It seems a simple enough challenge: Sit down on the floor and get back up without the help of your hands or knees. Try it, though, and you might discover it’s not as easy as it sounds.
This “sitting-rising” exercise was designed to predict mortality in middle-aged and older people. The test was devised by a team led by Claudio Gil Araújo, a Brazilian physician and researcher in exercise and sports medicine, and published in the European Journal of Cardiovascular Prevention in 2012. It resurfaces periodically in media outlets or online, causing widespread alarm regarding mortality among the many people (of all ages) who can’t seem to get themselves off the ground. We decided to find out whether that worry is warranted.
How to do it
The test requires you to lower yourself to the floor, crisscross style, without bracing yourself with your hands, knees, arms, or sides of your legs. If you can stand back up, again without the aid of those body parts, you’ve scored a perfect 10 (five points for sitting, five points for standing). You lose a point every time you support yourself with a forbidden joint or appendage.
The researchers tested 2,002 adults 51 to 80 years old, and then followed them until a participant died or until the study concluded, which was a median of 6.3 years. In that time, 159 people died — only two of whom had scored a perfect 10. Those who had the lowest score of zero to three points had a risk of death that was five to six times higher than those who scored eight to 10 points.
Sure, the test is a good measure of leg and core strength, as well as balance. Older adults who have such muscular strength and flexibility are less likely to fall. And falls are the leading cause of unintentional-injury-related deaths for people ages 65 and older, according to the Centers for Disease Control and Prevention.
But what if you can’t do it? Are you doomed? Should you plan for an early demise?
Luckily, a few more variables apply to our health (and our longevity) than those this particular test focuses on. It’s important to remember that the study results are most relevant to those the same age as the subjects in the testing group, who were ages 51 and up — a point often lost in discussion. Most of the people who scored the lowest on the test were in the 76-to-80 age range, a group that generally experiences decreased mobility and coordination. The research also didn’t reveal the causes of the 159 deaths during the follow-up period. Should we assume they all died of complications from falling, instead of cardiovascular disease or cancer? We don’t know.
It’s not completely bogus
The exercise serves as one method of screening an individual’s loss of muscle in the aging process, known as sarcopenia, said Greg Hartley, president of the Academy of Geriatric Physical Therapy and assistant professor at the University of Miami Miller School of Medicine. That decline leads to other mobility problems, which decreases quality of life, he said.
“Frailty, strength, muscle mass, physical performance — those things are all correlated to mortality, but I would caution everybody that correlation doesn’t mean causation,” Hartley said. “For example, if somebody had a really bad knee and there’s no way they could do the test, just because that person has a really bad knee doesn’t mean they’re going to die soon.”
Barbara Resnick, professor and chair of gerontology at the University of Maryland, said the ability to get off the floor is valuable but “it’s really pretty hard for anybody” if you’re not using your hands. Failure may be because of something as simple as where you carry your weight, she said. If you have a thicker midsection, getting off the floor might be challenging. But unless body composition is a sign of other health problems, such as obesity, you’re probably not going to die of it.
“[A high score] is a sign that at that point in time, you’re in pretty good physical condition in terms of muscle strength, but I do not believe it’s a predictor of longevity,” Resnick said. “There’s a genetic component. Some people are just stronger physiologically and more coordinated than others.”
If you’re sitting on the floor worried because you can’t get up, the good news is that barring complications such as arthritis or vestibular (inner ear) problems, you can work on it, and you’ll likely improve over time.
Bottom line? Get moving.
Once you’ve peeled yourself off the ground following the sit-rise test, use your newfound sense of defeat to get stronger and improve your fitness. The U.S. Department of Health and Human Services recently released new guidelines for physical activity, suggesting that adults 65 and older break their 150 to 300 minutes of exercise each week into short bouts of activities that focus on balance, aerobic exercise and muscle strengthening.
The key is to find forms of exercise you enjoy — or find purpose in doing what you may not like to do.
“If I tell a patient to exercise because it’s going to improve cardiovascular health, it doesn’t motivate them,” Hartley said. “What motivates them is the ability to go to a grandchild’s kindergarten graduation. What do you really care about? What do you want to be able to do?”
It’s also never too early or too late in life to start or increase physical activity — it’s beneficial and increases life expectancy no matter when you do it. Aim for 30 minutes of moderate exercise a day, Resnick said.
Read the entire article by Erin Strout at The Washington Post.