Skip to main content
  

Rehab Measures: 30 second sit to stand test

Link to instrument

 

Title of Assessment

30 second sit to stand test 

Acronym

30-s chair stand; 30CST

Instrument Reviewer(s)

Alicia Esposito, PT, DPT, NCS & the PD Edge Task Force of the Neurology Section of the APTA; Updated by Diane Wrisley, PT, PhD, NCS and Elizabeth Dannenbaum MScPT, for the Vestibular EDGE taskforce of the Neurology section of the APTA

Summary Date

5/20/2013 

Purpose

A measurement to assess functional lower extremity strength in older adults.  It is part of the Fullerton Functional Fitness Test Battery.  This test was developed to overcome the floor effect of the 5 or 10 repetition sit to stand test in older adults. 

Description

The 30 second chair test is administered using a folding chair without arms, with seat height of 17 inches (43.2 cm). The chair, with rubber tips on the legs, is placed against a wall to prevent it from moving.

The participant is seated in the middle of the chair, back straight; feet approximately shoulder width apart and placed on the floor at an angle slightly back from the knees, with one foot slightly in front of the other to help maintain balance. Arms are crossed at the wrists and held against the chest.

Demonstrate the task both slowly and quickly. 

Have the patient practice a repetition or 2 before completing the test.  

If a patient must use their arms to complete the test they are scored 0. 

At the signal “go,” the participant rises to a full stand (body erect and straight) and then returns back to the initial seated position.

The participant is encouraged to complete as many full stands as possible within 30 seconds. The participant is instructed to fully sit between each stand.

While monitoring the participant’s performance to ensure proper form, the tester silently counts the completion of each correct stand.  The score is the total number of stands within 30 seconds (more than halfway up at the end of 30 seconds counts as a full stand). Incorrectly executed stands are not counted.

The 30 second chair stand involves recording the number of stands a person can complete in 30 seconds rather then the amount of time it takes to complete a pre-determined number of repetitions. That way, it is possible to assess a wide variety of ability levels with scores ranging from 0 for those who can not complete 1 stand to greater then 20 for more fit individuals.

Area of Assessment

Balance Non-Vestibular; Functional Mobility; Strength 

Body Part

Lower Extremity 

ICF Domain

Body Function; Activity 

Domain

Motor 

Assessment Type

Performance Measure 

Length of Test

05 Minutes or Less 

Time to Administer

30 seconds

Number of Items

Equipment Required

43.2 cm (17in) folding chair with back, stopwatch, and wall space

Training Required

None, The Senior Fitness Test Manual provides detailed instructions and normative values

Type of training required

No Training; Reading an Article/Manual 

Cost

Free 

Actual Cost

$0

Age Range

Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Arthritis; Geriatrics; Movement Disorders 

Populations Tested

Community Dwelling Elderly
(Jones et al, 1999; n = 76 (34 men and 42 women; mean age: 70.5 (5.5); eligible participants were over the age of 60 years, community residing, functionally independent, ambulatory and did not suffer lower extremity pain, unstable cardiovascular disease or any other medical condition that would be contraindicated for maximal strength testing of the lower extremity according to the American College of Sports Medicine guidelines)
 
Community Dwelling Sexagenarian Women
(McCarthy et al, 2004; n = 47; mean age = 64.51(3.08) years; height = 163.03(4.34) cm; weight = 67.73(10.08) kg)
 
Hip OA
(Wright et al, 2011; n = 70 with 65 completed 9 week follow up; participants were able to walk 10 m without assistive device; age: 66.5(9.4) range 41-85 years old; patients underwent a 9 session physiotherapy program and were randomly allocated to receive either a) manual therapy, b) exercise therapy, or c) both manual therapy and exercise therapy)
 
Hong Kong Chinese Community Dwelling Elderly
(Macfarlane et al, 2006; n = 1038, females = 766 (mean age = 73.6(7.1) years, mean height = 150.6(6.1) cm, weight = 55.6(11.2) kg); males = 272 (mean age = 73.6(6.7) years, height = 162.7(6.4) cm, weight = 63.1(11.1) kg); inclusion criteria including elderly persons aged at least 60 years and residing in the community
 
Individuals with OA awaiting joint replacement of the hip or knee
(Gill et al, 2012; n = 82; mean age: 70.3(9.8) years; 51(63%) female; 35(43%) awaiting total hip arthroplasty)
 
The test has been validated with older adults at various physical activity levels and physical independence levels

Standard Error of Measurement (SEM)

Hip OA

(Wright et al, 2011)

  • SEM = 1.27

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Hip OA

(Wright et al, 2011)

External criterion standard: Participants graded their perceived level of change on the Global Rating of Change Score (GCRS) which is a 15 point scale from -7 to +7. A score of at least +5 is considered major improvement and a score of +4 or less is considered an unimportant change

