Chair To Stand Test And Falls Risk Screening

Why is the chair to stand test an important falls risk screening assessment? We explain what the test measures in detail, as well as how to set up and complete it. Indicating lower limb strength, the chair to stand test is a simple yet powerful predictor of falls risk, functional decline, and early mortality.

Falls are one of the most serious and common health risks for older adults. The mortality rate following hip fracture surgery is 30% within a year (Moran C. G. et al.; 2005). More than 300,000 people in the US sustain a hip fracture every year, according to the American Academy of Orthopaedic Surgeons. And in the UK, there are over 70,000 hip fractures a year, according to the Royal College of Physicians.

Recent data from the US National Vital Statistics System show that unintentional fall-related deaths among adults aged 65 and older have risen significantly between 2003 and 2023. This alarming trend underscores the urgent need to expand falls risk screening, improve access to prevention programs, and strengthen coordinated care for older adults.

Key takeaways: Chair To Stand Test

The test measures the strength and endurance of lower limb muscles, providing insights into mobility, balance, and independence in daily activities.
For example, a below average score for a 60 year old man is fewer than 14 repetitions and for a woman, fewer than 12.
The chair to stand test metric alone is not enough to classify a patient’s risk of falls. For example, the latest UK NICE guidelines recommend multifactorial assessment to guide intervention for patients at risk of falling in hospitals.
The combination of measuring grip strength, with US STEADI-recommended* assessments of gait speed, lower limb strength, and balance provides a comprehensive approach to objective falls risk assessment.
Able Assess is the first platform to combine these four key indicators of falls risk in one solution.

*STEADI (Stopping Elderly Accidents, Deaths & Injuries) is a program from the Centers for Disease Control and Prevention (CDC) that provides proven strategies for fall prevention in older adults.

What is the Chair To Stand Test (CST)?

Also known as the Chair Sit to Stand Test or the Sit Stand Sit (STS) test, it measures the strength and endurance of lower limb muscles. This test focuses on functional capacity and lower body strength, both critical components for mobility, balance, and independence in daily activities, particularly in older adults.

Regular assessment of lower limb strength helps identify at-risk individuals, promoting interventions that enhance functional independence and reduce falls risk (Kulkarni et al.; 2023 and Buatois et al.; 2008). The test is a widely used and validated measure in clinical and rehabilitation settings, providing reliable data on lower body strength and functional mobility (Bohannon; 1995 and Jones et al.; 1999).

A low score on the test can also help identify people at risk of worse outcomes after surgery (Gofus, J. et al; 2021) or after cancer treatment (Quadflieg K. et al; 2024). It may also indicate that a person’s heart and lungs are not functioning well enough (Vaidya T. et al; 2016), meaning they are at a higher risk of adverse cardiac events such as a heart attack, stroke or heart failure (Wang Z. et al; 2022).

How Does the Chair To Stand Test Work?

The following is a step-by-step guide to how the chair to stand test works using Able Assess, our falls risk screening platform. It counts how many times a person can stand up from a seated position and sit down again in 30 seconds, with below average scores indicating a risk of falls.

Our digital solution measures the test reliably and accurately. The control of the test can be carried out by an individual, or by an assessor on their behalf:

Taking the Chair To Stand Test

Choose the ‘Chair Stand Test’ option in the Able Assess app and prepare the items you will need for the test: the GripAble sensor, its accompanying waist bag, and an upright chair with a flat back.
Make sure the area in front of the chair is clear. Squeeze the GripAble sensor until a blue light turns on.
Place the GripAble sensor into the pocket of the belt bag provided and fasten the bag around your waist, buckling it at the front with the GripAble positioned on your lower back.
To start the test, while seated, press ‘Ready’ on the screen to begin the assessment and when you hear the beep, stand up. Then sit back down. Repeat as many times as possible in 30 seconds.
There will be two beeps when the test is finished. The GripAble device saves your data.

Here is a live demonstration of the test.

The results are compared to normative data for the patient’s age and biological sex, with below average scores for the age range indicating a risk of falls. For example, a below average score for a 60 year old man is fewer than 14 repetitions and for a woman of the same age, fewer than 12.

Below is an example of a person with average or above average scores, indicating a low risk of falling:

More Falls Risk Screening Measurements in Able Assess

Able Assess also captures three other integral measurements to help assess the risk of falls. Other key measurements available in the app that screen for the risk of falls include:

Grip Strength

Grip strength is measured using a hand dynamometer. It is a vital biomarker for senior care. Measuring full-body strength and physiological reserve, it is a very important assessment in falls risk screening. It is a core measure of functional health, reflecting muscle strength, bone density and balance, but also a key indicator of biological resilience for many chronic conditions.

Assessment: Single maximum grip strength test (SMGT): Measuring grip strength involves administering a SMGT, which assesses peak grip strength by recording the maximum force exerted in a single grip.

Dynamic Balance

Measurements of balance and functional mobility are extensively used in falls risk assessments to predict mobility impairments, frailty, and falls risk.

Assessment: Timed up and go (TUG) test: Assessing mobility as the patient stands up from a chair, walks to a line three meters away, turns, walks back and sits down again. An older adult taking more than 12 seconds to complete the TUG is at risk of falling, as per the CDC’s STEADI initiative.

Gait Speed

Indicating mobility and walking ability, gait speed is a simple yet powerful predictor of fall risk, functional decline, and early mortality.

A walking speed below 0.8 m/s for individuals aged 65+ indicates high fall risk and increased mortality, necessitating targeted interventions.

Assessment: 4 meter gait speed test: Timing how many seconds a patient takes to walk four meters, with below average scores indicating a risk of falls.

For more details, read out comprehensive guide: Able Assess as a Falls Risk Assessment Solution.

This video shows sample results from a patient at risk of falling. In this case, it is indicated by a below average score in the chair-to-stand test:

Able Assess: The Only Platform With Four Key Falls Risk Assessments

Falls are not only life-threatening but financially devastating. A single fall can cost up to $350,000+, much of it borne by Medicare and families. By preventing falls with effective early screening, healthcare providers can save lives, reduce hospitalizations, and cut avoidable costs.

This is why measuring grip strength has such an important role. It is an early indicator of overall physical health decline, in comparison to other recommended assessments that are used later on.

However, one test alone should not be used in isolation to identify patients at high risk of falls. The UK NICE guidelines recommend multifactorial assessment and intervention for patients at risk of falling in hospitals. Read our key takeaways for clinical practice in the NICE guidelines: falls prevention 2025 updates.

The Able Assess Falls Risk Screening platform is the first and only solution worldwide that is able to capture all four integral measurements accurately. However, the combination of measuring grip strength, lower limb strength, gait speed, and balance provides a comprehensive approach to falls risk assessment.

Able Assess delivers accurate, reliable and sensitive data for better decision-making. It measures the chair to stand test, a measure of mobility and walking ability that is extensively used in falls risk assessments to predict mobility impairments, frailty, and falls risk. In addition, it measures the TUG test, gait speed test, and the single maximum grip strength test (SMGT).

Able Care has designed the first falls risk screening tool that empowers every clinical and non-clinical staff member to deliver a standardized, objective, low-cost, data-driven assessment in under five minutes. It combines the best-in-class GripAble sensor with a user-friendly app, clinician-facing web portal and robust data model.