detectable change scores for sit-to-stand-to-sit tests, the six-minute walk test, the one-leg heel-rise test, and handgrip strength in people undergoing hemodialysis. Phys Ther. 2011;91:1244-52.

CHAIR STAND Tests


62. Canning C, Shepherd R, Carr J, et al. A randomized controlled trial of the effects of intensive sit-to-stand training after recent traumatic brain injury on sit-to-stand performance. Clin Rehabil. 2003;17:355-362.

63. Brunt D, Greenberg B, Wankadia S Trimble M. The effect of foot placmeent on sit to stand in healthy young subjects and patients with hemiplegia. Arch Phys Med Rehabil. 2002;83:924-929.

64. Jette A, Jette D, Ng J, et al. Are performance-based measures sufficiently reliable for use in multicenter trials? J Gerontol Med Sci. 1999;54A:M3-M6.

65. Rainville J, Jouve C, Finno M Limke J. Comparison of four tests of quadriceps strength in L3 or L4 radiculopathies. Spine. 2003;28:2466-2471.

66. Yamada TDemura S. Instruction in reliability and magnitude of evaluation parameters at each phase of a sit-to-stand movement. Percept Mot Skills. 2005;101:695-706.

67. Kluding PPinto G. Effect of ankle joint mobilization on ankle mobility and sit-to-stand in subjects with hemiplegia. J Neuro Phys Ther. 2004;28:72-83.

68. Perry S, Marchetti G, Wagner S Wilton W. Predicting caregiver assistance required for sit-to-stand following rehabilitation for acute stroke. J Neurol Phys Ther. 2006;30:2-10.

69. Dubost V, Beauchet O, Manckoundia P, Herrmann F Mourey F. Decreased trunk angular displacement during sitting down: an early feature of aging. Phys Ther. 2005;85:404-412.

70. Gill T, Williams C Tinett M. Assessing risk for the onset of functional dependence among old adults: the role of physical performance. J Am Geriatr Soc. 1995;43:603-609.

71. . 72. Taaffe D, Duret C, Wheeler S Marcus R. Once-weekly resistance exercise improves muscle

strength and neuromuscular performance in older adults. JAGS. 1999;47:1208-1214. 73. Akram SBMcIlroy WE. Challenging horizontal movement of the body during sit-to-stand: impact

on stability in the young and elderly. J Mot Behav. 2011;43:147-53. 74. Manckoundia P, Mourey F, Pfitzenmeyer P Papaxanthis C. Comparison of motor strategies in sit-

to-stand and back-to-sit motions between healthy and alzheimer's disease elderly subjects. Neuroscience. 2006;137:385-392.

75. Binder E, Brown M, Craft S, Schechtman K Birge S. Effects of a group exercise program on risk factors for falls in frail older adults. J Aging Phys Activity. 1994;94:25-37.

76. Vissers MM, Bussmann JB, de Groot IB, Verhaar JA Reijman M. Walking and chair rising performed in the daily life situation before and after total hip arthroplasty. Osteoarthritis Cartilage. 2011;19:1102-7.

77. Mak MK, Yang F Pai YC. Limb collapse, rather than instability, causes failure in sit-to-stand performance among patients with parkinson disease. Phys Ther. 2011;91:381-91.

78. Cahill BM, Carr JH Adams R. Inter-segmental co-ordination in sit-to-stand: an age cross-sectional study. Physiother Res Int. 1999;4:12-27.

79. Park ES, Park CI, Lee HJ, et al. The characteristics of sit-to-stand transfer in young children with spastic cerebral palsy based on kinematic and kinetic data. Gait Posture. 2003;17:43-9.

80. Hennington G, Johnson J, Penrose J, et al. Effect of bench height on sit-to-stand in children without disabilities and children with cerebral palsy. Arch Phys Med Rehabil. 2004;85:70-6.

81. Liao HF, Gan SM, Lin KH Lin JJ. Effects of weight resistance on the temporal parameters and electromyography of sit-to-stand movements in children with and without cerebral palsy. Am J Phys Med Rehabil. 2010;89:99-106.

82. dos Santos AN, Pavao SL Rocha NA. Sit-to-stand movement in children with cerebral palsy: a critical review. Res Dev Disabil. 2011;32:2243-52.

