What Systematic recommends
Where to start
- Use a stable surface around standard household-chair height. Stand with your feet about shoulder-width apart and parallel, with full barefoot contact and awareness of the tripod points of contact through each foot.
- Hold a household object weighing approximately 5-10 pounds, such as a water bottle, in front of your sternum as a counterweight, keep the elbows slightly bent and keep the counterweight extended to help maintain a more vertical spine. Keep the counterweight under 10 pounds, and the farther it is held in front of you, the more assistance it provides.
- Practice 3 sets of 3-5 squats per set, using a 3-second lowering phase, pause for approximately 1 second at the bottom, and a 3-second return to standing, with approximately 1 minute rest between sets. Keep feet flat, allow knees to travel over feet, lightly touch the surface rather than sitting fully, and stand all the way back up after each repetition.
Condensed from the published Development Pathway (The Sitting-Rising Test: Counterbalance Tempo Target Squat). This is a starting point, not a training program or medical advice.
What it measures
Getting down to the floor and back up takes three things working together. Mobility: the hips, knees, ankles, pelvis and spine need enough usable motion. Stability: you have to control your body's center of mass as your base changes from the floor to your feet. And usable force: enough muscle strength left to finish the move without extra support.
Systematic tests it twice, once with each foot forward, and reports the difference between the two as an observation. No size of difference is currently treated as clinically significant or abnormal.
Why it matters with age
A systematic review of how people rise found that older adults often use different joint strategies, more trunk movement and more sway, with changes in how the leg muscles coordinate. It studied sit-to-stand from a chair, which is related to rising from the floor but is not the same task.
What the research shows, and what it does not
The sitting-rising test has been studied directly in middle-aged and older adults. In a prospective cohort, lower scores were associated with higher natural and cardiovascular mortality. That is an association, not proof that raising your score changes your outcome, and it is not a prediction for one person.
That study used the original single test. It supports the sitting-rising test itself, but it did not test Systematic's addition of a second attempt with the other foot forward.
A lost point does not tell you why. Needing a hand or a knee, or losing balance, shows that you needed an extra strategy, not which joint, muscle or nerve is responsible. Pain, an irritated or swollen joint, an old injury, changed sensation or protective muscle tension can all reduce how well muscles switch on and change how a person gets up. One documented example is arthrogenic muscle inhibition, where an injured or irritated joint dampens the muscles around it, but a low score does not diagnose it and it is not the explanation for every result.
How Systematic scores it
The published test uses a 0 to 10 scale with reference scores by age and sex. Those reference scores are context. Systematic's red, yellow and green bands are Systematic standards built on them, and the standards page shows how.
See the standards for your age and sex
The evidence
Each cited source is labeled according to how it supports the particular claim on this page. Direct test evidence, underlying-capacity findings and population reference values are distinguished from Systematic-defined protocols and standards. Historical development notes are retained internally rather than presented as public evidence. A study of an underlying capacity is never presented as validation of the Systematic test itself.
-
Direct test evidence
Araújo et al. (2026; published online 2025). Sitting–rising test scores predict natural and cardiovascular causes of deaths in middle-aged and older men and women. European Journal of Preventive Cardiology.
What it found. In a prospective cohort of middle-aged and older adults, lower Sitting-Rising Test scores were associated with higher natural and cardiovascular mortality.
What it does not show. It does not show that improving a score lowers mortality, it is not an individual prediction, and it did not test Systematic's two-sided version.
-
Underlying-capacity evidence
Sadeh et al. (2023). Biomechanical and neuromuscular control characteristics of sit-to-stand transfer in young and older adults: A systematic review with implications for balance regulation mechanisms. Clinical biomechanics (Bristol, Avon).
What it found. Older adults rising from a chair often used different joint strategies, more trunk movement and more sway, with altered leg-muscle coordination.
What it does not show. It studied sit-to-stand from a chair, not rising from the floor or the Systematic test.
-
Underlying-capacity evidence
Lepley et al. (2022; published online 2021). Mechanisms of Arthrogenic Muscle Inhibition. Journal of sport rehabilitation.
What it found. Describes arthrogenic muscle inhibition, one of several ways an irritated or injured joint can reduce how well nearby muscles switch on.
What it does not show. It does not show that a low Sitting-Rising Test score diagnoses arthrogenic muscle inhibition and does not support arthrogenic muscle inhibition as the universal explanation for poor performance.
-
Normative/reference evidence
Araújo et al. (2020; published online 2019). Sitting–rising test: Sex- and age-reference scores derived from 6141 adults. European Journal of Preventive Cardiology.
What it found. The published Sitting-Rising Test provides an age- and sex-referenced 0-to-10 composite framework.
What it does not show. Reference values provide context and do not constitute a Systematic score and do not show causation.
The Systematic Healthspan Assessment is a physical baseline. It is not a diagnosis, and it does not estimate a biological age, a disease risk or a lifespan.