Ability to sit and rise from the floor as a predictor of all-cause mortality

Background: While cardiorespiratory fitness is strongly related to survival, there are limited data regarding musculoskeletal fitness indicators. Our aim was to evaluate the association between the ability to sit and rise from the floor and all-cause mortality. Design: Retrospective cohort. Methods: 2002 adults aged 51–80 years (68% men) performed a sitting-rising test (SRT) to and from the floor, which was scored from 0 to 5, with one point being subtracted from 5 for each support used (hand/knee). Final SRT score, varying from 0 to 10, was obtained by adding sitting and rising scores and stratified in four categories for analysis: 0–3; 3.5–5.5, 6–7.5, and 8–10. Results: Median follow up was 6.3 years and there were 159 deaths (7.9%). Lower SRT scores were associated with higher mortality (p < 0.001). A continuous trend for longer survival was reflected by multivariate-adjusted (age, sex, body mass index) hazard ratios of 5.44 (95% CI 3.1–9.5), 3.44 (95% CI 2.0–5.9), and 1.84 (95% CI 1.1–3.0) (p < 0.001) from lower to higher SRT scores. Each unit increase in SRT score conferred a 21% improvement in survival. Conclusions: Musculoskeletal fitness, as assessed by SRT, was a significant predictor of mortality in 51–80-year-old subjects. Application of a simple and safe assessment tool such as SRT, which is influenced by muscular strength and flexibility, in general health examinations could add relevant information regarding functional capabilities and outcomes in non-hospitalized adults.

[1]  L. Lipsitz,et al.  High-intensity strength training in nonagenarians. Effects on skeletal muscle. , 1990, JAMA.

[2]  B. Franklin,et al.  American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. , 2011, Medicine and science in sports and exercise.

[3]  CLAUDIO GIL ARAUJO,et al.  Prolapso da valva mitral em mulheres adultas: características clínicas, fisiológicas e cineantropométricas , 2007 .

[4]  Wim G. M. Janssen,et al.  Determinants of the sit-to-stand movement: a review. , 2002, Physical therapy.

[5]  Thomas Kirk Cureton,et al.  Flexibility as an Aspect of Physical Fitness , 1941 .

[6]  S. Blair,et al.  A prospective study of muscular strength and all-cause mortality in men with hypertension. , 2011, Journal of the American College of Cardiology.

[7]  U S Nayak,et al.  Balance in elderly patients: the "get-up and go" test. , 1986, Archives of physical medicine and rehabilitation.

[8]  W. Frontera,et al.  Skeletal muscle fiber quality in older men and women. , 2000, American journal of physiology. Cell physiology.

[9]  L. Bouter,et al.  Measuring functional limitations in rising and sitting down: development of a questionnaire. , 1996, Archives of physical medicine and rehabilitation.

[10]  Joel E. Cohen,et al.  Human Population: The Next Half Century , 2003, Science.

[11]  M. Sjöström,et al.  Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study , 2008, BMJ : British Medical Journal.

[12]  N. Alexander,et al.  Decreased Muscle Strength Relates to Self-Reported Stooping, Crouching, or Kneeling Difficulty in Older Adults , 2010, Physical Therapy.

[13]  Suzanne G. Leveille,et al.  Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[14]  CLAUDIO GIL ARAUJO Flexibility assessment: normative values for flexitest from 5 to 91 years of age. , 2008, Arquivos brasileiros de cardiologia.

[15]  Javaid Nauman,et al.  Temporal changes in resting heart rate and deaths from ischemic heart disease. , 2011, JAMA.

[16]  S. Studenski,et al.  Gait speed and survival in older adults. , 2011, JAMA.

[17]  B. Rowlands,et al.  Hand grip strength--a simple prognostic indicator in surgical patients. , 1985, JPEN. Journal of parenteral and enteral nutrition.

[18]  A. Bergland,et al.  Risk factors for serious fall related injury in elderly women living at home , 2004, Injury Prevention.

[19]  M. Marmot,et al.  Association of walking speed in late midlife with mortality: results from the Whitehall II cohort study , 2012, AGE.

[20]  Manish Prakash,et al.  Exercise capacity and mortality among men referred for exercise testing. , 2002, The New England journal of medicine.

[21]  L. Vianna,et al.  AGE‐RELATED DECLINE IN HANDGRIP STRENGTH DIFFERS ACCORDING TO GENDER , 2007, Journal of strength and conditioning research.

[22]  C. Davies,et al.  Different effects of ageing on the mechanical properties of human arm and leg muscles. , 1984, Gerontology.

[23]  CLAUDIO GIL ARAUJO Teste de sentar-levantar: apresentação de um procedimento para avaliação em Medicina do Exercício e do Esporte , 1999 .

[24]  CLAUDIO GIL ARAUJO,et al.  Teste de sentar-levantar: influência do excesso de peso corporal em adultos , 2001 .

[25]  R. Saggini,et al.  Sarcopenia: Age-Related Skeletal Muscle Changes from Determinants to Physical Disability , 2006, International journal of immunopathology and pharmacology.

[26]  N. Alexander,et al.  Rising from the Floor in Older Adults , 1997, Journal of the American Geriatrics Society.

[27]  CLAUDIO GIL ARAUJO,et al.  Autopercepcao corporal de variaveis da aptidao fisica relacionada a saude , 2002 .

[28]  CLAUDIO GIL ARAUJO,et al.  Does Flexibility Influence the Ability to Sit and Rise from the Floor? , 2013, American journal of physical medicine & rehabilitation.

[29]  Demosthenes B Panagiotakos,et al.  Exercise capacity and mortality in older men: a 20-year follow-up study. , 2010, Circulation.

[30]  J C Wall,et al.  The Timed Get-up-and-Go test revisited: measurement of the component tasks. , 2000, Journal of rehabilitation research and development.

[31]  CLAUDIO GIL ARAUJO,et al.  Avaliação da flexibilidade: valores normativos do flexiteste dos 5 aos 91 anos de idade , 2008 .

[32]  J. Myers,et al.  Heart rate recovery, exercise capacity, and mortality risk in male veterans , 2012, European journal of preventive cardiology.

[33]  C. Goldsmith,et al.  Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta‐Analysis , 2004, Journal of the American Geriatrics Society.

[34]  Suzanne G. Leveille,et al.  Disability, physical activity, and muscle strength in older women: the Women's Health and Aging Study. , 1999, Archives of physical medicine and rehabilitation.

[35]  CLAUDIO GIL ARAUJO,et al.  Teste de sentar-levantar: Estudos de fidedignidade , 2008 .

[36]  I. Tabata,et al.  Poor trunk flexibility is associated with arterial stiffening. , 2009, American journal of physiology. Heart and circulatory physiology.

[37]  H. Kohl,et al.  Changes in Physical Fitness and All-Cause Mortality: A Prospective Study of Healthy and Unhealthy Men , 1995 .

[38]  P O Riley,et al.  Biomechanical analysis of failed sit-to-stand. , 1997, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.