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A 30-s Chair-Stand Test as a Measure of Lower Body Strength in Community-Residing Older Adults
Research Quarterly for Exercise and Sport
Abstract
Measuring lower body strength is critical in evaluating the functional performance of older adults. The purpose of this study was to assess the test-retest reliability and the criterion-related and construct validity of a 30-s chair stand as a measure of lower body strength in adults over the age of 60 years. Seventy-six community-dwelling older adults (M age = 70.5 years) volunteered to participate in the study, which involved performing two 30-s chair-stand tests and two maximum leg-press tests, each conducted on separate days 2-5 days apart. Test-retest intraclass correlations of .84 for men and .92 for women, utilizing one-way analysis of variance procedures appropriate for a single trial, together with a nonsignificant change in scores from Day 1 testing to Day 2, indicate that the 30-s chair stand has good stability reliability. A moderately high correlation between chair-stand performance and maximum weight-adjusted leg-press performance for both men and women (r = .78 and .71, respectively) supports the criterion-related validity of the chair stand as a measure of lower body strength. Construct (or discriminant) validity of the chair stand was demonstrated by the test's ability to detect differences between various age and physical activity level groups. As expected, chair-stand performance decreased significantly across age groups in decades--from the 60s to the 70s to the 80s (p < .01) and was significantly lower for low-active participants than for high-active participants (p < .0001). It was concluded that the 30-s chair stand provides a reasonably reliable and valid indicator of lower body strength in generally active, community-dwelling older adults.
... The test assesses lower body strength and endurance in older adults. 20 Functional status was measured by evaluating Basic Activities of Daily Living (BADLs) and Instrumental Activities of Daily Living (IADLs) using the Barthel Index and the Lawton IADL scale, respectively. The Barthel Index evaluates a patient's functionality across 10 BADL items (feeding, grooming, transfer, toilet use, mobility, dressing, stairs, bathing, and bowel and bladder control) with a final score ranging from 0 to 100,while the Lawton IADL scale was used to assess 5 IADL items (ability to use telephone, shopping, transportation, managing medications, and managing finances), with an overall score ranging from 0 to 5. 21,22 ,23 For both indices, scores are assigned based on the ability to perform each task independently, and lower scores indicate a higher level of dependency. ...
Objective: Surgery poses significant challenges for older adults, potentially leading to functional decline. This study investigated the incidence and risk factors associated with postoperative functional decline in older adults and developed formulas to predict its occurrence. Materials and Methods: This cohort study analyzed patients aged 60 and over who underwent elective abdominal surgery at a tertiary care center in Thailand. The baseline characteristics including Basic Activities of Daily Living [BADL] and Instrumental Activities of Daily Living [IADL] scores, preoperative laboratory testing and surgical-related data were recorded. Functional status was reassessed one month post-surgery. Results: The study involved 97 participants. One month post-surgery, the incidence of functional decline was 61.9%. The mean BADL and IADL scores in the functional decline group decreased from 92.8 ± 11.3 to 83.5 ± 17.8 and from 4.3 ± 1.3 to 2.3 ± 1.3, respectively (p<0.001). Multivariable logistic regression analysis identified age ≥ 70 years (adjusted OR 3.18, 95% CI 1.11–9.06, p=0.031) and a length of stay > 7 days (adjusted OR 5.03, 95% CI 1.75–14.42, p=0.003) as factors most strongly associated with functional decline. Formulas created using five factors related to decline from univariable analyses effectively predicted its occurrence, with AUCs ranging from 0.766 to 0.814. Conclusion: Over 60% of older adults who underwent abdominal surgery experienced functional decline one month after surgery. The developed formulas can be used to identify patients at risk and help prevent functional decline in this population.
... Notably, performance in the standing long jump was inversely associated with AEA levels ( Table 1). return to a seated position, arm crossed over the chest, as many times as possible within 30 s [38]. The total count of these repetitions was recorded. ...
