Isokinetics and Exercise Science 15 (2007) 77–81 77

IOS Press

Five-repetition sit-to-stand test performance

by community-dwelling adults: A
preliminary investigation of times,
determinants, and relationship with
self-reported physical performance
Richard W. Bohannon a,∗, Megan E. Shove a, Susan R. Barreca b,d , Lisa M. Mastersd and
Christopher S. Sigouinc
a
Department of Physical Therapy, University of Connecticut, Storrs, CT, USA
b
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
c
Department of Health Policy, University of Toronto, Toronto, Ontario, Canada
d
Orthopedic and Rehabilitation Services, Hamilton Health Sciences, Ontario, Canada

Abstract. The 5-repetition sit-to-stand (STS) test is a widely used, but insufficiently evaluated, test for lower limb strength. We
therefore described STS test times for a sample of community-dwelling adults, examined the association of age, gender, height,
weight, and body mass index (BMI) with STS time, and determined the relationship of STS time with self-reported physical
functioning. Ninety-four community dwelling adults participated. Repeated measures of STS time were reliable (intraclass
correlation coefficient = 0.957). The mean STS time for all 94 subjects was 7.6 seconds. Age, weight, and BMI were (r =
0.281–0.528), but gender and height were not (r = −0.074 – 0.007), correlated significantly with STS time. Regression analysis
showed that age and BMI explained 43.7 percent of the variance in STS time. The correlation between STS time and physical
functioning (r = −0.474) was significant (p < 0.001). Regression analysis showed that age and BMI added slightly to the
explanation of variance in physical functioning provided by STS time.
In conclusion, this study provides STS times that might be useful for interpreting performance of adults screened with the test.
Such performance should be considered in light of age and BMI. The relationship of STS time with physical functioning provides
evidence of the validity of the measure.

Keywords: Muscle, strength, screening test, reliability, validity

1. Introduction diversity of medical conditions. Functional strength

Tests of muscle performance are a standard com-
ponent of the physical examination of patients with a
∗ Address for correspondence: Dr Richard W. Bohannon, Depart-
ment of Physical Therapy, University of Connecticut, Storrs, CT
06269-2101, USA. Tel.: +1 860 233 1033 (home phone), +1 860 486
0048 (office phone); Fax: +1 860 233 0609 (home fax), +1 860 486
1588 (office fax); E-mail: richard.bohannon@uconn.edu.
tests, that is those that use body weight for resistance
during functional activities, are among the options for
measuring muscle performance [8]. Timed sit-to-stand
(STS) tests are probably the most often used functional
strength tests. There are several variations on the STS
test. Csuka and McCarty first recommended document-
ing the time required to perform 10 STSs [7]. Since
that time, others have timed the duration of 1, 3, and

ISSN 0959-3020/07/$17.00  2007 – IOS Press and the authors. All rights reserved
78 R.W. Bohannon et al. / Sit-to-stand test performance
5 repetitions of the maneuver or indicated the number
of repetitions that could be completed in 10 or 30 sec-
onds [3]. The time required for 5 repetitions, however,
has probably realized the broadest application [2].
In spite of its wide use in screening, performance
on the 5-repetition STS test has not been reported for
adults of a wide age range. If performance on the test is
to be interpreted meaningfully, the association of age,
gender and anthropometric measures with performance
needs to be determined. If the STS test is to be useful,
performance on it should correlate with other impor-
tant variables such as physical functioning [9]. The
purposes of this study, therefore were three: 1) summa-
rize 5-repetition STS times for a sample of community-
dwelling adults, 2) examine the association of their age,
gender, height, weight, and body mass index (BMI)
with STS times, and 3) determine the relationship of
STS times with self-reported physical functioning.
2. Methods
This study, part of a larger investigation of STS per-
formance by adults, was approved by the institutional
review boards of University of Connecticut and Hamil-
ton Health Sciences.
2.1. Participants
A convenience sample of 94 adults, considered non-
disabled on the basis of their ability to ambulate with-
out a device or assistance, provided informed consent
and contributed data. Forty-five were residents of the
United States and 49 were residents of Canada. More
than half of the participants (57.4%) were women. All
but 4 were non-Hispanic white. They ranged in age
from 19 to 84 years. Forty-five (47.9%) worked full-
time, part-time, or as a homemaker, 18 (19.1%) classi-
fied themselves as students. Eighty-five (90.4%) rated
their health as good or excellent.
2.2. Instrumentation and procedures
Information about each person’s ethnicity, age, em-
ployment, health, height, and weight was provided by
subjects completing a survey. Body mass index (BMI)
was calculated from height and weight data. Subjects
also completed the Physical Functioning Subscale of
the Short Form (SF)-36 [12]. Their raw scores were
transformed to scale scores as follows: ((actual raw
score – lowest possible raw score)/possible score range)
* 100.
Subjects’ STS performance was measured using the
reliable 5-repetition STS test [11]. Specifically, they
stood up and sat down 5 times from a standard height
chair (40–45 cm) as fast as possible. Their arms were
folded across their chests. Timing with a digital stop-
watch began with the command “go” and ceased when
subjects achieved their final stand-up. Two trials were
allowed, with subjects provided sufficient time between
trials to feel fully recovered.
2.3. Data analysis
All analysis was conducted using the Statistical pack-
age for Social Sciences (SPSS, version 11.0) and Systat
(version 10.0). The significance level was set at p <
0.05 for all inferential statistical procedures. Conven-
tional descriptive statistics were employed to describe
study variables. Times for the 2 STS trials were com-
pared using a paired t-test and the intraclass correlation
coefficient (equation 3,1). Analysis of variance was
used to determine whether significant differences ex-
isted between different age groups’ STS performance.
The relationships of potential determinants (age, gen-
der, weight, height, and BMI) with STS performance
were determined using Pearson correlations (r) and for-
ward multiple regression analysis. The relationships
of STS performance, age, gender, and BMI with phys-
ical functioning were also determined using Pearson
correlations and forward multiple regression analysis.
Only the independent variables that correlated signif-
icantly with dependent variables were included in the
regression analysis.
3. Results
Table 1 summarizes STS data. The time for 5 STSs
was significantly less (t = 2.879, p = 0.005) for trial 2
than for trial 1; however, the times had a high intraclass
correlation coefficient (0.957). Therefore, the mean
time for the 2 trials was used in all subsequent analy-
sis. Figure 1 shows the distribution of the mean times.
The STS data were stratified by age groups based: 1)
on a review of a scatter-plot (Fig. 2) that showed a
curvilinear relationship with an apparent elbow in the
trend of STS times at about 50 years of age and 2)
on the precedent for presenting data by decades. The
analysis of variance supported the age categorization
 R.W. Bohannon et al. / Sit-to-stand test performance 79

