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Episode 99: Inbetweenie - Is the Sitting-Rising Test a Lifespan Predictor - or Just Hype?
372 Plays8 hours ago
In this 'Inbetweenie' episode of the Movement Logic podcast, Sarah delves into the widespread misinterpretation of a 2014 research study titled 'Ability to Sit and Rise from the Floor as a Predictor of All-Cause Mortality.' Popularly known as the Sitting Rising Test (SRT), the study has been sensationalized in the media and on social platforms, claiming that the ability (or inability) to get up from the floor without assistance can predict mortality. Sarah critiques the study's methodology, the pitfalls of its media representation, and the critical difference between correlation and causation. She also emphasizes the importance of proper interpretation to avoid fear-mongering and encourages training in strength and balance for overall health benefits.
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01:08 Overview of the Misinterpreted Study
03:35 Details of the Sitting Rising Test (SRT)
04:21 Methodology and Findings of the Study
14:33 Critique of the Study's Methodology
23:43 Misinterpretations and Media Hype
29:17 Conclusion and Final Thoughts
References:
Episode 15: 3! Easy! Rules! About! Research!
Ability to sit and rise from the floor as a predictor of all-cause mortality(abstract)
Conor O’Shea podcast: Taking Control of Your Pain Through Movement
Discover Magazine: Simple Sitting Test Predicts How Long You'll Live
Recommended
Transcript
Introduction to the Podcast and Mission
00:00:00
Speaker
I'm Laurel Biebersdorf, strength and conditioning coach. And I'm Dr. Sarah Court, physical therapist. With over 30 years of combined experience in fitness, movement, and physical therapy, we believe in strong opinions loosely held. Which means we're not here to hype outdated movement concepts.
00:00:15
Speaker
or to gatekeep or fearmonger strength training for women. For too long, women have been sidelined in strength training. Oh, you mean handed pink dumbbells and told to sculpt? Whatever that means, we're here to change that with tools, evidence, and ideas that center women's needs and voices.
00:00:32
Speaker
Let's dive in.
Misinterpretation of the Sitting and Rising Test Study
00:00:45
Speaker
Welcome to the Movement Logic Podcast. I'm Sarah Court. And today's InBetweenie episode, our mini episodes between seasons, I'm going to be talking about a pretty popular research study, popularly misinterpreted, that is, that seems to have once again reared its head in social media as of late.
00:01:06
Speaker
Now, the reason why this is a problem is that the study does not prove what people think it proves. so i I've said that so many times now, and every time I say it, I flash on the Princess Bride when Vizzini keeps saying, inconceivable!
00:01:22
Speaker
And Inigo Montoya finally tells him, you keep using that word. I do not think it means what you think it means. Anyway, I've said it a lot about other poorly interpreted studies, and I've even said it about this study before on the Movement Logic podcast way back in episode 15, which was called Three Easy Rules About Research.
00:01:42
Speaker
Link in show notes. That's from back when we were baby podcasters, just trying to figure out how to talk into a microphone and not keep talking over each other. So the study we're talking about today got a lot of attention when it first came out in 2014, and it immediately spread like wildfire on social media and in the news for several reasons, which I'm going to talk about.
00:02:05
Speaker
It's called Ability to Sit and Rise from the Floor as a Predictor of All-Cause Mortality, and it was published in the European Journal of Preventative Cardiology. I will put a link to the abstract for the paper in the show notes.
00:02:19
Speaker
Now, here at the Movement Logic Podcast, we have a secret weapon, and her name is Naomi Schwartz. And basically what happens is every now and then when I want to read a paper, but it's behind a paywall, I'm I hit Naomi up, who has access to all the research out there.
00:02:34
Speaker
And typically in a manner of minutes, she sends me the full paper, which makes me wonder what she does all day. I'm just kidding. I'm just kidding. Laurel and I are both unbelievably grateful for Naomi's ongoing assistance with getting papers as it allows us to talk about them and really dissect what's going on, which you don't always get to do when you only see the abstract. So in any event, this full paper was behind a paywall. So I am only able to share the abstract with you in the show notes.