CHAIR STAND Tests


83. Guralnik J, Simonsick E, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M85-M94.

84. Seeman T, Charpentier P, Berkman L, et al. Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. J Gerontol Med Sci. 1994;49:M97-M108.

85. Zabel R. Special feature: Reliability of selected performance measures in older adults residing in long-term care. Top Geriatr Rehabil. 2000;15:61-67.

86. Visser M, Pluijm S, Stel V, Bosscher R Deeg D. Physical activity as a determinant of change in mobility performance: The longitudinal aging study Amsterdam. JAGS. 2002;50:1774-1781.

87. Lusardi M, Pellechia G Schulman M. Functional performance in community living older adults. J Geriatr Phys Ther. 2003;26:14-22.

88. Lindsey C, Brownbill R, Bohannon R Ilich J. Association of physical performance measures with bone mineral density in postmenopausal women. Arch Phys Med Rehabil. 2005;86:1102-1107.

89. Peel C, Baker P, Roth D, et al. Assessing mobility in older adults: the UAB study of aging life-space assessment. Phys Ther. 2005;85(10):1008-1019.

90. Li F, Fisher KJ Harmer P. Improving physical function and blood pressure in older adults through cobblestone mat walking: a randomized trial. J Am Geriatr Soc. 2005;vol. 53:p. 1305-1312.

91. Schaubert KBohannon R. Reliability and validity of three strength measures obtained from community-dwelling elderly persons. J Strength Cond Res. 2005;19(3):717-720.

92. Belgen B, Beninato M, Sullivan P Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87:554-561.

93. Hoeymans N, Wouters E, Feskens E, van den Bos G Kromhout D. Reproducibility of performance-based and self-reported measures of functional status. J Gerontol. 1997;52A:M363-M368.

94. Ostchega Y, Harris T, Hirsch R, et al. Reliability and prevalence of physical performance examination assessing mobility and balance in older persons in the US: Data from the third national health and nutrition examination survey. JAGS. 2000;48:1136-1141.

95. Taaffe D, Simonsick E, Visser M, et al. Lower extremity physical performance and hip bone mineral density in elderly black and white men and women: cross-sectional associations in the health ABC study. Gerontology. 2003;58A:934-942.

96. Melzer D, Dik MG, van Kamp GJ, Jonker C Deeg DJ. The apolipoprotein E e4 polymorphism is strongly associated with poor mobility performance test results but ot self-reported limitation in older people. J Gerontol. 2005;60A(10):p. 1319-1323.

97. Shubert T, Schrodt LA, Mercer VS, Busby-Whitehead J Giuliani CA. Are scores on balance screening tests associated with mobility in older adults? J Geriatr Phys Ther. 2006;29:33-39.

98. LeBrasseur NK, Sayers S, Ouellette MM Fielding RA. Muscle Impairments and behavioral factors mediate functional limitations and disabliltiy following stroke. Phys Ther. 2006;86:1342-1350.

99. Lord S, SM M, Chapman K, Munro B Tidemann A. Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci. 2002;57A:M539-543.

100. Bernardi M, Rosponi A, Castellano V, et al. Determinants of sit-to-stand capability in the motor impaired elderly. J Electromyography Kines. 2004;14:401-410.

101. Hakkinen A, Kautiainen H, Hannonen P, et al. Muscle strength, pain, and disease activity explain individual subdimensions of the Health Assessment Questionaire Disability index, especailly in women with rheumatoid arthritis Ann Rheum Dis. 2006;65:30-34.

CHAIR STAND Tests


102. Mizner RSnyder-Mackler L. Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res. 2005;23:1083-1090.

103. Morita M, Takamura N, Kusano Y, et al. Relationship between falls and physical performance measures among community-dwelling elderly women in Japan. Aging Clin Exp Res. 2005;17:211-216.

104. Johansen KL, Painter P, Kent-Braun JA, et al. Validation of questionnaires to estimate physical activity and functioning in end-stage renal disease. Kidney Int. 2001;59:1121-7.

105. Johansen KL, Painter PL, Sakkas GK, et al. Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: A randomized, controlled trial. J Am Soc Nephrol. 2006;17:2307-14.

106. Koufaki P, Mercer TH Naish PF. Effects of exercise training on aerobic and functional capacity of end-stage renal disease patients. Clin Physiol Funct Imaging. 2002;22:115-24.