Table 1
Descriptive statistics for time (sec) for 5 sit-to-stand repetitions
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: 19–49 years (39) 6.2 ± 1.3 4.1–11.5
Mean: 50–59 years (15) 7.1 ± 1.5 4.4–9.1
Mean: 60–69 years (18) 8.1 ± 3.1 4.0–15.1
Mean: 70–79 years (16) 10.0 ± 3.1 4.5–15.5
Mean: 80–89 years (6) 10.6 ± 3.4 7.8–16.0

40 20
0.4

Mean Sit-to-Stand Time (s)

30 15
Number of Subjects

Proportion per Bar

0.3

20 10
0.2

10 0.1 5

0 0.0 0
0 5 10 15 20 10 20 30 40 50 60 70 80 90
Mean Sit-to-Stand Time (s) Age (yr)

Fig. 1. Histogram showing distribution of mean sit-to-stand times Fig. 2. Scatter-plot showing the relationship between mean
for 94 community-dwelling participants. sit-to-stand times and age for 94 community-dwelling participants.

by its demonstration of a significant difference in times
between age groups (F = 10.8, p < 0.001).
Descriptive statistics for continuous data are present-
ed in Table 2. Age, weight, and BMI were signifi-
cantly correlated with STS time (Table 3), with STS
time higher in participants with greater age, weight and
BMI. Age had the highest zero-order correlation with
STS time (r = 0.528). As the relationship between
age and STS time was already shown to be curvilin-
ear (Fig. 2), age-squared was added to the independent
variables included in the regression analysis. As BMI
had a higher zero order correlation with STS time than
weight and as BMI is computed using weight, weight
was excluded from the regression analysis. The re-
gression analysis demonstrated that age, age-squared,
and BMI contributed independently to the explanation
of STS time. Together they explained 43.7% of the
variance in STS time.
The STS time had a significant and fair correlation
with physical functioning (r = −0.474); as did (to a
lesser degree) age and BMI (Table 3). Physical func-
tioning was more limited in subjects with longer STS
times, greater age, and higher BMI. Multiple regression
(Table 4) showed that age and BMI added slightly to
the explanation of physical performance provided by
STS time. Together the variables explained 26.6% of
the variance in physical performance.
4. Discussion
In spite of the widespread use of the 5 repetition
STS test, sufficient information has not been available
heretofore to aid in interpreting performance on the test.
We therefore summarized participant performance on
the test, described the association of potential determi-
nants with that performance, and explored the relation-
ship of STS performance with self-reported function-
ing.
Performance on the 5 repetition STS test was de-
scribed for individuals from 19 to 84. Many of the par-
ticipants, therefore, were younger than those described
in most of the extant research [2]. For participants with-
in age groups previously described (e.g., 60–69, 70–
79, 80–89) [2], STS times were shorter in the present
study. The reasons can only be posited, but may relate
to our sample or to the testing procedures. Our sam-
ple may have performed better because it was healthi-
er. More than 90 percent rated their health as good or
excellent and all were independently ambulatory with-
80 R.W. Bohannon et al. / Sit-to-stand test performance