00:03:00
Speaker
You're going to have to find your own Naomi to exploit if you want to read the whole thing. But what this tells us is that most people, if they read about this study in an article, and if they then tried to follow up and read the actual paper itself, which is something I always recommend because media articles often exaggerate or misdescribe research, they most likely could not access the full paper and therefore did not.
00:03:27
Speaker
So let's just put a pin in that for later. This is ah also related, but a bit of a side note. A few years ago, I saw an Instagram post by someone named Connor O'Shea, who is a very popular mobility coach from Ireland. And he posted about the test and he said, it predicted your mortality. So I decided it was very important that I go on the internet and correct him.
00:03:48
Speaker
And so I did. I sent him a direct message and told him he was wrong. And... I'm laughing because I'm embarrassed about my own behavior. He ended up being incredibly generous of spirit and actually invited me on his podcast. And I'm going to search around for that link and post it for you guys.
00:04:04
Speaker
I think that speaks more to his impeccable manners and his generous Irish spirit than to the general success rate or whether or not it's a good idea to try to correct someone online.
00:04:17
Speaker
Yeah. So let's go back to the study.
Validity and Execution of the SRT Study
00:04:20
Speaker
The study became known as the sitting rising test or SRT because it used an established test called the SRT.
00:04:28
Speaker
And it made a very bold claim, which is if you need to use your hands or knees to get up off the floor and get back down again, you are going to die sooner. In other words, your ability to perform this movement could predict your lifespan.
00:04:46
Speaker
Now, I want you to put another pin in that word predict, because as we often say, it's doing a lot of heavy lifting in this study title. And spoiler alert, it might not be the right verb to describe what this test actually does.
00:05:00
Speaker
Also known as, i do not think it means what you think it means. More about that in a moment. Let's look at the study itself and what the researchers did. And I'll be commenting about the criteria and the methodology as far as what's positive and what's negative about how the study itself was put together and how it was performed.
00:05:17
Speaker
So this study tracked 2002 adults aged for just over six years. So that's a really good large number of people. We like that. Each of the participants performed the SRT, which went like this.
00:05:33
Speaker
The participant had to sit down on the floor and then stand back up using as little help as possible from their hands or knees. They started with five points for each action. So five points for sitting down and five points for standing back up.
00:05:47
Speaker
And then one point was deducted for each time they needed support. So a hand, a knee, a forearm, the side of your lower leg, or even your hand on your knee.
00:05:59
Speaker
And then another half point was deducted if you looked wobbly while you were doing it. So before we go on, if if you've never tried to do this yourself, pause this episode for a moment and go do it. So you start standing, you're going to sit all the way down to the ground on the floor without using your hands or knees if possible, and then stand back up the same way and then score yourself, right? So you'll score yourself with a point off for every additional contact that you use, hand, knee, forearm, when you're getting down and when you're getting back up.
00:06:31
Speaker
And if you are like Laurel and you are super competitive, you might try it a couple of times if the first time was not perfect. Okay, so back to the study. After the test, they then followed these people for roughly six years to see if and when they died.
00:06:48
Speaker
So these 2002 adults from age 51 to 80 were followed up. I don't know with what, but I'm sort of imagining like a phone call like, hello, are you still alive? Great.
00:06:59
Speaker
Talk to you next year. And then they recorded who passed away during that time. Now, the longer your study goes on for in this kind of situation, the greater accuracy your data will have.
00:07:10
Speaker
But at the same time, the longer your study goes on, the more people you potentially lose contact with and then must remove from your data set. So it's it's a tough call, I think, to figure out exactly how long to follow people.
00:07:22
Speaker
But six years is a good chunk of time. The researchers then performed statistical analysis on the data, and what they found was that lower scores correlated with a higher all-cause mortality.
