Get up from the chair, sit down again and repeat the movement five times, without using your hands. A daily gesture which, measured with a stopwatch, can provide useful information on the mobility and balance of elderly people. To perform it you need legs capable of lifting the body, stability during the change of position and control when returning to the seat.
It is the Five Times Sit-to-Stand Test, also known as the chair test. The test is also used by the World Health Organization to identify possible mobility difficulties in the elderly. A study published on Scientific Reports examined how well this simple exercise measures changes in physical abilities over time, also finding a link with improvements in the quality of life reported by participants.
What do five get ups from the chair tell us
When we stand up, the leg muscles must produce the force necessary to lift the body. They also have to do it quite quickly, as we shift our weight forward and try to maintain balance. Sitting down requires another type of control: you need to slow down the descent, bend your knees and accompany your body until you sit.
They are movements that we repeat dozens of times without thinking too much about them. In the morning, when we get out of bed. After lunch, when we leave the table. Or when we have to get up from the toilet or from a particularly low chair.
As we age, however, these gestures can become more tiring. There are those who begin to push themselves on their thighs to get up, those who always look for an armrest to hold on to and those who take a few more seconds before being able to stand completely. The chair test allows you to observe these very skills working together: leg strength, speed of movement and balance. All important to continue carrying out daily activities independently.
How to do the chair test
The process is simple. According to the protocol described by the Shirley Ryan AbilityLab, we start sitting on a stable chair, with our feet resting on the floor and our arms crossed on our chest. At the signal you must stand up completely, sit down again and repeat the movement five consecutive times, as quickly as possible and without using your hands. The stopwatch starts at the start and stops when you sit down for the fifth time.
For a standardized assessment, a chair with a backrest is used, generally about 43-45 centimeters high. Height matters: getting up from a high stool requires a different effort than leaving a low, soft chair. Also for this reason, if you want to repeat the test after a few weeks to check for any improvements, you must use the same chair and the same execution methods.
The test should be carried out in safe conditions, preferably under the supervision of a professional. Anyone who has balance problems, pain or difficulty standing up without support should not attempt to complete it alone.
When is it time to talk to your doctor about it? WHO guidelines
The chair test also appears in the World Health Organization’s indications for the care of elderly people, within the ICOPE program, dedicated to the evaluation of physical and mental abilities and the maintenance of autonomy.
The WHO uses the five lifts as a first check of mobility and indicates a precise reference: if an elderly person cannot complete the five repetitions without using their arms, or it takes more than 14 seconds, a more in-depth evaluation is recommended. This means that if you always need to push yourself with your hands to get up from the chair, or if the movement has become particularly slow and tiring, it may be useful to talk to your doctor.
Such a difficulty can depend on various factors, such as a reduction in muscle strength, joint problems or balance changes. Then there is a detail to consider: if a person who until recently got up normally begins to need to lean on furniture, or struggles to get up from the sofa, the change deserves attention, even without a stopwatch.
The study on 96 elderly people
Researchers from Brunel University of London and Oxford Brookes University involved 96 elderly people, with an average age of 71 years. 80% were women and all lived in their own homes.
In addition to the chair test, participants performed other simple tests: balancing on one leg, standing up and walking for a short distance, walking the greatest distance possible in two minutes and measuring hand strength. After an initial evaluation and some advice on physical activity, the researchers repeated the tests approximately 12 weeks later.
The results showed that those who completed the chair test faster also tended to perform better in the mobility and balance tests. Furthermore, those who improved in the five lifts also tended to make progress in walking. The test can therefore help to understand how strength and ability to move change over time, two fundamental aspects for maintaining one’s autonomy.
Because a second and a half can make the difference
The most interesting discovery concerns time. In the study, a reduction of 1.48 seconds was the value that allowed us to better distinguish those who reported an improvement in their quality of life. Let’s take an example: it takes a person 12 seconds to stand up and sit down five times. After a few weeks he can complete the test in about 10 and a half seconds. He gained just a second and a half, yet a similar difference, in the group studied, was also associated with a more positive evaluation of one’s life, collected through a questionnaire.
This doesn’t mean that getting faster automatically guarantees you’ll get better. The research involved a relatively small group, mainly composed of self-employed elderly women, and the result will need to be confirmed by other studies. However, a useful indication remains: even small improvements can help follow the progress of mobility. For an elderly person, being able to get up from the armchair with less effort or without asking for a hand can make a big difference in everyday life.
