5 times sit to stand

The Five Times Sit to Stand Test (5xSST) is a functional assessment used to measure lower limb strength, transitional movements, dynamic balance, and fall risk. Although it can be applied to adults aged 18 years and older, it is especially relevant in populations over 65 years

The test is frequently used to:

• Assess hip and knee extensor strength

• Evaluate dynamic balance and postural control

• Identify fall risk in patients with dementia, stroke, vestibular disorders, frailty, or balance impairments

• Estimate functional mobility when walking speed cannot be measured

Test Procedure

Required equipment:

• Stopwatch

• Standard chair (straight back, no armrests, seat height 43–45 cm)

Execution:

1. The subject sits with their back against the chair and arms crossed across the chest.

2. At the command “ready, go”, the subject stands up and sits down five times as quickly as possible, without using arms or leaning back between repetitions.

3. Timing begins at “go” and stops when the buttocks touch the chair after the fifth repetition.

4. If the subject cannot complete the task without arm support or fails to finish five repetitions, the test is considered failed.

Documentation:Any modifications must be noted (e.g., arm support, fewer repetitions, alternative positions).

Interpretation of Results

Lower times indicate better performance. Normative values vary by age group:

Age Group	Mean Time
60–69 yrs	11.4 seconds
70–79 yrs	12.6 seconds
80–89 yrs	14.8 seconds

• Fall risk threshold: >15 seconds = high risk of falls, reduced strength, and functional limitations

Measurement properties:

• Minimal Detectable Change (MDC): 3.6–4.2 seconds

• Minimal Clinically Important Difference (MCID): 2.3 seconds

Scientific Evidence

Reliability:

• Intra-rater ICC: 0.914–0.933

• Test-retest ICC: 0.988–0.995

Validity:

• Strong correlation with other functional and balance measures such as Timed Up and Go (TUG) (r = 0.64, p < 0.001)

Responsiveness:

• Moderate responsiveness in populations with balance or vestibular disorders (Responsiveness Coefficient RT = 0.58)

Clinical Use and Limitations

Advantages:

• Simple and quick to administer

• Requires minimal equipment

• Safe for most patients

Limitations:

• Not suitable for individuals with severe mobility restrictions or those unable to rise without support

• Not sufficiently specific to differentiate between neurological or vestibular causes of impairment

Thus, the 5xSST should be included as part of a comprehensive functional assessment battery, particularly in elderly populations or those at risk of falls.

Summary

The Five Times Sit to Stand Test (5xSST) is a cost-effective, reliable, and valid clinical tool for assessing lower limb strength, dynamic balance, and fall risk. When used systematically, it helps clinicians track progress, evaluate treatment response, and detect early declines in physical function.

Sources:

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