00:07:35
Speaker
So if you had to use your hands and knees a lot to get up and down from the floor, that lowered your score. And they found that the people who had to do that were more likely to die sooner.
00:07:47
Speaker
The big headline and the one that made it into a lot of the media coverage was this. Every point you got on the test gave you a 21% better chance of survival over the study period, even after adjusting for age, sex, and BMI.
00:08:04
Speaker
By the way, BMI is a crappy metric. That's for another podcast. So that sounds impressive, right? I mean, if you if you just tried it just now and you didn't do as well as you thought you would or you thought you should, it sounds like you want to start working on getting up and down from the floor with no hands. Am I right?
00:08:23
Speaker
Not
Understanding Study Results and Risks
00:08:24
Speaker
so fast. let's Let's investigate the study a little more closely, starting with the test itself. So according to the study, and this is a quote, the SRT was administered on a non-slippery surface in a minimal space of two meters squared with the subject standing barefoot and wearing clothing that did not restrict body movements.
00:08:45
Speaker
Before the SRT, the evaluator instructed, without worrying about the speed of movement, try to sit and then to rise from the floor using the minimum support that you believe is needed.
00:08:59
Speaker
There is a YouTube video of the test methodology, and I'll link it in the show notes, but it shows exactly this setup as described of above. And it also highlights, and this is in the paper as well, that the SRT itself is a reliable test that has been used in previous research. And this is important to note.
00:09:16
Speaker
When you're using a test in your research, it's always a good idea to use one that has been established as being reliable by other research already. It makes your study stronger. Another thing we see in the video, and this is translated from the Portuguese, which I do not speak, but I think it's pretty accurate.
00:09:33
Speaker
And this is a quote, crossing the legs from either sitting or standing is allowed while the sides of the subject's feet were not used for support. If a five score is not obtained, some advice is offered that might assist the subject to improve their SRT score in other trials.
00:09:51
Speaker
And it says that in the write-up as well. So evidently people got more than one chance to try to perform the test to the best of their ability, but it's not clear how many. And then in the study, it says, and this is a quote, independently of the number of attempts performed, the resulting SRT partial scores were considered as the best score for each one of the actions, e.g.
00:10:13
Speaker
four and two for the actions of sitting and rising from the score, respectively. So this leads me to assume that if you got anything less than a five on each part of the test, you got a little advice, like try crossing your legs to sit down and then you got to try it again.
00:10:32
Speaker
I actually don't hate this because you might do better at it after a few attempts if it's not a movement you've done before. I just wish the write-up was clearer about how many attempts each person got and whether or not everyone got the same number Because this is definitely a test that you can get better at with practice. And if somebody scored poorly, but then got five attempts to ah improve, but then the next person only got two attempts to improve, that's going to skew our results. And we know that not everybody got to just keep practicing until it was a five out of five, right?
00:11:03
Speaker
Any whoozle, so here we are, the researchers took this data and they separated it into four groups based on their score, basically like broke it into quarters. And after performing various types of statistical analysis, here is what they concluded. And again, this is a quote.
00:11:20
Speaker
Based on age, gender, and BMI-adjusted Cox analysis, there was a three-year shorter life expectancy among subjects placed in the lowest score category, like the bottom 25%, as compared to subjects with the best score category in the top 25%. Proportional hazards analysis.
00:11:41
Speaker
identified that SRT score was a significant predictor of all-cause mortality, with subjects in the lower score range exhibiting a five to six times higher risk as compared to those in the reference.
00:11:55
Speaker
Multivariate analysis adjusting for age, sex, and BMI confirmed these findings, with similar hazard ratios as those in the unadjusted model. By proportional hazards analysis, each increment in the SRT score was associated with a 21% reduction in all-cause mortality.
00:12:16
Speaker
Crystal clear, right? Okay, no. So in plain English, let me let me help you with this. So people who scored the lowest were found to live on average three years less. Fewer?
