Measurement properties of the sit-to-stand test in community-dwelling people with chronic obstructive pulmonary disease: a COSMIN systematic review

Clinical Snapshot

Key Findings

• P Value: Not applicable - measurement property assessment

• Effect Size: Not applicable - measurement property study

• Primary Outcome: Measurement properties (validity, reliability, responsiveness) of seven unique STS test variants

• Nnt Or Sensitivity: 1-minute STS test: high-quality evidence for construct validity; 30-second STS test: moderate-quality evidence for responsiveness

• Confidence Interval: Not applicable - qualitative synthesis using COSMIN framework

Clinical Application

Highly feasible - STS tests require minimal equipment, space, and time; suitable for routine clinical assessment Directly applicable to Australian COPD management pathways, pulmonary rehabilitation programs, and RACGP chronic disease management plans Community-dwelling adults with COPD across all severity levels in primary care, respiratory clinics, and pulmonary rehabilitation settings

Abstract

BACKGROUND: The sit-to-stand (STS) test can assess physical function in people with chronic obstructive pulmonary disease (COPD); however, there are multiple versions. No study has used current guidelines to assess the measurement properties of the STS tests in people with COPD. METHODS: We conducted a systematic review using current COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Full text peer-reviewed publications were included if they assessed the measurement properties (validity, reliability and/or responsiveness) of at least one STS test among community-dwelling people with COPD. We searched six databases and imported results into Covidence where title/abstract screening and full text selection was completed independently and in duplicate. Extraction was conducted independently and in duplicate using the COSMIN extraction file. We assessed study risk of bias (very good, adequate, doubtful or inadequate), measurement property quality (sufficient, indeterminate or insufficient) and overall certainty of evidence (high, moderate, low or very low) using the COSMIN recommended tools. RESULTS: We assessed 2577 titles/abstracts and 102 full texts for inclusion; 30 publications met eligibility. Seven unique STS tests were located with the most common being the 1 min STS test (n=14, 39%), 5-repetition STS test (n=10, 28%) and the 30 s STS test (n=8, 22%). Where assessed, reliability was sufficient for the 1 min, the 5-repetition and the 30 s STS tests. Only the 1 min STS test had high-quality evidence of sufficient construct validity, while the 30 s STS test was the sole test with at least moderate quality evidence of sufficient responsiveness. CONCLUSIONS: The 1 min STS test has the most robust measurement properties for cross-sectional assessments while the 30 s STS test is more robust to assess change.

References

1. 1.Farley, C., Newman, A. N. L., Phillips, S. M., Smith-Turchyn, J., & Brooks, D. (2026). Measurement properties of the sit-to-stand test in community-dwelling people with chronic obstructive pulmonary disease: a COSMIN systematic review. Thorax. https://doi.org/10.1136/thorax-2025-223967