The Ultimate Physical Health Test for Older Adults

Far too many adults today spend a large percentage of their daytime hours sitting down for various purposes, such as working on a computer, commuting, or watching TV. Too much sitting can, unfortunately, lead to weakness in the legs and core, lack of flexibility, and a higher risk for weight gain.



Experts consider the gesture of getting up from a chair to sit to be an essential activity of daily living. For example, the ability to stand up from a chair is an important component of maintaining independence among elderly people because it makes it possible to get up from the toilet, out of bed, and out of a car.


The "sit-to-stand test" is a physical assessment that's done in order to determine someone's level of mobility, stability, balance, and endurance. Among older adults, a high score on this type of test is linked with greater independence, general well-being, and even longevity. This isn't surprising considering that research shows an association between greater retention of muscle mass and strength and a higher likelihood of living into older age.


If your healthcare provider has recommended that you complete the sit-to-stand test to determine your overall physical capabilities, then you're probably wondering what information you should be aware of beforehand, such as what to expect and how to prepare.


Below we'll look more closely at two different versions of this test, plus offer strategies for getting yourself in shape beforehand, as well as after you've received your results.


How The sit-to-stand Test Works

sit-to-stand tests are most often performed by older adults, ranging from those in their 60's through their 90's. Doctors and physical therapists (PTs) sometimes also use these tests with younger people (18+) who are recovering from conditions such as a stroke, accident, balance disorder, osteoarthritis, or dementia.


The main purpose of these tests is to assess several markers of physical wellness, including lower extremity strength, balance, risk of falls, transitional movements, and coordination.


One of the great things about this test is that it's easy to perform, non-invasive requires no technical equipment, and can be performed in any environment. It's also able to test how well multiple body parts are working together, including someone's legs, back, and core.


There are multiple ways to do the sit-to-stand test, such as from the floor to standing, or from a chair to standing. There are also several variations of this test that all interpret results a bit differently — for example some focus on how many reps you can perform within a time frame, while others record how long it takes you to stand and sit back down five times successfully.


Two of the most popular versions of the sit-to-stand test include the 30-Second Chair Test and the Fives Times sit-to-stand Test (5XSST).


The 30 Second Chair Test measures how many times you can stand and sit back down in 30 seconds. The Fives Times sit-to-stand test measures how long it takes you to complete 5 reps of sitting to standing.


These versions of the sit-to-stand test require you to first sit on a chair without arm support with your arms crisscrossed over your chest, and then to stand up, without bracing yourself with your hands or using any support from your arms, or the sides of your legs. Not using other body parts for support is key, since this indicates you have the proper balance and strength to stand.


After standing up, you lower yourself down to sit, again without the aid of any other body parts. You repeat this cycle over and over, at least 5 times. If you can do this relatively easily, then you'll receive a perfect score. Each variation of the test is a bit different, but most deduct points every time you support yourself with a forbidden body part.


Here are instructions that your doctor or physical therapist will likely give you before you perform these tests:


  1. Sit in the middle of the chair. Place your hands on the opposite shoulder crossed, at the wrists. Keep your feet flat on the floor and your back straight, and keep your arms against your chest. *Note that each person’s health and strength are at a different level, so the provider will determine if any adjustments need to be made.

  2. On “Go,” stand up to a full standing position, then sit back down again. Repeat this for 30 seconds (or as long as your healthcare provider tells you).

  3. The person running the test will count the number of times you come to a full standing position in 30 seconds.


What If You Get a Low Score?

What is considered a good score on the sit-to-stand test? Younger adults are generally expected to be able to complete more reps than older adults, due to having more strength and endurance.


On average, adult men should be able to complete between 7 and 14 reps of sitting to standing within 30 seconds, and adult women should be able to complete between 4 and 12. Men and women in their 60's are expected to be at the higher end of this range than those who are much older.


If your doctor/PT determines that your score is below average, they'll likely recommend that you start doing exercises to build strength, mobility, and endurance.


Here are common exercise suggestions that can help you build strength in your lower body, while also improving your stability:


  • Practice sitting-to-standing reps daily. Slowly build up to 10 or more repetitions per day, then focus on speed and good form/posture when this becomes easy.

  • Take daily walks. Get up and move more often to keep your joints and muscles healthy. Swimming and cycling are other low-impact exercises to build endurance.

  • Perform lower body exercises that you're capable of doing. You can try squatting next to a wall, doing slow lunges, or marching in place while lifting your knees.

  • Other exercises that PTs recommend for seniors include: practicing leg circles, standing on one leg, lifting one leg straight back behind the body, and standing and lifting the heels to stand up on the toes. Aim to perform each about 10 times daily or more.

  • If you are typically frail or wobbly, use an inexpensive gait belt for extra safety when performing these exercises.

  • Try a chair yoga class, which also helps with flexibility and posture. You can also stretch at home in a sturdy chair to help improve circulation and range of motion in your back/spine, sides, shoulders, and chest.