00:12:28
Speaker
Numbers is fewer. Three years fewer? Less as long? Their lives were three years shorter, how about that, than people who scored the highest. And then even when the research is adjusted for age, sex, and BMI to rule out how those factors influence the results, the findings stayed the same.
00:12:46
Speaker
And then something called proportional hazards analysis. We're going to talk about this for a little bit. That showed that low scores on this test were strongly linked to a higher risk of dying from any cause.
00:12:57
Speaker
Specifically, those in the lowest scoring group were five to six more times likely to die than those in the highest scoring group. So what is proportional hazards analysis? Well,
00:13:08
Speaker
it looks at so how certain characteristics like age, gender, or in this case, SRT score, change the risk of something happening over time without assuming that the baseline risk is the same for everyone.
00:13:21
Speaker
So instead of just asking who died more, this would be a very weird question, it asks, given how much time passed, how did different variables affect how soon people were likely to die?
00:13:37
Speaker
Now, the model assumes that the hazard ratios, which is a fancy way of saying risk levels, between the groups stayed proportional over time. And this is important to understand. For example, if group A is twice as likely to die as group B at year one, that two times risk holds at year two, same at year three, same at year four, and so on.
00:13:59
Speaker
It assumes that the ratio stays constant. Right. Even if the actual risk itself changes, the the relative risk between the two stays the same. But this assumes that the proportionality remains the same, that the relative risk risks don't change over time.
00:14:19
Speaker
And this is part of what's why they can't call this a correlation, because we don't know if this assumption really did hold true for everyone. right We don't know what caused the death of the people who passed away during the trial period.
00:14:38
Speaker
And so the results may not be as accurate as they think. Now, they also found that for every one point increase in the SRT score, there was a 21% drop in the risk of dying from any cause. So small improvements in how well you can get up from down the floor, from down the floor.
00:14:54
Speaker
So small improvements in how well you can get up and down from the floor without support appears to be linked to a meaningful increase in survival odds.
00:15:05
Speaker
But again, put a pin in that. I hope you have brought a lot of pins with you today because there's a lot of pinning going on. All right, we're going to come back to that. It's my favorite thing to do is to come back to something.
Critiques on Study Methodology
00:15:18
Speaker
let's Let's look at the study's potential problems. And then the actual biggest problem, say it with me, I do not think it means what you think it means.
00:15:31
Speaker
All right, well, first of all, the instruction was kind of vague because participants were told to use the minimum support you believe is needed, which is subjective.
00:15:43
Speaker
They didn't say use the minimum support you can. They said the minimum support you believe is needed, which I think is a weird way to state it because if I don't understand that I'm trying to not use any help at all, if the goal is to use no help, I mean, I'm going to probably stick a hand down to help myself.
00:15:58
Speaker
Why not? If you're if you're a naturally cautious person or this is a thing you haven't done before, you might just put a hand down even if you don't really need to. Right. So right out of the gate, we're not testing pure physical capacity. We're testing beliefs about capacity.
00:16:14
Speaker
We're testing movement strategies, whether or not somebody has one. And we're also maybe testing someone's fear around falling, whether whether or not they're really at that high of a risk. Now, they did account for this somewhat by allowing people to try again and giving them some advice.
00:16:30
Speaker
But the advice was about body placement. It wasn't about what they believed that they could do. In other words, they weren't being coached to, you know, try harder, try to do it without your hands, you know, turn your glutes on more or something, right?
00:16:47
Speaker
they're They're coached like, try closet crossing your legs, which is just a different strategy possibly than the person used. So even with the advice on technique, they're still moving how they believed that they could.
00:17:01
Speaker
And then the exclusion criteria, the people that they admitted from this study, people who did not qualify for the study, were the following. This is a quote. Subjects that met any of the following criteria were excluded. A, those regularly competing in sports events.
00:17:17
Speaker
B, presenting with any relevant musculoskeletal limitations that could affect SRT. And C, refusal in performing the SRT. C is hopefully self-explanatory. If the person refuses to do the test, you can't include them in and the test, in the study, because they're refusing. They don't want to do it.