Measure/Method

MCII (Minimally Clinical Important Improvement)

30 s chair stand

Method 1 (the sensitivity and specificity based approach)

2.0

Within patients score change approach

2.6

Between patients score change approach

2.1 (p = 0.06)

Cut-Off Scores

Moderately Active Older Adults:

Normative data published in Rikli and Jones 1999b

 
(Rikli and Jones, 2013; n = 2140 moderately active older adults)
 
Criterion fitness standards to maintain physical independence
Age
60-64
65-69
70-74
75-79
80-84
85-89
90-94
Women
15
15
14
13
12
11
9
Men
17
16
15
14
13
11
9

Normative Data

Community Dwelling Elderly

(Jones et al, 1999)

Characteristics

Men (n = 34)

Women (n = 42)

 

Mean

Standard Deviation

Mean

Standard Deviation

Age (years)

72.6

6.6

69.1

5.1

Height (cm)

177

7.4

163.1

5.8

Weight (kg)

83.1

16.6

71.2

14.3

Chair stand

13.7

3.2

12.7

3.6

Leg press (resistance in pounds/body weight in pounds)

3.2

1.8

2.4

0.1










 

 

  • Scores ranged from 2-21 correct stands within 30 seconds

Community Dwelling Elderly

(Jones et al, 1999; as an adjunct to the main part of the study, chair stand scores of 190 male and female residents from a nearby retirement housing complex (mean age = 76.2(6.7) years were analyzed to determine the test’s ability to detect age differences over 3 age groups (60’s, 70’s, 80’s) as well as differences in people with high and low levels of fitness (high level of fitness = individuals who participated in moderate physical activity at least 3 days a week, that is activity strenuous enough to cause a noticeable increase in breathing, heart rate and perspiration; low level of fitness = those who either did not participate in moderate exercise or who participated less then 3 times/week)

N

Mean

SD

Age groups

60-69 years

32

14

2.4

70-79 years

96

12.9

3.0

80-89 years

62

11.9

3.6

Activity Group

High activity

144

13.3

2.8

Low activity

46

10.8

3.6


Community Dwelling Sexagenarian Women

(McCarthy, et al, 2006)

  • Mean number of stands: 13.97(3.07)

Hip OA

(Wright et al, 2011)

External criterion standard: Participants graded their perceived level of change on the Global Rating of Change score (GCRS) which is a 15 point scale from -7 to +7. A score of at least +5 is considered major improvement and a score of +4 or less is considered an unimportant change

30 s chair stand; n repetitions

Overall (n = 65)

Major improvement (n = 9)

Unimportant change (n = 56)

Baseline scores

10.1(4.4)

8.4(4.2)

10.3(4.4)

9 wk. scores

10.9(5.5)

11.0(3.8)

10.8(5.7)

Change scores

0.8(3.0)

2.6(2.2)

0.5(3.1)






 

 

 

Hong Kong Community Dwelling Elderly

(MacFarlane, et al, 2006)

30 CST across age span (years)

Mean # of stands

Female 60-64

12.3(4.2)

Female 65-69

11.3(3.5)

Female 70-74

10.1(3.8)

Female 75-79

9.4(3.4)

Female 80-84

9.3(3.1)

Female 85-89

8.3(2.4)

Female 90+

7.9(2.7)

Male 60-64

14(4.3)

Male 65-69

12.9(4.6)

Male 70-74

11.6(3.3)

Male 75-79

11.3(4.4)

Male 80-84

11.1(4.2)

Male 85-89

8.1(4.0)

Male 90+

5.8(2.6)
















 

 

Individuals with OA awaiting joint replacement of the hip or knee

(Gill et al, 2012)

  • Mean number of stands for individuals who do not walk with gait aid = 7.3(2.8) (n = 50)
  • Mean number of stands for individuals who walk with a gait aid = 4.5(3.3) (n = 32)

Moderately Active Older Adults:

(Rikli and Jones, 1999; n = 7183 community residing subjects aged 60-94)

Range of scores between 25-75 percentiles

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

Test-retest Reliability

Community Dwelling Elderly

(Jones et al, 1999)

Participants

Test 1

Test 2

R

95% CI

Mean

SD

Mean

SD

# Of chair stands

Total (n = 76)

13.1

3.4

13.4

4.0

0.89

0.79-0.93

Men (n = 34)

13.7

3.2

13.8

3.8

0.84

0.77-0.90

Women (n = 42)

12.7

3.5

13.0

4.2

0.92

0.87-0.95

 

 

 

 

 

  • Excellent test-retest reliability total number of participants: r = 0.89 (95% Confidence interval 0.79-0.93)
  • Excellent test-retest reliability total number of male participants: r = 0.84
  • Excellent test-retest reliability total number of female participants: r = 0.92

Hip and Knee Osteoarthritis:

(Gill et al, 2008)

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

Interrater/Intrarater Reliability

Community Dwelling Elderly

(Jones et al, 1999 a pilot study using a subsample of 15 participants)

  • Excellent interrater reliability: r = 0.95 (95% CI = 0.84-0.97)

Hip and Knee Osteoarthritis:

(Gill et al, 2008)

  • Established inter-rater reliability between 2 administrations of the same test by 2 different raters on the same day.  Reliability was assessed at 3 time points over 15 weeks in 42 patients awaiting total hip or knee replacement.  ICC (1,1) ranged from 0.93 (95% CI 0.87-0.96) to 0.98 (95% CI 0.96-0.99).

