5 Times Sit to Stand Test: How to Administer, Interpret, and Apply Norms

The 5 times sit-to-stand test is a fast, equipment-light way to quantify one of the most common functional movements in daily life: repeated chair transfers. In less than a minute, it can provide insight into transfer capacity, balance control, and potential fall risk, often revealing mobility limitations that may not be apparent during straight-line walking.

What the 5 times sit-to-stand test measures (and why it’s used)

The 5 times sit-to-stand test (often abbreviated 5xSTS) records the time it takes to stand up from a chair and sit back down five times. Although it is frequently described as a lower-extremity strength measure, performance reflects multiple systems working together:

• Hip and knee extensor strength

• Trunk control

• Dynamic balance during the transition to standing

• Eccentric control during the return to sitting

Published work supports its clinical usefulness as a functional measure in older adults, with age-referenced values synthesized across studies to support interpretation.¹ The test is also widely used in neurologic and orthopedic populations because repeated sit-to-stand can expose compensations that are not obvious during a single transfer.

A practical approach is to view the 5xSTS as two results in one:

• The score (seconds): quantifies transfer speed and capacity

• The movement quality: explains what is driving the score (momentum use, asymmetry, hesitation, loss of control on descent, or pain-limited depth)

How to administer the 5-Times Sit-to-Stand (5xSTS) test consistently

Consistency determines whether your score is clinically useful. Chair height, arm use, instructions, and timing rules can meaningfully influence results. Standardizing your process and documenting deviations makes change over time interpretable.

Setup and equipment

Most protocols use a standard chair and a stopwatch. Many references describe chair height as 43 to 45 cm (17 to 18 inches), though there is variation in research and practice.² If your chair height differs, document it and keep it consistent for re-testing.

Starting position

The individual begins seated with feet flat on the floor. A commonly used standardized approach requires arms to be crossed over the chest to reduce upper-extremity assistance.² If crossing arms is not feasible or safe, allow the safest strategy and document the modification.

Standard instructions (recommended baseline)

Use a consistent script such as:

“When I say go, stand up all the way and sit down all the way five times as quickly as you can, without using your hands. I’ll be timing you.”

Timing typically starts on “Go” and stops when the person returns to sitting after the fifth stand.²

Safety and modifications

If a guard or a gait belt is required, use it. If the individual uses hands, shifts feet between repetitions, pauses, or does not reach full standing, those details are important for interpretation and comparison across visits.

Reliability

A systematic review and meta-analysis report high test–retest reliability for the five-times sit-to-stand test across adult populations, supporting its use for repeat measurement when procedures are consistent.³

Interpretation: Scoring, thresholds, and 5 times sit-to-stand norms

The output is time in seconds. Lower times generally reflect better transfer performance. Interpretation is strongest when you combine:

1. Age-referenced normative context

2. Risk thresholds reported in the literature

3. Direct movement observation

4. Measurement error awareness

A practical interpretation frame

Many clinicians use broad ranges as a starting point (not a diagnosis):

• Faster performance often aligns with fewer transfer limitations.

• Slower performance suggests greater mobility limitation and may warrant closer fall risk consideration, depending on population and setting.

In community-living adults aged 65 and older, times greater than 15 seconds have been associated with recurrent falls.⁴ Other studies report cutoff ranges around 12 to 15 seconds, depending on the population and outcomes studied.⁵

5 times sit-to-stand norms (age-referenced values)

Norms vary by protocol and inclusion criteria, but a descriptive meta-analysis provides age-related reference values commonly used in clinical contexts. A commonly cited set includes:¹

• 60 to 69 years: approximately 11.4 seconds

• 70 to 79 years: approximately 12.6 seconds

• 80 to 89 years: approximately 14.8 seconds

Use norms as a lens, not a label. A person scoring near age-referenced values may still demonstrate poor control, asymmetry, or fear. Conversely, someone slower than norms may remain safe and independent depending on strategy, environment, and supports.

Minimal Detectable Change (MDC): When is improvement real?