00:17:35
Speaker
You can't force them. There's a real strong no-forcing policy in research. Okay, so in other words, they filtered out both the the fittest people and anybody who might be physically limited with a musculoskeletal injury or a chronic condition, right? They took out the fittest ones and they took out the most physically incapacitated ones.
00:17:58
Speaker
It reminds me of like um when they score gymnastics routines and they remove the highest and the lowest scores before giving the final score as an average of the remaining scores. In that situation, it's trying to minimize the bias of either overly harsh or overly generous judges, but that's because subjectivity often plays a role.
00:18:19
Speaker
I remember watching gymnastics in the 80s and the Russian judges were notoriously poor scoring of Team USA and vice versa. So I suppose in this instance, let's say you had a ah random former Olympian in your group and they did it with a perfect score.
00:18:35
Speaker
That's going to skew the results away from the average. The next thing that I want to talk about I do think was a problem, which is this. They didn't track activity levels, health history, or any other major risk factors.
00:18:52
Speaker
We have no idea how these people lived, whether they exercised, what medications they took, what else might have contributed to their mortality risk.
00:19:04
Speaker
Remember the proportional hazards analysis, the model that assumes that hazard ratios, right, risk levels between groups stay proportional over time. So this study assumes that the relative risks didn't change over time.
00:19:20
Speaker
And we just don't know that. We don't know if these relative risks changed for some people, right? In the following six years, did they become more or less active? Did they develop a chronic condition?
00:19:32
Speaker
Did they have surgery? Did they take up smoking or bungee jumping? Or did some other major stressors contribute to decreased health? This is somewhat addressed by the fact that they studied over 2000 people as the assumption would be that enough people would change their relative risk in both directions, that they would kind of cancel each other out, right? In other words, roughly the same number of people would become more healthy and roughly the same number will become less healthy over the following six years so that it wouldn't affect the results. But I'm not sure that that's actually a great assumption to make because I think generally as we age,
00:20:12
Speaker
People tend to have more disease processes going on. People tend to often become less physically active, not more physically active. So I think this was actually a bit of ah a flaw in the in the research itself.
00:20:26
Speaker
And then the last thing I wanted to talk about is they're studying what's called all-cause mortality. All-cause mortality is exactly what it sounds like, dying from any cause, any cause.
00:20:38
Speaker
And we don't know anything about the cause of death for the people who died during this time period. We don't know if it was because of falling, cardiovascular disease, cancer,
00:20:49
Speaker
or getting hit by a bus. It's not reported in the study if any deaths that were perhaps accidental were included or not. So we have to assume that all deaths were included for whatever reason.
00:21:03
Speaker
And that may have skewed the results some, but again, I think the researchers are just banking on the fact that they had so many people in their study that any random causes of death would not affect the results in a meaningful way. Okay.
00:21:14
Speaker
So let's let's get into our interpretation of the results. right We have to talk about what the results actually showed in terms of how the data was spread out over the different age ranges.
00:21:26
Speaker
Because here's what they found. right The people with the lowest SRT scores, the people who had to give themselves the most amount of help getting up and down from the floor, were the older people.
00:21:41
Speaker
And the older participants also have a higher mortality rate. Friends, this is not a bombshell. That is basic biology, right? The older you are, the closer you are to dying.
00:21:59
Speaker
And yes, the authors did adjust for age, sex, BMI, but with a retrospective cohort like this, you can't fully figure out whether the the low SRT score is a cause of increased mortality or just a marker that someone is older and more frail.
00:22:21
Speaker
ah SRT score does correlate with strength, mobility, flexibility, and balance, but it doesn't cause mortality. A low score on the SRT is like a flag that maybe you need to work on your strength, your mobility, your flexibility, your balance, right?
00:22:40
Speaker
But its it's not a crystal ball determining your fate. Now, If we return to the beginning of the episode and we grab one of those pins that I asked you to pin, and this one was the idea that if you need to use your hands and knees to get up off the floor, you're going to die sooner, i.e.
