What a Chair Rise and a Handshake Reveal About How Well You Are Aging

Two Assessments, Five Minutes, and a Surprising Amount of Information

Standing up from a chair five times. Squeezing a handheld device as hard as you can. Neither movement looks like a medical test, yet both have been studied in hundreds of thousands of adults across dozens of countries, and both are now used clinically to estimate functional capacity, fall risk, and the trajectory of aging. The Five Times Sit-to-Stand Test (5xSTS) and the handgrip strength test cost almost nothing, require no laboratory, and produce a number you can act on the same day. That combination of simplicity and predictive power is why exercise physiologists at Pritikin use them, and why they are worth understanding before you are ever handed a dynamometer.

The Five Times Sit-to-Stand Test, Defined

The 5xSTS is a validated measure of lower-extremity functional performance. An individual rises from a standard chair to a full standing position and sits back down five times as quickly as possible, without using the arms for assistance. The total time to complete five repetitions is recorded, and shorter times indicate better functional performance. What sounds like a mundane task is actually a compressed assessment of several physical qualities at once.

What the Chair Rise Is Actually Measuring

The test evaluates a cluster of capacities that everyday life quietly demands:

• Lower-limb strength — the force your legs can produce against your body weight
• Muscle power — the ability to generate that force rapidly, which is what separates a smooth rise from a struggle
• Balance — the postural control required to transition between sitting and standing repeatedly
• Mobility — the joint range and coordination that make the movement efficient
• Rate of force development — how quickly your neuromuscular system can respond

Research has shown that 5xSTS performance is strongly associated with physical function, muscle power, frailty status, mobility limitations, and the ability to independently perform activities of daily living.

Why Standing Up Is a Bellwether for Independence

Rising from a chair is not an exercise. It is a prerequisite. Getting out of bed, off a toilet, up from a restaurant booth, or off the floor after playing with a grandchild all depend on the same movement pattern. That is why the 5xSTS has become one of the most commonly used functional assessments for older adults and individuals with mobility impairments, and why it appears across clinical, rehabilitation, and fitness settings to assess functional capacity, monitor change over time, identify fall risk, and evaluate whether an exercise intervention is working.

What Poor Performance Signals

Slow chair-rise times are not a matter of vanity. Poor 5xSTS performance has been linked to sarcopenia, frailty, increased risk of falls, disability, hospitalization, and loss of independence. Because the test reflects lower-limb muscle power so closely, it functions as an early indicator of age-related functional decline rather than a late one. The encouraging corollary is equally well documented: improvements in 5xSTS performance generally indicate enhanced lower-body function and better overall physical health.

How Researchers Established What “Normal” Looks Like

Interpreting a number requires context, and the reference data has improved dramatically in recent years. A pooled analysis published in GeroScience in 2026 by Grgic, Schoenfeld, Maier and colleagues established reference values for the 5xSTS in a large, population-representative sample drawn from 14 European countries, comprising 45,470 participants aged 50 and older. Participants stood and sat five times as quickly as possible with arms folded across the chest, and results were calculated across percentiles ranging from the 5th to the 95th, separated by sex. For younger adults, a 2024 cross-sectional study in Physiotherapy by Vilarinho and colleagues developed reference values for both the 1-minute sit-to-stand and the 5 times sit-to-stand tests. Together, these datasets allow a result to be placed within a peer group rather than judged in isolation.

What Actually Improves Chair-Rise Time

This is where the research becomes genuinely useful, because the most intuitive answer is not the best one. Evidence consistently shows that the most effective way to improve 5xSTS performance is through interventions that enhance lower-extremity power and the ability to generate force rapidly, rather than focusing solely on maximal strength. Approaches shown to improve sit-to-stand performance in older adults include:

• High-velocity resistance training
• Power-oriented resistance training
• Explosive concentric movements
• Velocity-monitored resistance training
• Plyometric exercise
• Programs combining power training with fast walking

Large reviews have found that high-velocity resistance exercise produces superior improvements in the 5xSTS and other functional tasks compared with traditional resistance training, and intervention studies show meaningful reductions in sit-to-stand time following power-focused programs. Training designed to move resistance quickly and explosively appears to be particularly effective for chair-rise ability. This is precisely the kind of nuance that a well-designed exercise program is built to deliver, and it is why generic advice to “lift weights” leaves value on the table.