Using the 5xSTS to track progress helps to determine whether a change in time reflects true improvement or normal test variability. That’s where minimal detectable change (MDC) comes in: it represents the smallest change beyond measurement error that can be interpreted as a “real” change in performance with confidence.³

Because the five-times sit-to-stand test shows high test–retest reliability when procedures are standardized, it can be a strong tool for repeat measurement, provided testing conditions remain consistent across visits (chair height, arm use, instructions, timing rule, and guarding/assistance).^2,3 Even small protocol shifts can create a change in seconds that looks like progress but isn’t.

What does that mean in practice? In adult samples included in reliability research, reported minimal detectable change values for the 5xSTS commonly fall in the low single-digit seconds, though estimates vary by population and testing conditions.³ Instead of focusing on small, second-by-second differences, interpret change with two anchors:

• Time change under the same conditions, and

• Movement quality change (less trunk momentum, improved symmetry, better eccentric control, fewer pauses)

When both improve together and the time change is large enough to exceed expected measurement error, you can be more confident that the patient’s transfer performance is genuinely improving, not just their strategy or the testing setup.

Use complementary measures for clearer interpretation

The 5xSTS focuses on repeated transfers. When broader mobility insight is needed, pairing it with one additional measure can clarify what is driving limitations:

• The Timed Up and Go test adds gait initiation, turning, and walking speed components that the 5xSTS does not capture.

• The Berg Balance Test provides a broader balance profile that can help interpret whether a slow 5xSTS time is tied more to balance confidence and postural control than to transfer strength alone.

Clinical applications: How to use results in day-to-day practice

Fall risk conversations and mobility screening

The 5xSTS contributes meaningfully to fall risk discussions because it reflects repeated transfers under time pressure. In the Buatois study, slower 5xSTS performance, particularly above 15 seconds, was associated with a higher risk of recurrent falls among community-living older adults.⁴ 

The test should not be used in isolation, but it provides an objective data point that complements gait observation and patient history.

Progress tracking across episodes of care

The 5xSTS is well-suited for re-testing due to its brevity and repeatability. The key is controlling testing conditions so that the change reflects function rather than protocol differences.

When using it for progress tracking, focus on two outcomes:

• Time change (seconds) under consistent conditions

• Movement quality change (less trunk momentum, improved symmetry, better eccentric control, fewer pauses)

Even modest time improvements can represent meaningful gains when they align with improved toileting transfers, car transfers, or increased confidence standing from low surfaces.

Translating findings into a plan

A simple way to connect results to intervention is to match the primary limiter to a training emphasis:

• Force production limited: Progressive sit-to-stand loading, hip and knee extensor strengthening, task practice from varied seat heights

• Balance/control limited: Controlled descent work, graded transfer practice, dynamic stability demands

• Pain limited: Adjust seat height and depth, address pain drivers, build tolerance with reassessment

In documentation, this can be concise: “5xSTS 18.0 s with uncontrolled descent; focus on eccentric control and progressive transfer training.”

Example: Using norms and pairing tests to clarify the picture

An adult in their mid-70s presents after hospitalization with reduced transfer confidence and slower mobility. The initial 5 times sit-to-stand test score is 18.6 seconds on a standard chair. Observations include marked trunk flexion to generate momentum and uncontrolled descent during the final repetitions.

This time exceeds thresholds associated with recurrent fall risk in community-living adults⁴ and is slower than age-referenced norms for the 70 to 79 range.¹

After six weeks of progressive strengthening, repeated sit-to-stand practice, and eccentric control training, the score improves to 13.2 seconds under identical conditions, with smoother lowering and reduced trunk momentum. This change supports measurable improvement in transfer performance and better alignment with age-referenced norms.

Documentation tips that keep interpretation clean

You don’t need lengthy notes to make the 5xSTS clinically meaningful, but you do need consistency. Small documentation details determine whether the score is interpretable six weeks later or during the next episode of care.

At a minimum, include:

• Chair type and height (or document “standard clinic chair” if consistently used)

• Arm position (arms crossed vs pushing off thighs or armrests)

• Level of assistance or guarding (independent, supervision, contact guard, etc.)