Background
Depression is a leading cause of global disability, affecting approximately 280 million individuals worldwide. Emerging evidence suggests that both physical fitness and endocannabinoids system play significant roles in the pathophysiology and management of depressive disorders.
Purpose
To examine the associations between physical fitness, in terms of cardiorespiratory fitness (CRF) and muscular fitness (MF), with plasma levels of endocannabinoids (eCBs) and their analogues, in adults diagnosed with depression.
Methods
The study involved 80 adults (ages 25–65) with a psychiatric diagnosis of mild-to-moderate depression based on the International Classification of Diseases 10th Revision (ICD-10) criteria. Physical fitness was assessed through tests measuring CRF (6-Minute Walk Test) and MF (Handgrip, Arm Curl, Chair Stand, Standing Long Jump Test). Fasting plasma levels of eCBs, such as anandamide (AEA) and 2-arachidonoyl glycerol (2-AG), and their analogues were measured using liquid chromatography-tandem mass spectrometry. Linear regression analyses were conducted or the associations between fitness variables and plasma levels of eCBs and their analogues using three models.
Results
CRF and jump performance were inversely associated with plasma levels of the eCBs AEA (β range: − 0.302 to − 0.237 for CRF, − 0.315 to − 0.370 for jump; All p < 0.05) and 2-AG (β range: − 0.308 to − 0.326 across all models). eCBs analogues correlated negatively with CRF [2-linoleoylglycerol, 2-oleoylglycerol, docosatetraenoylethanolamide (DEA)] and jump (linoleylethanolamine, stearoylethanolamine, DEA); findings persisted after lean mass normalization.
Conclusion
Our findings indicated that higher physical fitness was associated with lower plasma levels of eCBs and their analogues.
... As for the 30-second sit to stand test, participants will be instructed to sit in the middle of the chair with their back straight, feet flat on the floor, and arms crossed at the wrists, held against the chest. They will be requested to stand up and sit down in the chair repeatedly as many times as possible for 30 s [47]. The total number of sit-tostands completed within 30 s will be recorded. ...
Background
Although older adults with Mild Cognitive Impairment (MCI) face an increased risk of dementia, accumulating evidence has revealed that their cognitive functions could revert to normal levels with effective interventions. Exercise, particularly a combination of physical and cognitive training delivered in the form of an exergame, has shown promising effects in improving cognitive function of older adults with MCI. Nonetheless, previous research often prescribed center-based, moderate to vigorous intensity exercise, posing potential risks to older adults with physical or medical conditions as well as limiting accessibility for those with schedule or transportation constraints. Therefore, this study aims to evaluate the effects of home-based, low-intensity, combined physical-cognitive exercise in the form of an exergame, on cognitive function in individuals with MCI and to further investigate potential biomarkers linking the effectiveness of the exercise program to cognitive alterations.
Methods
Sixty-four older adults with MCI will be enrolled and randomly allocated to either the exercise group or the control group. The exercise group will engage in a low-intensity, combined physical-cognitive exercise through an exergame, with a 50-minute session, 3 times per week for 12 consecutive weeks. The control group will not receive any intervention. Primary outcome measures will be cognitive performance (global cognition, executive function, memory, and attention), and secondary outcome measures will be plasma biomarkers and physical performance. All assessments will be administered at baseline and after a 12-week intervention.
Discussion
The findings of this study might provide valuable insights into an effective and practical intervention program aimed at improving cognitive function of older adults with MCI. The low-intensity, home-based exergaming could have considerable clinical implications, as it has the potential to enhance accessibility for individuals who are unable to engage in high-intensity exercise or attend center-based exercise programs.
Trial registration
ClinicalTrials.gov identifier: NCT06201533, Registered January 11, 2024.
... The CS-30 test was conducted using a chair with a height of 40 cm, with the measurer supporting the participant's chair with care to minimize the risk of falling [34]. The posture at the beginning of the test was uniform: sitting in a chair with both lower limbs shoulderwidth apart, back off the backrest, and arms crossed in front of the chest. ...