00:22:57
Speaker
this test predicts your all-cause mortality, right? That sentence makes a causal sounding forecast about a future outcome, which is dying sooner based on a current observation, which is needing hands or knees to rise from the floor.
00:23:16
Speaker
And this is a problem for a few reasons. It's overly deterministic. It implies a direct inevitable outcome.
Media Influence and Miscommunication
00:23:24
Speaker
You are going to die sooner. It removes any nuance or acknowledgement of individual variation, context, or other contributing factors.
00:23:34
Speaker
And it also actually misrepresents the data because the SRT study found statistical associations, not certainties, People who used more support had a higher risk not a guaranteed earlier death, right?
00:23:53
Speaker
Risk is not the same thing as a guarantee. And this causal sounding forecast, right? This predictive language could be misleading or fear-mongering if used in public health messaging or fitness marketing, especially if it's not explained properly.
00:24:11
Speaker
And guess what, friends? That's exactly what happened. Because when this study came out, it spread like wildfire in the yoga, movement, functional fitness spaces for several reasons.
00:24:22
Speaker
Because it's easy to film, right? You film yourself doing the test. It's easy to score. You just take a point away for every hand and knee down, right? It's easy to link to a dramatic claim about your health.
00:24:35
Speaker
And it's an easy way to get people to buy your 12-week functional mobility course or something, right? You would post your score, you challenge your friends, you'd use it to lure people into your program, things like that.
00:24:53
Speaker
And there were tons of examples of this study being misrepresented in the media. One that I found when I look back was Discover Magazine in May 2019 published an article entitled Simple Sitting Test Predicts How Long You'll Live.
00:25:09
Speaker
And it's it's truly just one of many examples of how it was misinterpreted in the media. Because the thing is, the study doesn't support the weight of all that hype.
00:25:20
Speaker
Because let's talk about the difference between correlation and causation.
00:25:26
Speaker
There's in a correlation between the SRT and all-cause mortality, but it's not a causation, right? There's an association, but it's not the reason why.
00:25:39
Speaker
It's similar to using grip strength as a correlate for mortality. But we know that it doesn't improve your mortality to just go out and start squeezing things as hard as you can to try to improve your group grip strength, right?
00:25:55
Speaker
The grip strength is a stand-in, right? It's a proxy. It suggests you've been doing things like lifting things that are heavy, right? And that suggests that you've been more active, which suggests you're going to live longer.
00:26:09
Speaker
In the same way, because strength and balance and coordination are specific, i.e. they improve only in the specific ways they are trained, if you just practiced getting up and down from the floor until you can do it with no hands, it doesn't mean what you think it means.
00:26:27
Speaker
Sorry, that one just popped out. It doesn't mean you won't have a heart attack five years from now. But do you remember how the full study is actually behind a paywall?
00:26:38
Speaker
And most people, if they bothered to look up the test, which let's be honest, most people don't bother to look up the test, but even if they did, they would only have gotten the abstract. From the abstract, you would take away the idea that it is a causation and it's not a correlation.
00:26:55
Speaker
So the sitting rising test itself, not this particular study, but just the the test of standing up and sitting down. Here's what we can actually say about it. It is a simple, fast, zero equipment required way to get a picture of some of a person's movement quality and strength, right?
00:27:17
Speaker
It might flag if you have decreased lower body strength or mobility. That's useful because let's say I had somebody come in and they said they wanted to work on their mobility. And maybe I say, mean, I likely wouldn't, but maybe I say, okay, let's see you get up and down from the floor with no hands.
00:27:34
Speaker
And they had a tough time doing it. Then I'd be like, all right, well, that's something that we are going to work on. Right. And we're not necessarily going to work on this test. We're going to work on your strength and your mobility in your lower body. right If you can't do the test well, it's not a like instant countdown to death. It's just a sign that it might be time to actually work on your strength and balance and skills of getting up and down from the floor, which are things you can actually train.
