The sit to stand to sit postural transition variability in the five time sit to stand test in older people with different fall histories

•The sit to stand to sit (STSTS) transition variability is analyzed in older people.•The first STSTS transition is compared to the last transition.•The variability is measured using DTW method.•Older fallers have significantly larger STSTS variability compared to older non-fallers.•There is a significant correlation between STSTS variability and BBS. It has been proved that increased motion variability can be indicative of lack of stability. Despite the extensive literature on single sit to stand/stand to sit postural transitions analysis in older people, no studies to this date have assessed the sit to stand to sit (STSTS) transition variability in older adults. To investigate the variability in STSTS transition during the five times sit to stand (FTSS) test in older people with different fall histories. Seventy-five older (80.5 ± 7.5) and twenty-five younger (27.7 ± 6.5) subjects participated in the study. The older participants were categorized into three groups of non-fallers, once-fallers, and multiple-fallers based on their fall histories. Subjects were fitted with an IMU at their lower backs and asked to fully stand up and then sit down again five times in a row. The angular rotation of the trunk in the sagittal plane was recorded. Using the DTW method, the first STSTS transition of each subject was compared to the last transition and the variability was measured. The correlation between STSTS variability and older participants’ Berg balance scale (BBS) was investigated. The STSTS variability results were significantly different in older fallers (multiple-fallers and once-fallers) compared to both younger participants and older non-fallers. The results yielded a sensitivity of 85.4 % and a specificity of 83.3 % in recognizing older fallers from older non-fallers and a sensitivity and specificity of 86.7 % and 85.7 % respectively in recognizing older multiple-fallers from other older participants. The STSTS variability was found to be significantly correlated with BBS. The findings demonstrated a strong indication of variability in the STSTS transition in older fallers and a significant correlation between STSTS variability and BBS. The results suggest that variability analysis of the STSTS transition has the potential to be used for fall risk analysis in older adults.