60-Second Sit-to-Stand Test Valid for Exercise Assessment in Acute Exacerbations of COPD: Study
Written By : Medha Baranwal
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2026-09-17 01:30 GMT | Update On 2026-09-17 10:06 GMT
Australia: In a new study, the 60-second sit-to-stand test (60STS) was found to be a valid and responsive measure of exercise performance in patients hospitalized with acute exacerbations of COPD (AECOPD). It may serve as a practical alternative to the 6-minute walk test (6MWT), although its inherent limitations should be considered.
Published in Respiratory Medicine, the study by Olivia McDonald, Department of Physiotherapy, Monash University, Melbourne, Australia, and colleagues assessed whether the 60STS could reliably evaluate exercise performance in people recovering from AECOPD. The test is increasingly used because it requires minimal space and equipment and can be completed quickly, potentially making it useful in hospital settings where conventional walking tests may be difficult to perform.
The prospective cohort study included 54 patients hospitalized with AECOPD. Of the participants, 53% were male, with a mean age of 69 years and a mean forced expiratory volume in one second (FEV1) of 46.5% of the predicted value. Participants underwent the 60STS and 6MWT before hospital discharge, with the sit-to-stand assessment conducted 30 minutes after the walking test. A subgroup of 39 patients underwent repeat testing one month later.
Researchers compared the number of repetitions completed during the 60STS (60STSr) with 6-minute walk distance (6MWD), while also examining heart rate, oxygen saturation, perceived breathlessness and perceived exertion. Statistical analyses assessed concurrent, convergent, predictive, and discriminant validity, as well as responsiveness to changes in exercise performance.
Key findings
- 60STSr was strongly correlated with 6MWD at discharge, with a correlation coefficient of r = 0.61, supporting concurrent validity.
- Bland-Altman analysis showed acceptable agreement between the tests for nadir oxygen saturation, peak heart rate, Borg dyspnoea scores and perceived exertion, although the limits of agreement were wide.
- Patients with poorer 60STS performance were older, had weaker quadriceps muscles and achieved shorter 6MWD compared with better-performing participants.
- However, 60STSr did not remain a significant predictor of 6MWD after adjustment for potential confounding factors in multivariate regression analysis.
- At one-month follow-up, 80% of patients who improved their 60STS performance also achieved an improvement of more than 30 metres on the 6MWT, indicating good responsiveness.
The researchers noted that the findings provide evidence for concurrent, convergent and discriminant validity of the 60STS in people recovering from AECOPD. Its ability to detect changes over a relatively short period also supports its potential usefulness for monitoring recovery following hospitalization.
The study has limitations, including the relatively small sample and wide limits of agreement between some 60STS and 6MWT measures. The test should therefore not be viewed as an exact substitute for the 6MWT in every clinical situation. Nevertheless, its simplicity, low cost and minimal space requirements could make the 60STS a practical option for assessing exercise performance in patients with AECOPD, particularly when a walking test is difficult to administer.
Reference:
McDonald, O., Perraton, L., & Osadnik, C. (2023). Validity and clinical applicability of the 60-second sit-to-stand test in people with acute exacerbations of COPD. Respiratory Medicine, 107264. https://doi.org/10.1016/j.rmed.2023.107264
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