Background
As the Japanese population continues to age, functional decline with aging will inevitably become more pronounced. Vision loss and decline in lifestyle and motor functions are the main causes of functional decline. To date, a few studies have examined the relationship between visual and overall physical function. Therefore, this study aimed to quantitatively investigate the relationship between loss of visual acuity and the decline of physical functionality.
Methods
This cross-sectional study was based on the data of 86 community-dwelling older adults (average age ± standard deviation, 75.7 ± 5.5 years; 34 men) who participated in the October 2020–May 2022 baseline survey. Visual function was assessed based on the measurement of binocular near functional visual acuity (NFVA) using the Smart Vision Check application. Physical function tests were performed by measuring grip strength, 30-second chair stand (CS-30), Timed Up and Go (TUG), with eyes open, one-leg standing balance (OLSB), and two-step test. Multivariate regression analysis was performed to examine the association between NFVA and physical function, and partial regression coefficient (β) and 95% confidence interval (95%CI) were calculated.
Results
After adjusting for all covariates, NFVA was significantly associated with grip strength (β: 3.54, 95%CI: 0.39, 6.70). Meanwhile, no association was noted between NFVA and CS-30 (β: -0.35, 95%CI: -2.68, 1.97), TUG (β: -0.23, 95%CI: -0.65, 0.19), OLSB (β: 6.13, 95%CI: -5.09, 17.35), and two-step test (β: 0.01, 95%CI: -0.05, 0.08).
Conclusions
The study showed an association between quantitatively assessed visual and physical functions in community-dwelling older adults living in Japan. Thus, the findings indicate that maintaining and enhancing grip strength and visual function in older adults may be an important factor in leading a healthy and fulfilling life.
Trial registration
Registration number, UMIN000041970.
The Health Sciences College at Trairi (FACISA), Specialized Unit of Rio Grande do Norte Federal University (UFRN), was invited to take part at a health extension action iwith the idealizers of the Sport and Leisure in City Program (PELC in Portuguese), implanted in Santa Cruz/RN by the Federal Institute of Education, Science and Technology of Rio Grande of Norte State (IFRN). The proposal was to make leisure possible all over the community, creating centers for children, adolescents and adults. The objective was to evaluate the neuromotor performance, the tolerance to the submaximum efforts, anticipatory balance, and anthropometry of PSLC adult participants, in order to stimulate a healthy life style, and to offer a greater knowledge about their health condition. The sample was composed by 18 PELC participants, all of them female, more than 60 years old and favorable cardiologic evaluation for the practice of physical activity. The strength of lower limbs ( seating and to standing test) and flexibility of lower limbs (seating and reaching test) were evaluated; body mass index (BMI) and waist-to-hip ratio (anthropometric measures); evaluation of the tolerance to the submaximum efforts (6 minutes walking test - TC6); antecipatory balance (test of functional reach); and blood pressure (indirect method). It was observed that the women studied in this research presented significant aging characteristics, such as: tolerance to the submaximum efforts lower than expected (n=13); obesity (n=8); elevated deposition of abdominal fat (n=17); hypertension (n=12); moderate risk for falls (n=9). Thre was negative statistical significant correlation between the following variables: age x flexibility (r=-0.59, p=0.01); age x TC6 (r=-0.61, p=0.007); and sistolic blood pressure X anticipatory balance (r=0,47, p=0,05). A significant positive correlation between systolic blood pressure and relation C/Q (r=0.49, p=0.04), and flexibility and TC6 (r=0.51, p=0.03) was found. This extension action allowed greater knowledge about the health of PELC participants.
