How Getting Up From the Floor Can Save Your Life!

At the Kahn Center, we discuss methods to measure extend healthy lifespans, also known as healthspans. The focus is usually on lifestyle assessments, laboratory testing, and imaging studies. However, we are always looking for new ways to determine fitness and predicted survival in patients seen.

One unique test is so simple that it is usually overlooked. Called "the sitting to rising test" or SRT, this movement requires enough balance, muscle strength and flexibility to be able to sit down on the floor without using arms, hands or knees and then to stand up again just as unaided. The movement is a way to determine non-aerobic fitness, and it reveals potential problems that might be otherwise missed. 

Researchers at the Exercise Medicine Clinic in Rio de Janieiro reported in a prior study that the ability to sit and rise from the floor, particulary with no assistance of any kind,  was associated with all-cause mortality.

Now the same researchers sought to assess whether an SRT score of how well persons performed this maneuver also predicted premature natural and cardiovascular (CV) deaths.

STUDY

A total of 4282 adults aged 46–75 years (68% men) performed sitting and rising from the floor, which was scored from 0 to 5, with one point being subtracted from 5 for each support used (hand/knee) and 0.5 for an unsteadiness execution.

The final SRT score was obtained by adding sitting and rising scores and stratified in five groups for analysis: 0–4, 4.5–7.5, 8, 8.5–9.5, and 10.

During a median follow-up of 12 years, there were 665 deaths (15%). There was a continuous trend for higher mortality with low SRT scores, with death rates of 4, 7, 11, 20, and 42%, respectively, for Groups 5 to 1 of SRT scores. That is, those with the greatest ability to perform the SRT maneuver had the lowest mortality in follow up.

 Natural and CV mortality was 4-6 fold higher in those with the worst SRT scores, even after adjusting for variables, when comparing the highest and lowest SRT score groups.

CONCLUSIONS

The SRT is a simple assessment tool that is influenced by muscular strength/power, flexibility, balance, and body composition.  Studies suggest it could add relevant clinical and prognostic information to routine examinations of healthy and unhealthy individuals.

The inflluence of the quality of performing the SRT test on long term survival was remarkable. The vast majority of perfect scorers were still alive at follow-up, compared with a little more than 9 in 10 of those who had lost two points and, dramatically, just under half of those with scores between 0 and 4.

If someone scores poorly, they might start working on their flexibility and balance. The test can provide a red flag for overall poor health. Weight training, balance training and improving flexibility can help improve performance of the test and, hopefully, improve long term outcomes