STANDING ON ONE LEG AND RISING FROM THE FLOOR: WHAT THE MORTALITY STUDIES MEASURED

Two of the simplest physical checks in the research literature need no equipment at all: standing on one leg for ten seconds, and sitting down on the floor and getting back up. A Brazilian research group has followed thousands of adults in their fifties, sixties, and early seventies after these tests, and in their cohorts the people who struggled with them died at higher rates over the following years. Here's what those studies measured, what they didn't, and what the training research does and doesn't show.

The Ten-Second One-Leg Stand

Araújo and colleagues published this cohort in 2022 in the British Journal of Sports Medicine. They tested 1,702 adults aged 51 to 75, 68% of them men, between 2008 and 2020, and recorded one thing: could the person complete a ten-second stance on one leg, or not?

One in five, 20.4%, could not. Over a median follow-up of seven years, 4.6% of those who completed the stance died, compared with 17.5% of those who didn't. After adjusting for age, sex, body mass index, and comorbidities, the hazard ratio for all-cause mortality in the group that could not complete the test was 1.84 (95% CI 1.23 to 2.78). The authors also reported that adding the test to a model of established risk factors improved how well that model predicted death.

The authors named their own limitation in the conclusion: the analysis did not control for variables such as a recent history of falls or physical activity levels.

Sitting Down and Getting Back Up

The same group scores the sitting-rising test from 0 to 10: five points for sitting down to the floor, five for getting back up. In their most recent paper, a point comes off each half for every hand or knee used for support, and half a point comes off for an unsteady execution.

Their first mortality analysis, a retrospective cohort published in 2014 in the European Journal of Preventive Cardiology (Brito et al.), covered 2,002 adults aged 51 to 80, again 68% men. Over a median 6.3 years there were 159 deaths. Lower scores were associated with higher mortality. Compared with the top scoring group (8 to 10), adjusted hazard ratios ran 5.44, 3.44, and 1.84 moving from the lowest scores upward, and each one-point increase in score was associated with a 21% improvement in survival.

A larger follow-up by Araújo and colleagues, published online in 2025 in the same journal, tested 4,282 adults aged 46 to 75 and followed them for a median of 12.3 years. There were 665 deaths from natural causes, with COVID-19 and external causes excluded. Death rates climbed steadily as scores fell: 3.7% among those scoring a perfect 10, then 7.0%, 11.1%, 20.4%, and 42.1% among those scoring 0 to 4. Comparing the lowest and highest groups after adjustment, the hazard ratio was 3.84 (95% CI 2.25 to 6.97) for natural-cause death and 6.05 (95% CI 2.29 to 20.94) for cardiovascular death. That second confidence interval is very wide, which means the cardiovascular estimate is much less precise than the headline figure suggests.

The authors describe the test as one influenced by several things at once: muscular strength and power, flexibility, balance, and body composition.

What These Studies Can and Can't Tell You

All three are observational cohorts. They show that performance on these tests was associated with survival, not that the test performance itself caused anything. A difficult floor rise may simply be a visible sign of lower strength, stiffer joints, higher body weight, or illness that hasn't been diagnosed yet.

All three papers also come from the same research group, led by Claudio Gil Araújo, and every one of these cohorts was about two-thirds men.

A broader picture comes from a 2010 systematic review and meta-analysis in the BMJ by Cooper and colleagues, which pooled published and unpublished data on grip strength, walking speed, chair rising, and standing balance. They found consistent associations between poorer performance on all four and higher all-cause mortality, with real heterogeneity between studies. Comparing the weakest and strongest quarters of grip strength, the summary hazard ratio was 1.67 (95% CI 1.45 to 1.93); for the slowest versus fastest quarter of walking speed, 2.87 (95% CI 2.22 to 3.72). The authors noted one limit that matters for this audience: the walking speed, chair-rising, and standing-balance studies had all been done in older populations averaging over 70. Only grip strength had been studied in groups averaging under 60. (WPP has covered the grip strength data separately.)

These studies were designed to predict outcomes in populations, not to classify individuals. None of them provides a personal cutoff that tells any one reader what their own result means. If a result concerns you, that's a conversation for your physician.

Does Training Balance Change the Outcome?

This is the question the studies above don't answer, and it's worth being precise about why.

Balance itself is trainable. A 2015 Sports Medicine systematic review and meta-analysis by Lesinski and colleagues pooled 23 randomized controlled trials in healthy, community-dwelling adults aged 65 and older. Balance training improved static balance (SMD 0.51), dynamic balance (0.44), proactive balance (1.73), reactive balance (1.01), and scores on balance test batteries (1.52). The authors' dose-response analysis found the largest effects with training periods of 11 to 12 weeks, three sessions per week, 31 to 45 minutes per session, and 91 to 120 minutes per week in total.

The authors attached real caveats. Those dose findings came from comparing across studies rather than testing doses head to head within one trial, the included trials had a mean PEDro quality score of 5, and heterogeneity was high (I² of 76% to 92%). The outcomes were also balance-test performance, not falls, not hospital admissions, and not survival.

What I could not find, after searching PubMed directly, is a trial showing that improving a person's one-leg stand or sitting-rising score changes their mortality. The cohorts show that the scores were associated with survival, and the training trials show that balance performance can be improved. No study I found connects those two findings.

For which types of exercise have actually reduced falls in trials, see WPP's review of the fall-prevention evidence.

The Protocol

• The tests, as the researchers ran them: a ten-second stance on one leg, and a floor sit and rise scored 0 to 10, with a point off each half for every hand or knee used and half a point off for unsteadiness. If you try either one, do it beside a counter or with someone nearby. Both carry a fall risk by design.
• The balance-training dose the trials used: roughly 11 to 12 weeks, three sessions per week, 31 to 45 minutes per session, per the Lesinski meta-analysis in adults 65 and older.
• What the floor test represents: in its authors' own description, a combination of strength, power, flexibility, balance, and body composition. That makes it a snapshot of several capacities at once, not a balance-only measure.
• What hasn't been shown: that raising your score changes your risk. The association showed up consistently in these cohorts; I found no trial testing a cause-and-effect link.

Battle Hard. — Will Power