Handgrip Strength: A Small Measurement With Broad Reach

The handgrip strength test evaluates the integrated performance of the muscles by determining the maximal grip force produced in a single muscular contraction, which serves as a marker for general muscle strength. Muscular strength is a powerful marker of current health status and a predictor of age-related disease and disability, and grip is the most practical way to capture it. The measurement takes seconds, requires one instrument, and travels anywhere.

The Scale of the Evidence Base

The normative data behind grip strength is unusually robust. A 2025 systematic review published in the Journal of Sport and Health Science by Tomkinson, Lang, Rubín and the international handGRIP Strength (iGRIPS) Group searched six databases for peer-reviewed observational studies reporting normative handgrip data in adults aged 20 and older. The review captured 100 studies covering roughly 2.4 million adults from 69 countries and regions, tested from 2000 onward. The result is a set of normative values for absolute handgrip strength in kilograms by age and sex, alongside normalized values that divide grip strength in kilograms by height in meters squared. Earlier work contributed as well: the Prospective Urban Rural Epidemiologic (PURE) study, published by Leong and colleagues in 2016, established reference ranges from 125,462 healthy adults across 21 countries.

What Grip Strength Predicts

An umbrella review of systematic reviews with meta-analyses of observational studies, published by Soysal and colleagues in the Journal of Sport and Health Science, examined handgrip strength against a wide range of health outcomes. Three findings stood out clearly:

• Lower all-cause mortality among those with higher grip strength
• Lower cardiovascular mortality
• Lower risk of disability

Grip strength is also a rapid, simple measure that helps stratify an individual’s risk of developing cardiovascular disease or susceptibility to death from an incident illness. Beyond risk estimation, grip measures carry excellent clinical utility because they appear in decision algorithms and assessment criteria for identifying sarcopenia, dynapenia, and frailty.

Why Grip Says Something About Your Legs

One of the more counterintuitive findings is that grip strength reflects muscle strength in other muscle groups, including the lower body. The umbrella review found suggestive evidence that the handgrip test may be a good indicator of chair rise performance over time. Higher grip strength is associated with better chair rise performance in both men and women, which means grip can serve as an indicator of leg power. Work from the HALCyon programme, published by Hardy, Cooper, Aihie Sayer and colleagues in PLOS ONE, examined body mass index, muscle strength, and physical performance across eight cohort studies of older adults, contributing to this broader picture of how strength measures relate to function. This relationship is exactly why the two assessments are more informative together than either is alone.

Grip Strength as a Nutrition Signal

There is a second reason clinicians value grip. Because muscle function reacts early to nutritional deprivation, hand grip strength has become a popular marker of nutritional status. Work by Norman, Stobäus, Gonzalez and colleagues in Clinical Nutrition documented that short-term effects of nutritional therapy are visible in muscle function before changes in body composition appear. In practice, grip strength can demonstrate improvement from a nutritional intervention weeks before the scale or a body composition scan reflects it. For anyone changing how they eat, that makes grip a faster feedback loop than weight, and it is one reason nutrition and physical assessment belong in the same conversation rather than in separate appointments.

When Grip Peaks, and What Happens Next

The international norms data describes a clear trajectory. Grip strength improves through early adulthood, peaks between ages 30 and 39, and declines afterward. The age-related decline accelerates from middle to late adulthood and is slightly larger for males than females during middle adulthood. Knowing that the curve bends downward by default reframes the goal: the objective is not to avoid aging but to change the slope of that line through deliberate training.