107. Tiedemann A, Shimada H, Sherrington C, Murray S Lord S. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing. 2008;37:430-5.

108. Blake CO'Meara Y. Subjective and objective physical limitiations in high-functioning renal dialysis patients. Nephrol Dial Transplant. 2004;19:3124-3129.

109. McCarthy EK, Horvat MA, Holtsberg PA Wisenbaker JM. Repeated chair stands as a measure of lower limb strength in sexagenarian women. J Gerontol A Biol Sci Med Sci. 2004;59:1207-12.

110. Sherrington CLord S. Reliability of simple protable tests of physical performance in older people after hip fracture. Clin Rehabil. 2005;19:496-504.

111. Bohannon RW, Shove ME, Barreca SR Masters LM. Five-repetition sit-to-stand test performance by community-dwelling adults : A preliminary investigation of times , determinants , and relationship with self-reported physical performance. Iso and Ex Sci. 2007;15:77-81.

112. Bohannon RW. Test-retest reliability of the five-repetition sit-to-stand test: a systematic review of the literature involving adults. J Strength Cond Res. 2011;25:3205-7.

113. Schaubert KLBohannon RW. Reliability of Sit to Stand tests over dispersed sessions. Iso and Ex Sci. 2005;13:119-122.

114. Bohannon R, Brennan P, Pescatello L, et al. Adiposity of elderly women and its relationship with self-reported and observed physical performance. J Geriatr Phys Ther. 2005;28:10-13.

115. Menz H, Morris M Lord S. Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol. 2005;60A:1546-1552.

116. O'Donnell A, Travison T, Harris S, Tenover L McKinlay J. Testosterone, Dehydroenpiandrosterone, and physical performance in older men: results from the massachusetts male aging study. J Clin Endocrinol Metab. 2006;91:425-431.

117. Guralnik J, Ferrucci L, Simonsick E, Salive M Wallace R. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New Engl J Med. 1995;332:556-561.

118. Buatois S, Gueguen R, Gauchard G, Benetos A Perrin P. Posturograpgy and risk of recurrent falls in healthy non-institutionalized persons aged over 65 Gerontology. 2006;52:345-352.

119. Delbaere K, Van den Noortgate N, Bourgois J, et al. The physical performance test as a predictor of frequent fallers: a prospective community-based cohort study. Clin Rehabil. 2006;20:83-90.

120. Buatois S, Perret-Guillaume C, Gueguen R, et al. A simple clinical scale to stratify risk of recurrent falls in community-dwelling adults aged 65 years and older. Phys Ther. 2010;90:550-60.

121. Rosano C, Kuller L, Chung H, et al. Subclincal brain magnetic resonance imaging abnormailites predict physical functional decline in high-functional older adults JAGS. 2005;53:649-654.

122. Lord S, Tiedemann A, Chapman K, et al. The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial. JAGS. 2005;53:1296-1304.

CHAIR STAND Tests


123. Hoogeboom TJ, Dronkers JJ, van den Ende CH, Oosting E van Meeteren NL. Preoperative therapeutic exercise in frail elderly scheduled for total hip replacement: a randomized pilot trial. Clin Rehabil. 2010;24:901-10.

124. de Groot IB, Bussmann HJ, Stam HJ Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res. 2008;466:2201-8.

125. Headley S, Germain M, Mailloux P, et al. Resistance training improves strength and functional measures in patients with end-stage renal disease. Am J Kidney Dis. 2002;40:355-64.

126. Jordre B, Schweinle W, Beacom K, Graphenteen V Ladwig A. The five times sit to stand test in senior athletes. J Geriatr Phys Ther. 2013;36:47-50.

127. Bohannon RW. Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Percept Mot Skills. 2006;103:215-22.

128. Wicherts I, Van Schoor N, Boeke J, et al. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab. 2007;92:2058-2065.

129. Lundin TM, Jahnigen D Grabiner MD. Maximum trunk flexion angle during the Sit to Stand is not determined by knee or trunk-hip extension strength in healthy older adults. J of App bio. 1999;15:233-241.

130. Netz Y, Ayalon M, Dunsky A Alexander N. 'The multiple-sit-to-stand' field test for older adults: what does it measure? Gerontology. 2004;50:121-6.

131. Alp A, Kanat E Yurtkuran M. Efficacy of self-management program for osteoporotic subjects Am J Phys Med Rehabil. 2007;86:633-639.