 

Internal Consistency

Not Established

Criterion Validity (Predictive/Concurrent)

Community Dwelling Elderly

(Jones et al, 1999)

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

Community Dwelling Sexagenarian Women

(McCarthy, et al, 2006)

  • Adequate validity when compared to hip extensor isokinetic strength: r = 0.33
  • Adequate validity when compared to hip flexor isokinetic strength: r = 0.47
  • Adequate validity when compared to knee extensor isokinetic strength: r = 0.44
  • Adequate validity when compared to knee flexor isokinetic strength: r = 0.33
  • Adequate validity when compared to ankle plantar flexor isokinetic strength: r = 0.52
  • Poor validity when compared to ankle dorsiflexion isokinetic strength: r = 0.21
  • Excellent validity when compared to 5x sit to stand test: r = 0.83

Hong Kong Chinese Community Dwelling Elderly

(MacFarlane et al, 2006)

  • Adequate criterion validity compared to isometric hip flexion (HF) using Nicholas Manual Muscle Tester: r = 0.42 (95% CI = 0.27-0.54)
  • Poor criterion validity compared to isometric knee extension (KE) using Nicholas Manual Muscle Tester: r = 0.29 (95% CI = 0.14-0.44)
  • Adequate criterion validity compared to HF/kg: r = 0.33 (95% CI = 0.17-0.47)
  • Poor criterion validity compared to KE/kg: r = 0.24 (95% CI = 0.08-0.39)

Construct Validity (Convergent/Discriminant)

Individuals With OA Awaiting Joint Replacement of the Hip or Knee

(Gill et al, 2012)

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

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Community Dwelling Elderly

(Jones et al, 1999)

  • 0% floor effects

Responsiveness

Community Dwelling Elderly

(Jones et al, 1999)

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

Individuals with OA awaiting joint replacement of the hip or knee

(Gill et al, 2012)

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

Professional Association Recommendations

Considerations

Variations in sit to stand tests are available. Examples include

  • 5x sit to stand
  • 10x sit to stand
  • 10 second sit to stand

Measurements of time are more precise (5x sit to stand; 10x sit to stand) then counting of repetitions within a particular time frame (30 second sit to stand; 10 second sit to stand). Individuals who are weak however may not be able to complete the requisite number of repetitions and consequently counting the number of repetitions in a pre set amount of time may be preferable for certain patient populations.

Although chair heights vary depending on literature ensure consistency of chair height when performing serial assessment.

Bibliography

Gill, S. and McBurney, H. (2008). "Reliability of performance‐based measures in people awaiting joint replacement surgery of the hip or knee." Physiotherapy Research International 13(3): 141-152.

Gill, S. D., de Morton, N. A., et al. (2012). "An investigation of the validity of six measures of physical function in people awaiting joint replacement surgery of the hip or knee." Clin Rehabil 26(10): 945-951. Find it on PubMed

Jones, C., Rikli, R., et al. (1999). "A 30-s chair-stand test as a measure of lower body strength in community-residing older adults." Research Quarterly for Exercise and Sport 70(2): 113.

Macfarlane, D. J., Chou, K. L., et al. (2006). "Validity and normative data for thirty-second chair stand test in elderly community-dwelling Hong Kong Chinese." Am J Hum Biol 18(3): 418-421. Find it on PubMed

McCarthy, E. K., Horvat, M. A., et al. (2004). "Repeated chair stands as a measure of lower limb strength in sexagenarian women." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59(11): 1207-1212.

Rikli, R. E. and Jones, C. J. (1999). "Development and validation of a functional fitness test for community-residing older adults." Journal of aging and physical activity 7: 129-161.

Rikli, R. E. and Jones, C. J. (1999). "Functional fitness normative scores for community-residing older adults, ages 60-94." Journal of Aging and Physical Activity 7: 162-181.

Rikli, R. E. and Jones, C. J. (2013). "Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years." The Gerontologist 53(2): 255-267.

Wright, A. A., Cook, C. E., et al. (2011). "A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis." J Orthop Sports Phys Ther 41(5): 319-327. Find it on PubMed

Year published

1999 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 12/18/2013 2:13 PM  by Jason Raad 
Last modified at 1/31/2014 12:55 PM  by Jason Raad