Why is the Get Up and Go Test the Best Predictor of All Cause Mortality and What does it Mean for You?
By now you have probably heard of the Dunning-Kruger effect, a cognitive bias which often results in the individuals with less knowledge on a subject speaking with more confidence and authority than the people who are experts in the field. Perhaps because to the dilettante everything looks black and white whereas the expert understands the complexities and nuances.
Byng Pool reopened January 6th meaning I have returned to my Tuesday recovery day protocol of swimming, sauna and hot tub. Frequently this means listening to the unsolicited health advice of a self-declared expert. Based on Greg Glassman’s advice about debating with invincible ignorance, I no longer waste my time engaging with the retired gentleman who doesn’t mind wasting hours prattling on about any subject at all to anyone he can corner. Instead, I merely eavesdrop on his conversations as he unloads his opinions on another hapless victim.
This week he was touting the importance of time release vitamin B12 tablets but in previous episodes I’ve heard him argue in favour of statins for everyone or how Ozempic will drive gyms out of business. He is trapped, as much of his generation is, in reductionist thinking. It reminds me of the parable of the frog at the bottom of the well who, looking up at the well opening, believed he could see the whole sky. Any effort to convince him there was more to see beyond the confines of the well were met with disbelief.
Listening to another “this one thing will fix everything” argument got me thinking about the get up and go test used by geriatric physicians the world over to evaluate patient health status. Statistically, the get up and go test has been proven to be the best predictor of all cause mortality outperforming blood draws, genetics or any other single attribute measure available to medicine.
Why do you think that is? It is because your component parts perform as one unified system and your work capacity accurately reflects the degree to which all systems are optimally operating. So while our self proclaimed expert cites studies on the effects of statins on cholesterol or Ozempic trials and weight loss, he fails to recognize that the studies themselves have limitations in that they seek to measure one single parameter instead of taking a bigger picture view. For example, do people with lower cholesterol live longer or enjoy a higher quality of life than their high cholesterol counterparts?
Why then is the get up and go test so powerful a predictor? Because to get up and go requires the synchronous workings of multiple systems. Obviously your skeletal-muscular system must be in good health to lift you off the chair and commence ambulation but so too must your vestibular system (balance) and proprioceptive systems (coordination). Indirectly this also measures your cardiovascular, digestive and cognitive health as a deficit in any of these would most likely result in a marked decrease in muscle mass and strength.
For the organism to operate, all systems must be working. Failure in a single system will result in performance deficits and a loss of functionality. This is why in CrossFit we take a functional approach focusing on measuring your work capacity and power output. This, incidentally, is the actual reason why we record our workout scores. It has nothing to do with the leaderboard or how you compare with your peers. It is to track your progress over time and identify leading indicators of impending health problems.
Members newer to Empower will not recall the time that I sent a PT client to the ER based on declining workout scores. Over a two week period I noted a marked drop in the member’s power output that coincided with swelling in his legs. He had seen his cardiologist the day before and based on the cardiology tests, the doctor assured his patient that the swollen legs were nothing to worry about and they would follow up again next month.
Based on the member’s workout scores, I disagreed with the cardiologist's assessment and insisted the client go immediately to the ER following up with his wife to make sure my directions were followed. It was a good thing too because the ER doctors found him close to kidney failure and were able to intervene quickly to correct the problem. He is still healthy and active today.
With all the noise out there, it’s easy to get tangled in the weeds. What matters most is your total work capacity and your power output. Keep tracking your numbers! Our job is to continue to help you maintain your ability to get up and go:)
Friday Make Up Day
And speaking of work capacity, Ben Bergeron considers the OHS the best measure of athletic potential as it challenges upper and lower body strength and mobility simultaneously and requires unparalleled trunk (core) stability. That's why today’s coaching will focus on mastering the OHS. If this sounds like a bad day to you, then workout 1 is probably the workout you should be doing!
1) OHS Ladder
Choose a weight no heavier than 65/95lbs, no rack
In minute 1, perform one OHS
In minute 2, perform two OHS
In minute 3, perform three OHS
Etc.
Continue until you cannot complete the required number of OHS reps within the designated minute.
Your score is last round completed + reps of the unfinished round (so, if you completed 14 reps in the 14th minute but only got 12 reps in minute 15 your score = 14+12)
2) Complete as many rounds and reps as possible in 12 minutes of:
5 pull-ups
10 knees-to-elbows
15 goblet squats
3) Hero WOD Hoover
8 rounds for time of:
400-meter run
15 burpee box jump-overs
10-calorie bike
6 alternating dumbbell snatches