132. Painter P, Carlson L, Carey S, Paul SM Myll J. Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients. Am J Kidney Dis. 2000;35:482-92.

133. Segura-Orti E, Kouidi E Lison JF. Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clin Nephrol. 2009;71:527-37.

134. Jones C, Rikli R Beam W. A 30-s chair-stand test as a measure of lower body stength in community-residing older adults. Res Q Exerc Sport. 1999;70:113-119.

135. Kuo YL. The influence of chair seat height on the performance of community-dwelling older adults' 30-second chair stand test. Aging Clin Exp Res. 2013;25:305-9.

136. Gill SMcBurney H. Reliability of performance-based measures in people awaiting joint replacement surgery of the hip or knee. Physiother Res Int. 2008;13:141-52.

137. Alfonso-Rosa RM, Del Pozo-Cruz B, Del Pozo-Cruz J, Sanudo B Rogers ME. Test-Retest Reliability and Minimal Detectable Change Scores for Fitness Assessment in Older Adults with Type 2 Diabetes. Rehabil Nurs. 2013.

138. Smith WN, Del Rossi G, Adams JB, et al. Simple equations to predict concentric lower-body muscle power in older adults using the 30-second chair-rise test: a pilot study. Clin Interv Aging. 2010;5:173-80.

139. Macfarlane DJ, Chou KL, Cheng YH Chi I. Validity and normative data for thirty-second chair stand test in elderly community-dwelling Hong Kong Chinese. Am J Hum Biol. 2006;18:418-21.

140. Aalund PK, Larsen K, Hansen TB Bandholm T. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty: which measure is most closely associated with performance-based and self-reported function? Arch Phys Med Rehabil. 2013;94:384-90.

141. Brown K, Kachelman J, Topp R, et al. Predictors of functional task performance among patients scheduled for total knee arthroplasty. J Strength Cond Res. 2009;23:436-43.

142. Gill SD, de Morton NA Mc Burney H. An investigation of the validity of six measures of physical function in people awaiting joint replacement surgery of the hip or knee. Clin Rehabil. 2012;26:945-51.

CHAIR STAND Tests


143. Almeida C, Castro C, Pedreira PG, Heymann RE Szejnfeld VL. Percentage height of center of mass is assocaited with the risk of falls among elderly women: A case-control study. Gait Posture. 2011;34:208-212.

144. Kawabata YHiura M. The CS-30 test is a useful assessment tool for predicting falls in commuity-dwelling elderly people. Rigakuryoho Kagaku. 2008;23:441-445.

145. Topp R, Swank AM, Quesada PM, Nyland J Malkani A. The effect of prehabilitation exercise on strength and functioning after total knee arthroplasty. PM R. 2009;1:729-35.

146. Carbonell-Baeza A, Romero A, Aparicio VA, et al. Preliminary findings of a 4-month Tai Chi intervention on tenderness, functional capacity, symptomatology, and quality of life in men with fibromyalgia. Am J Mens Health. 2011;5:421-9.

147. Skou ST, Odgaard A, Rasmussen JO Roos EM. Group education and exercise is feasible in knee and hip osteoarthritis. Dan Med J. 2012;59:A4554.

148. Jorgensen MG, Laessoe U, Hendriksen C, Nielsen OB Aagaard P. Efficacy of nintendo wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2013;68:845-52.

149. Hallage T, Krause MP, Haile L, et al. The effects of 12 weeks of step aerobics training on functional fitness of elderly women. J Strength Cond Res. 2010;24:2261-6.

150. Okamoto N, Nakatani T, Morita N, Saeki K Kurumatani N. Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults. Int J Sports Med. 2007;28:1040-5.

151. Plachy JK, Kovach MV Bognar J. Improving flexibility and endurance of elderly women through a six-month training programme. Human Movement. 2012;13:22-27.

152. Blair CK, Madan-Swain A, Locher JL, et al. Harvest for health gardening intervention feasibility study in cancer survivors. Acta Oncol. 2013.

153. Holm B, Kristensen MT, Husted H, Kehlet H Bandholm T. Thigh and knee circumference, knee-extension strength, and functional performance after fast-track total hip arthroplasty. PM R. 2011;3:117-24; quiz 124.

154. Rikli REJones CJ. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist. 2013;53:255-67.

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