Background/Objectives: Lower-limb muscle function is traditionally assessed with tests like the five times sit-to-stand test (5STS) and the 30-s chair stand test (30CS). The ADR Encoder, a linear transducer, measures power and velocity during the sit-to-stand test. This study aimed to validate its use as functional indicators of muscle function in older adults. Methods: A cross-sectional study with 114 participants (mean age: 72.92 ± 4.97 years) was conducted. The 5STS, 30CS, power, and speed were measured using the ADR Encoder. Participants were categorized into frail, pre-frail, and robust groups according to the FRAIL Scale. Criterion, intraobserver, and interobserver validity were assessed. Results: Strong correlations (r > 0.7; p < 0.001) were found between power, speed, and both 5STS and 30CS. The interobserver intraclass correlation coefficient (ICC) for speed was 0.90 and the intraobserver ICC was 0.85. For power, the interobserver ICC was 0.88 and the intraobserver ICC was 0.79, all statistically significant (p < 0.001). Significant differences in power (7.78 W vs. 11.26 W; p < 0.001) and speed (0.40 m/s vs. 0.58 m/s; p < 0.001) were observed between frail and non-frail participants. Conclusions: The ADR Encoder is a valid, reliable tool for measuring power and speed in older adults. Its strong correlations with the 5STS and 30CS demonstrate its clinical relevance, with high reproducibility across observers and time points. Its application in diverse clinical and community settings could broaden its utility in geriatric functional assessment.
Background/Objectives: The global increase in life expectancy has led to a higher prevalence of cognitive and physical decline in older adults, particularly in those with mild cognitive impairment (MCI). This study aimed to evaluate the effects of a combined cognitive stimulation and resistance training intervention on cognitive performance, physical function, and fall risk in older adults with MCI. Methods: A randomized controlled trial was conducted with 80 community-dwelling older adults diagnosed with MCI. Participants were randomly assigned to an experimental group (EG), which received a 12-week intervention consisting of cognitive stimulation and progressive strength training, or a control group (CG), which maintained their usual routine. Pre- and post-intervention assessments included measures of cognitive function, verbal fluency, attention, processing speed, executive function, gait, balance, fall risk, and lower- and upper-body strength. Results: The EG showed significant improvements compared with the CG in cognitive impairment, verbal fluency, processing speed, balance, gait, and risk of falls (all p < 0.05), with effect sizes ranging from moderate to large. Notably, strength gains were observed in both lower body and grip strength. Attention and executive function also improved in the EG, although with smaller effect sizes. No adverse events were reported. Conclusions: A combined intervention of cognitive stimulation and resistance training is effective in improving multiple domains of cognitive and physical function in older adults with MCI. These findings support the integration of multidomain interventions in clinical and community settings to promote autonomy, reduce fall risk, and delay cognitive and functional decline. Future studies should explore the long-term sustainability of these effects and the individual contribution of each intervention component.
Objectives
To compare gait parameters, functionality (muscle strength, balance, exercise capacity) and health status (kinesiophobia, fatigue, quality of life) in lower extremity lymphedema patients and healthy controls and to determine correlations between exercise capacity, gait parameters, muscle strength, balance, quality of life and lymphedema severity.
Methods
Twenty-two lymphedema patients and 20 healthy controls participated in the study. Participants’ demographic and medical characteristics were recorded. Muscle strength, endurance, balance, functional exercise capacity, gait parameters, kinesiophobia, fatigue and quality of life were assessed with dynamometer, 30-s chair stand test, Biodex, 6-min walk test (6MWT), 8-m test (8-MWT), Tampa Scale, Fatigue Severity Scale and Short Form-36, respectively.
Results
Lymphedema patients had lower muscle strength and endurance, 6MWT distance, speed, cadence and stride length, 8-mWT speed, cadence and left stance phase, and higher swing phase-left and single support phase-right compared to healthy controls ( p < .05). Balance parameters were worse in lymphedema patients compared to healthy controls ( p < .05). Quality of life was lower and kinesiophobia and fatigue levels were higher in lymphedema patients compared to healthy controls ( p < .05). Significant correlations were found between 6MWT distance, speed and stride length, 8-mWT speed and stride lengths and lymphedema severity, muscle strength, balance, and quality of life ( p < .05). Multiple regression analyses identified balance and lymphedema severity as predictors for 6MWT distance, speed, and stride length.
