Are sit-to-stand tests as safe and effective as walk tests for people with PH?

A study supported by the PHA UK has investigated whether a one-minute sit-to-stand test can be as effective as a walk test in assessing patients with pulmonary hypertension.

The PERSPIRE study was led by Carol Keen, a specialist physiotherapist at the Sheffield Pulmonary Vascular Disease Unit, and concluded in early 2022. Here, she explains the rationale, findings, and what future research in this area might look like:

“People with PH will be familiar with the walking tests that they do when they come to hospital – either the 6-minute Walk Test or the Incremental Shuttle Walk test, depending on which specialist centre they come to.  These tests form a part of the teams’ assessment of how patients are doing, and if any changes are needed to their treatment.

During the COVID-19 pandemic we did many more telephone and video consultations. These were really helpful when we couldn’t see patients, but of course we couldn’t do all the measures we do when people come to their specialist centre, including their walking tests. This got us wondering whether there was something similar to the walking test, but that people could do at home by themselves.

We looked at the different options and decided that the best was something called the one-minute sit-to-stand test.  It’s pretty simple – you stand up and sit down from a regular chair as many times as possible in one minute and count the number of times that you do it.

It’s a test that’s been used in other lung diseases, but never in PH before. So, we needed to do some research to see firstly if it safe for PH patients, and secondly if it compares well to the existing tests that we use.

75 patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension were recruited to this study.  They completed two exercise tests – the Incremental Shuttle Walk test and the one-minute sit-to-stand test. Both tests were completed in hospital on the same day, with a rest period of at least 30 minutes between them.


All of the patients completed the one-minute sit to stand test safely, and 97% said they would be happy to complete it at home as part of a remote assessment. 

The one-minute sit-to-stand test was found to be less physically demanding for patients, which also suggests it could be suitable for use as a home-based test. 

The findings also compare well with the Incremental Shuttle Walk test – people who recorded a short walk distance completed only a small number of sit-to-stands in one minute, while people who walked further were able to do more sit-to-stands.

A further sample of 11 patients completed the one-minute sit-to-stand test at home at a later date. These were also completed without any safety issues. 

As a result of the findings of this study, we think more work should be done to see if the one-minute sit-to-stand test could be used as part of remote risk assessment for these patients, to help in the management of their health, and we are looking into that research. 

As ever, the PHA UK and patients with PH played a crucial part in this research. They helped us design the study, checked that the information we were giving patients made sense, and were part of the group of people overseeing the study too. 

We ran the study in Sheffield, and the patients we asked to take part could not have been more supportive and helpful.  People gladly gave us their time if they were able to and were happy to be involved and make a contribution to this research which might benefit others.  We’d like to thank you all for your ongoing support of research in PH, and this study in particular.”