Table 2
Descriptive satistics for demographic and physical functioning data
Variable Mean ± SD Minimum-Maximum
Age (years) 51.1 ± 20.8 19–84
Weight (kg) 73.0 ± 16.0 49.1–127.3
Height (m) 1.68 ± 0.09 1.47–1.88
Body mass index (kg/m2 ) 25.6 ± 4.5 18.9–40.8
Physical functioning (%) 87.2 ± 18.6 0–100

Table 3
Pearson correlations of independent variables with sit-to-stand time and
physical functioning
Independent Variables Sit-to-Stand Time Physical Functioning
r (p) r (p)
Sit-to-stand time −0.474 (0.001)
Gender −0.074 (0.481) 0.151 (0.145)
Age 0.528 (0.001) −0.407 (0.001)
Weight 0.281 (0.006) −0.175 (0.092)
Height 0.007 (0.943) 0.149 (0.151)
Body mass index 0.339 (0.001) −0.310 (0.002)

Table 4
Final regression models for explanation of sit-to-stand time and physical
performance
Sit-to-Stand Time
Variable Coefficient Standard t (p)
β Error
Constant 3.307 1.574 2.101 (0.038)
Age squared 0.002 0.001 3.931 (0.001)
Body mass index 0.219 0.049 4.490 (0.001)
Age −0.166 0.060 −2.774 (0.007)
Adjusted R2 = 0.437

Physical Performance
Variable Coefficient Standard t (p)
β Error
Constant 132.646 10.010 13.252 (0.001)
Sit-to-stand time −1.933 0.752 −2.568 (0.012)
Age −0.211 0.094 −2.249 (0.027)
Body mass index −0.778 0.390 −1.994 (0.049)
Adjusted R2 = 0.266

out an assistive device. Their mean scale score on the
Physical Function subscale (87.2) was slightly higher
than the norm mean (84.1) for the United States popu-
lation [12]. Our instructions clearly called for partici-
pants to perform the test as quickly as possible. Timing
ceased after the fifth stand. In some studies, investiga-
tors have had individuals perform repeated STSs at a
self-selected pace or have ceased timing after the indi-
vidual sat following the fifth stand [2]. Either variation
might add to the time required to complete the test.
Clearly, standardization is warranted.
Of the possible determinants of STS test perfor-
mance that we investigated, age and BMI were par-
ticularly noteworthy. The results of the present study
suggest that judgments about individual performance
should take these 2 variables into account. A recent
meta-analysis of STS times indicated the importance
of age, but that analysis was limited to individuals at
least 60 years of age [2]. Csuka and McCarty showed
that age should be considered, but their research fo-
cused on the 10 repetition STS test [7]. Csuka and
McCarty also found gender to be a factor [7]. In re-
gard to that finding, our study differed. Our discovery
that BMI influenced performance at the STS test has
been demonstrated previously, but only among elderly
women [5].
The validity of the 5-repetition STS test has been
questioned by Netz et al because of the lack of sig-
 R.W. Bohannon et al. / Sit-to-stand test performance
nificant correlations between STS time and isokinetic
strength measures of isolated lower limb joints [9]. Al-
though other versions of the STS test have been shown
to correlate with isolated and multi-joint measures of
limb strength [1,6,10] and with function [5] in patient
samples, validation of the 5-repetition STS test is ap-
parently limited to its correlation with walking perfor-
mance and self reported function among elderly wom-
en [4,5]. In this study we used self-reported physical
function as our standard. The correlation between STS
time and physical function was significant and greater
than the correlation between either age or BMI and
physical function. While these 2 variables added to the
explanation of physical function, the additional expla-
nation of variance (4.1%) was minimal. Consequent-
ly, time for the 5-repetition STS test would appear to
have validity. Its ability, relative to other strength mea-
sures, to explain self-reported physical function and
measured physical performance (eg, gait speed) should
be examined.
This study had several limitations, some alluded to
heretofore. First, the sample was one of convenience.
As a consequence, it may have been healthier than the
population as a whole and was not ethnically diverse.
Moreover, the sample included only 6 individuals in
the 80 to 89 year age group. That sample was quite
small and less than half the size of that in any other age
group. Had we used of a probability sample from the
population and included additional older participants,
our results may have been different. Second, although
all testing was performed using the same instructions,
there was some variability in the procedure. Testing at
many different sites using available chairs meant that
the height, padding, and dimensions of chairs varied
slightly. By putting limits on the height variance, we
believe we minimized the contribution of such variance
to performance. Whatever the influence, the factors did
not preclude the demonstration of significant correla-
tions of age and BMI with STS time or of STS time
with physical function.
5. Conclusions
This study provides STS times that may be useful for
interpreting performance of adults of a wide age range.
81
Such performance should be considered in concert with
age and BMI. The relationship of STS time with phys-
ical functioning provides new evidence of the validity
of the measure.
Acknowledgements
Funding was provided by the Ontario Ministry of
Health and Long Term Care through the Ontario Stroke
Strategy.
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