Conclusions
Lymphedema patients have reduced muscle strength, exercise capacity, quality of life, and increased kinesiophobia and fatigue. Lymphedema negatively impacts gait and balance. Gait parameters are correlated with muscle strength, balance, quality of life and lymphedema severity in lymphedema patients.
Introduction
Aging is often accompanied by decreased muscle mass, strength, and physical function. Resistance exercise may mitigate this loss; however, data are lacking that compare physical function of younger and older community-dwelling adults who do or do not include resistance training in their health and fitness routine. Therefore, the purpose of this study was to determine how skeletal muscle mass, strength, and physical function differ by age and resistance training status in community-dwelling adults.
Methods
For this cross-sectional study, healthy younger (23.8 ± 0.4 yr) and older (68.7 ± 1.2 yr) adults ( n = 76) were categorized into four groups based on resistance training status: younger resistance trained (YRT; n = 22), younger not resistance trained (YNT; n = 16), older resistance trained (ORT; n = 17), and older not resistance trained (ONT; n = 21). Participants performed stair climb, 30-s sit-to-stand, 6-min walk, and grip strength tests and had dual energy x-ray absorptiometry scans to measure skeletal muscle mass.
Results
For stair climb, YRT, YNT, and ORT were faster than ONT ( P ≤ 0.05). For 30-s sit-to-stand, YRT and ORT completed more reps than ONT and YNT ( P ≤ 0.05; ORT vs ONT: d = 1.468; YRT vs YNT: d = 1.767). For 6-min walk, ORT, YRT, and YNT walked farther than ONT ( P ≤ 0.05; ORT vs ONT: d = 1.007), and YRT walked farther than YNT ( d = 0.764). Thirty-second sit-to-stand and 6-min walk were not different between ORT and YRT, 6-min walk and stair climb were not different between ORT and YNT, and grip strength and lean leg mass were not different between ONT and ORT ( P > 0.05).
Conclusion
Older adults who engage in regular resistance training can maintain physical function levels similar to that of younger adults. Additionally, these data provide evidence-based support that resistance training performed by community-dwelling adults on their own based on American College of Sports Medicine guidelines translates to real-world benefits to mitigate age-related functional decline.
Preventing or delaying the onset of physical frailty is an increasingly important goal because more individuals are living well into their 8th and 9th decades. We describe the development and validation of a functional fitness test battery that can assess the physiologic parameters that support physical mobility in older adults. The procedures involved in the test development were (a) developing a theoretical framework for the test items, (b) establishing an advisory panel of experts, (c) determining test selection criteria, (d) selecting the test items, and (e) establishing test reliability and validity: The complete battery consists of 6 items (and one alternative) designed to assess the physiologic parameters associated with independent functioning-lower and upper body strength, aerobic endurance, lower and upper body flexibility, and agility/dynamic balance. We also assessed body mass index as an estimate of body composition. We concluded that the tests met the established criteria for scientific rigor and feasibility for use in common community settings.
Fifteen community dwelling older adults, ages 66 to 97 years, with at least one risk factor for recurrent falls, attended a thrice weekly group exercise class for 8 weeks. In post- versus preexercise comparisons, knee extensor torque at 0°/sec increased by 16.5% (p = 0.055); time to perform the stand-up test once, and five times consecutively, improved by 29.4 and 27.4%, respectively (p = 0.05, p = 0.01); gait speed for 24 feet increased by 16.5% (p < 0.001); and performance of the progressive Romberg test of balance improved with a mean increase of 1.1 ± 0.9 positions (p = 0.001). Participants reported a significant increase in the mean number of times per week that they went out of their apartment/home independent of exercising, and a significant increase in the mean number of city blocks they could walk. Performance data for nine exercise participants at 1-yr postintervention are presented. A low- to moderate-intensity groups exercise program can effect improvements in lower extremity strength, gait sp...