00:28:00
Speaker
I want to make a point here. A lot of people, you know, quote unquote, train balance with their older clients, whether they are clinicians or yoga teachers or anything in between.
00:28:11
Speaker
Not a lot of people train their clients on how to get up from the floor if they fall. And this is a actually very worthwhile and meaningful skill to drill for people who are at a falls risk.
00:28:27
Speaker
I specifically remember one patient that I did with this. We took one of our entire hour long sessions. I covered the floor with yoga mats and we went step-by-step through how to get up from the floor.
00:28:38
Speaker
And then would get back down on the floor and we would do it again. And then we would get back down on the floor and we would do it again. In this instance, I was just trying to teach this person how to get up and down from the floor. This was not a, can you do it with no hands?
00:28:51
Speaker
Right? We just need a strategy to use after someone has fallen. And this patient was so irritated with me that I made them do it for an hour. But... In the time that has passed since then, they have told me that on more than one occasion, when they have fallen, because they are somebody that falls, they use the strategies that we practiced to get back up instead of just lying there on the floor.
00:29:17
Speaker
So I highly recommend if you work on balance with any of your clients, work on teaching them how to get up from the floor if and when they do fall, because it's a really important skill and it's going to give them some more confidence and a little less fear around like, oh my God, I fell down on the floor. How the F am I supposed to get up from here?
00:29:38
Speaker
Nobody's coming. The cat's going to eat my face.
Implications and Understanding of SRT Scores
00:29:43
Speaker
Okay, so what can we actually accurately conclude from this study? The SRT is associated with all-cause mortality in this specific population between 51 to 80, but it doesn't predict when someone will die.
00:30:02
Speaker
It doesn't prove that if you improve your SRT score, it will reduce your mortality and it doesn't establish causality. It's also unclear from this study if a low score reflects a modifiable risk, like strength or mobility, or a non-modifiable status, like some sort of illness or chronic pain.
00:30:26
Speaker
The most honest conclusion that we can draw is a low SRT score from in this study reflects reduced physical capacity, which in turn is associated with other known risk factors for mortality.
00:30:42
Speaker
It is a marker, not a mechanism. Why does this hair splitting between a mechanism and a marker matter? Because a marker, it's like a sign pointing to a village, but the mechanism would be the village itself.
00:31:00
Speaker
You wouldn't go up to the sign and say, I made it to the village when the village is still 10 miles away. What you could say that would be much more accurate instead of, if you need to use your hands or knees to get up off the floor, you're going to die sooner, you could say something like, needing to use your hands or knees to get off the floor is linked to a higher risk of earlier death.
00:31:25
Speaker
Or people who can't get off the floor without support tend to have a higher risk of dying sooner, according to research. So you know what? Do the SRT, post your videos, challenge your friends, try it because it's hard, try it because it's fun, but it's really important to not confuse correlation and causation generally.
00:31:54
Speaker
And this is an example of specifically why you don't wanna do that. If you want a real measure of your health, start training strength, power, and aerobic capacity.
00:32:09
Speaker
Working on these capacities will lead you to doing better on these kinds of challenge videos for social media. But please be more nuanced when you post about the SRT and stop talking about it like it's a one-to-one correlation because it's not.
00:32:25
Speaker
All right, friends, that's it for today. If you like our show, it always helps us if you rate, review, and subscribe. If you know someone who recently posted about this study, send them a link to this podcast episode like a real know-it-all and tell them that they're wrong.
00:32:43
Speaker
And as always, the wait list for our next cohort of the BBC, the Bone Density Course, is open for you to sign up on our website. You will get free video content along the way and other free cool stuff.
00:32:56
Speaker
And getting on this list is the only way that you will access our discount code for the course, which will start in early November. And that's all I've got for you.
00:33:08
Speaker
We will see you in two weeks. He didn't fall! Inconceivable! give You keep using that word. I don't think it means what you think it means.