For thousands of years, humans have been squatting and sitting on the floor. Children naturally sit on the floor as do our primate cousins.

The majority of the population in Asia and Africa continue to sit on the floor on a daily basis, for various activities such as working, eating or simply resting.

Children often rest by sitting freely and comfortably on the floor, but something happens along the way where the adults in the Western world “grow out of it” and are eventually unable to do this fundamental task.

In this study, 2000 adults aged 51-80 years were asked to perform a sitting-rising test (SRT) to and from the floor, which was scored from 0 to 5, on the way down and 0 to 5 coming back up.

The subjects were the followed for 6 years and in that period 159 of them died of various illnesses.

 Conclusion: The inability to easily sit and stand up from the floor was a predictor of serious illnesses, as it appears to be a good indicator of the overall strength and health of a person.


“The sitting-rising test (SRT) to and from the floor, was a significant predictor of mortality in 51-80-year-old subjects.” – Brito et al., 2012

Try this yourself now. Stand up and sit on the floor without using any hands and without kneeling. If you can go down without any support, you score 5/5 and if you get back up without any support, you score 5/5 again, which is a total of 10/10.

However, if you have to place one hand on the floor to get down you lose a point so you get 4/5. If you need to use one hand to get up, you lose another point so you get 4/5, which is a total of 8/10.

If you need to use one hand and one knee on the ground, you lose 2 points, meaning you now get a score of 3/5 for each way. If you require the use of both hands and both knees, you lose 4 points which means you get score of 1/5 on the way down and 1/5 on the way up. Each time you lose your balance and lack control, you lose ½ a point.

If a patient can’t even sit on the floor, never mind getting back up, the score will be 0/10.

This study concluded, if you get 8, you are doing great! …meaning the risk of death within 6 years was improbable. However if you score less than 5, the risk of death is high!

Please do not panic if you had to use your hands or knees to do the SRT, it does not mean that you are going to get ill. An association does NOT mean cause and effect.

However, do not underestimate the value of sitting on the floor and getting back up again, so make a point of doing it few times every day. Ideally try to use only one hand on the floor for support but if needed, you may certainly use both hands.

Since I have found fear to be a common limiting factor, I frequently demonstrate floor sitting using 2 hands and have my patients copy me. It is amazing how they improve in their speed and confidence by the fifth attempt.

They are often very pleased when they realize that they can do this task and I end up giving them a high five. Perhaps with the COVID stuff I may have to stop giving high fives for a while.

Reference: Brito LB et al Ability to sit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 2014 Jul;21(7):892-8.
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