With the projected growth in the older adult population, preventing or delaying physical disability in later years has become a national goal. Evidence suggests that physiological decline, especially that associated with physical inactivity, is modifiable through proper assessment and activity intervention. However, a major limitation in reducing loss of function in later years is the lack of suitable assessment tools. Especially lacking are tests that can measure physical performance on a continuum across the wide range of functioning in the independent, community-residing older adult population. Of special concern is the ability to assess underlying physical parameters associated with common activities of daily living. Additional tools are needed for measuring physical performance in older adults, especially tools that meet established guidelines in terms of reliability, validity, discrimination power, and performance evaluation standards.
The U.S. Department of Health and Human Services (1990) has specified as a key objective the reduction of disability in the performance of activities of daily living (ADL) for persons over the age of 65 years. Many ADL involve combinations of muscular strength, muscular endurance, and flexibility, three components that together have been referred to as "muscular fitness." The capacity of the elderly to remain functionally independent, therefore, may depend less on cardiovascular fitness, which has traditionally been the focus of health related fitness research, than on these components of muscular fitness. This review addresses the issue of muscular fitness and disability in the elderly by considering three questions: Is muscular fitness associated with ADL performance? Can muscular fitness be improved with exercise training? Do improvements in muscular fitness improve ADL performance? Answers to these questions will have important implications for future research and program implementation. Although init...
This article describes a nationwide study conducted to develop normative performance data for community-residing older adults. The physical parameters assessed are strength, aerobic endurance, flexibility, and agility/balance. Body mass index was also assessed as an estimate of body composition. The sample comprised 7,183 participants from 267 sites in 21 states. Summary data (M, SD, and percentiles) are reported separately for men and women in 5-year age groups. Results reveal a pattern of decline across most age groups on all variables. ANOVA and post hoc comparisons indicated a significant main effect for age on all variables and that most 5-year age-group declines were significant (p < .007). ANOVAs also revealed a significant main effect for gender on all test items (p < .0001): Men scored better on strength, aerobic endurance, and agility/balance; women scored better on flexibility. The data provide information about normal variations within and usual rates of change across age groups, and they provide a database for subsequent evaluation of individual and group performance.
Objective.
—To determine how multiple risk factors for osteoporotic fractures could be modified by high-intensity strength training exercises in postmenopausal women.Design.
—Randomized controlled trial of 1-year duration.Setting.
—Exercise laboratory at Tufts University, Boston, Mass.Population.
—Forty postmenopausal white women, 50 to 70 years of age, participated in the study; 39 women completed the study. The subjects were sedentary and estrogen-deplete.Interventions.
—High-intensity strength training exercises 2 days per week using five different exercises (n=20) vs untreated controls (n=19).Main Outcome Measures.
—Dual energy x-ray absorptiometry for bone status, one repetition maximum for muscle strength, 24-hour urinary creatinine for muscle mass, and backward tandem walk for dynamic balance.Results.
—Femoral neck bone mineral density and lumbar spine bone mineral density increased by 0.005±0.039 g/cm2 (0.9%±4.5%) (mean±SD) and 0.009±0.033 g/cm2 (10%±3.6%), respectively, in the strength-trained women and decreased by -0.022±0.035 g/cm2 (-2.5%±3.8%) and -0.019±0.035 g/cm2 (-1.8%±3.5%), respectively, in the controls (P=.02 and.04). Total body bone mineral content was preserved in the strength-trained women (+2.0±68 g; 0.0%±3.0%) and tended to decrease in the controls (-33+77 g; -1.2%±3.4%, P=.12). Muscle mass, muscle strength, and dynamic balance increased in the strength-trained women and decreased in the controls (P=.03 to <.001).Conclusions.
—High-intensity strength training exercises are an effective and feasible means to preserve bone density while improving muscle mass, strength, and balance in postmenopausal women.(JAMA. 1994;272:1909-1914)