Bone mass may be adjusted to control the strains produced by muscular activity. We assessed the relationship between maximum rising strength (MRS), a new measurement of sit-to-stand performance, and femoral neck (FN) bone mineral density (BMD), taking into account possible confounding variables. The study population consisted of 249 healthy women aged 18-76. We measured MRS with a dynamometer fixed on the ground and connected by an adjustable nonelastic cord to a padded belt. FN BMD was measured by dual X-ray absorptiometry. Women in the first quartile of FN BMD (<0.702 g/cm(2)) had significantly lower values of MRS, body weight, height, lean mass, past 5-year physical activity expenditures, blood 17 beta estradiol (E2), 25-hydroxyvitamin D (25(OH)D), dehydroepiandrosterone sulfate (DHEAS), and insulin like growth factor 1, and higher values of age and parathyroid hormone than other women. In the logistic regression model, FN BMD values in the lowest quartile were associated with age (adjusted odds ratio [OR(a)] per 10-year increase = 1.84, 95% confidence interval [95% CI] = 1.33-2.54, P < 0.001), body weight (OR(a) per 10-kg decrease = 3.67, 95% CI = 2.08-6.47, P < 0.001), MRS (OR(a) per 20-kg decrease = 1.17, 95% CI = 1.02-1.34, P = 0.03), serum DHEAS (OR(a) < 0.5 mg/ml vs > or =0.5 mg/ml = 2.83, 95% CI = 1.3-6.12, P = 0. 01), and serum E2 (OR(a) per 10-pmol/l decrease = 1.02, 95% CI = 1.01-1.03, P = 0.03). The present study suggests a significant association between low FN BMD and low sit-to-stand performance in healthy women, independent of possible confounding variables.