• Observed deviations (pauses, foot repositioning, incomplete hip extension, loss of balance, pain behavior)

• One movement quality note (e.g., trunk momentum, asymmetry, uncontrolled descent)

These details make it possible to compare performance accurately across visits, interpret differences between clinicians or settings, and defend changes in score during documentation review. They also help distinguish true functional improvement from protocol variation, such as differences in chair height, arm use, or guarding.

Limitations and common pitfalls

The 5 times sit-to-stand test is widely used and well-supported, but interpretation requires context.

Chair height variability

Seat height meaningfully affects difficulty. A lower chair increases required knee and hip extensor demand and often increases forward trunk lean. Without documenting height, comparisons across visits or across settings may be misleading.

Arm use changes the task

Allowing upper-extremity assistance reduces lower-extremity demand and alters balance requirements. A score obtained with push-off is not equivalent to one performed with arms crossed.

Pain and fear can slow performance

Slower times do not always reflect strength deficits. Pain avoidance, guarded movement, or fear of falling can drive pacing and hesitation. In these cases, observation of movement quality becomes especially important.

Pacing strategy variability

Some individuals rush the first repetitions and fatigue on the last two; others pace themselves evenly. Without noting visible fatigue or changes in quality across repetitions, interpretation may be incomplete.

Ceiling effects in higher-functioning individuals

In younger or high-functioning adults, times may cluster in a narrow “fast” range. In these cases, movement quality, asymmetry, and control may provide more clinically relevant insight than raw time.

Overreliance on a single threshold

Using a single cutoff (e.g., 15 seconds) as a fall-risk determinant without considering population, setting, or complementary measures oversimplifies interpretation. The 5xSTS is best used as one component of a broader mobility profile.

From score to strategy

The 5 times sit-to-stand test offers a fast, repeatable way to quantify transfer performance and identify what is limiting it. When interpreted alongside age-referenced norms, fall-risk thresholds, measurement error considerations, and one clear movement-quality observation, it becomes more than a time in seconds; it becomes a tool for targeted intervention and progress tracking.

Used thoughtfully, the 5xSTS can support screening, guide plan-of-care decisions, and strengthen clinical communication across settings.

To build confidence in administration, scoring, and real-world application, explore Medbridge’s course on the 5 Times Sit-to-Stand Test, presented by J.J. Mowder-Tinney, which walks through practical setup considerations, interpretation strategies, and integration into everyday assessment workflows.

References

1. Bohannon RW. Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Percept Mot Skills. 2006 Aug;103(1):215-22. doi: 10.2466/pms.103.1.215-222. PMID: 17037663. https://pubmed.ncbi.nlm.nih.gov/17037663/

2. Shirley Ryan AbilityLab. (2013, June 20). Five Times Sit to Stand Test. Rehabilitation Measures Database. https://www.sralab.org/rehabilitation-measures/five-times-sit-stand-test

3. Muñoz-Bermejo L, Adsuar JC, Mendoza-Muñoz M, Barrios-Fernández S, Garcia-Gordillo MA, Pérez-Gómez J, Carlos-Vivas J. Test-Retest Reliability of Five Times Sit to Stand Test (FTSST) in Adults: A Systematic Review and Meta-Analysis. Biology (Basel). 2021 Jun 9;10(6):510. doi: 10.3390/biology10060510. PMID: 34207604; PMCID: PMC8228261. https://pmc.ncbi.nlm.nih.gov/articles/PMC8228261/

4. Buatois S, Miljkovic D, Manckoundia P, Gueguen R, Miget P, Vançon G, Perrin P, Benetos A. Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. J Am Geriatr Soc. 2008 Aug;56(8):1575-7. doi: 10.1111/j.1532-5415.2008.01777.x. PMID: 18808608. https://pubmed.ncbi.nlm.nih.gov/18808608/

5. Hyuma Makizako, Hiroyuki Shimada, Takehiko Doi, Kota Tsutsumimoto, Sho Nakakubo, Ryo Hotta, Takao Suzuki, Predictive Cutoff Values of the Five-Times Sit-to-Stand Test and the Timed “Up & Go” Test for Disability Incidence in Older People Dwelling in the Community, Physical Therapy, Volume 97, Issue 4, April 2017, Pages 417–424, https://academic.oup.com/ptj/article/97/4/417/3078574