How to Build Grip Strength

Strength training has consistently produced statistically significant improvement in handgrip strength, and meta-analysis has found consistent gains following resistance training programs in older adults. Two complementary approaches are supported:

• Compound resistance training — deadlifts, rows, pull-ups, and a range of dumbbell exercises all challenge the hands while training the larger muscles that drive whole-body function
• Hand-focused training — wrist curls, plate pinches, and hammer curls produce small to moderate improvements in grip strength and large gains in manual dexterity

Notably, hand-focused training effects were observed more in older adults than in younger populations, which may reflect lower baseline strength and dexterity and a higher potential for neuromuscular adaptation. In other words, the people most often told it is too late frequently have the most to gain.

Testing Without a Plan Changes Nothing

A number by itself is inert. The value of an assessment lies in what happens in the following hours: interpretation against appropriate reference data, identification of the specific capacity that is limiting performance, and a program targeted at that limitation. This is the logic behind how the Pritikin Program works — establish where someone is, help them understand what the results mean, intervene, and measure again.

Where These Assessments Fit at Pritikin

At the Pritikin Longevity Center in Miami, Florida, functional testing is not a standalone service but one input among many. Exercise physiologists use insight from biomechanical and functional assessments to design personalized plans for strength training and cardiovascular fitness sessions, supported by physicians for guests with medical needs. Small-group training pairs guests with others of similar ability, and more than 40 electives — including yoga, indoor cycling, aquatics, and Pilates — give people room to find movement they will actually continue. Because chair-rise performance responds best to power-oriented work, that emphasis can be built directly into a plan rather than left to chance.

The Nutrition Half of the Equation

Muscle responds to what you feed it, which is why the Pritikin Eating Plan sits alongside the exercise program rather than beneath it. The approach centers on minimally processed, nutrient-rich, mostly plant-based whole foods with healthy amounts of lean animal protein such as fish, prepared without added salt, sugar, or fat. Guests work with registered dietitians and put the principles into practice in a hands-on cooking school with the executive chef, so the skills survive the trip home. Given that grip strength registers nutritional change early, this pairing is not incidental.

Recovery, Sleep, and the Capacity to Adapt

Adaptation happens during rest, not during effort. The recovery and resilience component addresses sleep quality, stress, and physical restoration through stretching classes, massage, cold therapy, and access to physical therapists. For anyone attempting to build power in their sixties or seventies, recovery is often the variable that determines whether training produces progress or accumulated fatigue.

Results That Have Been Documented, Not Asserted

Pritikin is the only resort-based program with results documented in more than 100 peer-reviewed medical journals. Among the published results: 83% of guests no longer needed blood pressure medication, 54% of type II diabetics reached non-diabetic levels, LDL cholesterol fell by an average of 23%, and 60% of participants no longer had metabolic syndrome. Leading journals including the New England Journal of Medicine and Archives of Internal Medicine have documented outcomes from the program. That evidentiary standard is a central reason Pritikin compares favorably to other wellness retreats, where clinically proven programs and standard physician involvement remain rare.

What a Stay Actually Looks Like

The Pritikin experience unfolds on an 800-acre tropical resort and includes physician consultations, more than 30 weekly wellness education classes, small-group exercise, and advanced medical and performance testing, with no resort fees, taxes, or gratuities added at checkout. Guests arrive with different goals — sustainable weight loss, better glucose control, lower cholesterol, or simply the ability to move well for another few decades — and leave with a plan built for their life rather than a generic protocol. For readers thinking specifically about muscle and aging, Pritikin’s article on how muscle mass predicts longevity after 60 is a useful next read.

Take the First Step

If a chair rise or a grip reading has you curious about where you stand and what you could change, a Pritikin Program Advisor can walk you through it. Advisors help you clarify your goals, tailor a program to your medical history and fitness level, and provide an all-inclusive price with no hidden fees. Book a consultation at your convenience, or call (800) 327-4914 to speak with an advisor directly.