The Five-Times Sit-to-Stand (5xSTS) test is a highly reliable and efficient performance-based measure used across numerous health and fitness disciplines. It requires minimal equipment and serves as a rapid assessment of an individual’s lower body muscular strength and functional mobility. The time it takes to complete the task is compared against established benchmarks, which allows clinicians to quickly screen for potential functional limitations. This comparison against normative data is a fundamental step in interpreting a person’s physical capacity relative to their age group.
The Five-Times Sit-to-Stand Assessment
The 5xSTS assessment is designed to quantify the dynamic strength and power of the lower extremities, specifically the muscles required for rising from a chair. The test directly measures the speed and efficiency of a transitional movement that is performed dozens of times daily, making it a strong indicator of real-world function. It also provides insight into balance control and the movement strategies a person uses to complete the task.
Healthcare providers use the 5xSTS as a screening tool to identify people who may be experiencing early functional decline or who are at increased risk for mobility impairment. Furthermore, the test is valuable for monitoring progress during a rehabilitation program or following a surgical procedure. By tracking changes in the time required to complete the five repetitions, clinicians can objectively measure the effectiveness of an intervention.
Standardized Testing Procedure
To ensure the reliability of the 5xSTS results, a highly standardized procedure must be followed during administration. The required equipment consists of a stopwatch and a sturdy, backless chair with a seat height of approximately 17 to 18 inches (43 to 45 cm). The chair must be placed securely against a wall or otherwise stabilized to prevent movement during the test.
The person being tested begins seated with their back against the chair and their feet flat on the floor, positioned slightly behind the knees. They are instructed to fold their arms tightly across their chest and maintain this position throughout the entire sequence. The tester provides the command “Go,” which simultaneously starts the stopwatch and the person’s first attempt to stand.
The individual must stand up completely, achieving full hip and knee extension, and then return to the seated position five consecutive times as quickly as possible. The timing stops the moment the person’s buttocks make contact with the chair after the fifth and final repetition. If the person uses their hands or fails to stand fully upright, the test is often terminated, and the inability to complete the task is recorded.
Age-Related Performance Norms
The time taken to complete the 5xSTS test naturally increases with age, reflecting the gradual decline in lower extremity power and muscle mass across the lifespan. Normative data are derived from large studies of generally healthy adults and serve as benchmarks for expected performance. Comparing an individual’s score to these norms allows for a judgment about whether their performance is considered average or below average for their specific age bracket.
A significant meta-analysis established cut-off times for individuals considered to have worse-than-average performance in older age groups:
- For those aged 60 to 69 years, a time exceeding 11.4 seconds is generally considered below the expected average. This benchmark reflects the typical functional capacity of people in this decade who are active and community-dwelling.
- Performance times lengthen in the subsequent decades, with a cut-off of over 12.6 seconds indicating below-average performance for adults aged 70 to 79 years.
- For the 80 to 89 age group, the benchmark increases further, with a time greater than 14.8 seconds falling into the worse-than-average category.
- In the oldest-old population, those aged 90 years and older, the mean time for the traditional 5xSTS test has been documented to be around 16.2 seconds.
These norms emphasize that acceptable functional speed diminishes as a person ages. The rate of change in performance is often more pronounced in these later years, making the use of specific age-matched reference values particularly important for accurate interpretation.
Implications for Mobility and Fall Risk
The time recorded on the 5xSTS test is a predictor of future health outcomes and functional independence. When a person’s score exceeds certain clinical thresholds, it signals a heightened likelihood of experiencing adverse events. This predictive value is why the test is used widely as a screening tool for risk stratification. Specific time markers are utilized to identify risk:
- A performance time greater than 10 seconds has been associated with a significantly higher risk of developing future disability.
- Individuals who take 12 seconds or more to complete the task have been shown to have an increased post-test probability of experiencing a fall. This specific time threshold is a commonly cited indicator for initiating a more comprehensive fall risk assessment and preventative intervention.
- Taking 13.6 seconds or longer to complete the test is linked to increased morbidity and reduced ability to perform activities of daily living.
- The clinical threshold of 15 seconds is considered the optimal cut-off time for predicting recurrent fallers in community-dwelling older adults.
Clinicians utilize these specific time markers to identify frailty and predict the potential need for future assisted living or hospitalization.