Timed Up and Go test

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Timed Up and Go test
Purposedetermine a person's mobility

The Timed Up and Go test (TUG) is a simple test used to assess a person's mobility and requires both static and dynamic balance. [1]

It uses the time that a person takes to rise from a chair, walk three meters, turn around 180 degrees, walk back to the chair, and sit down while turning 180 degrees. During the test, the person is expected to wear their regular footwear and use any mobility aids that they would normally require. [2] The TUG is used frequently in the elderly population, as it is easy to administer and can generally be completed by most older adults. [3]

One source suggests that scores of ten seconds or less indicate normal mobility, 11–20 seconds are within normal limits for frail elderly and disabled patients, and greater than 20 seconds means the person needs assistance outside and indicates further examination and intervention. A score of 30 seconds or more suggests that the person may be prone to falls. [4] [5] Alternatively, a recommended practical cut-off value for the TUG to indicate normal versus below normal performance is 12 seconds. [6] A study by Bischoff et al. showed the 10th to 90th percentiles for TUG performance were 6.0 to 11.2 seconds for community-dwelling women between 65 and 85 years of age, and determined that this population should be able to perform the TUG in 12 seconds or less. [6] TUG performance has been found to decrease significantly with mobility impairments. Residential status and physical mobility status have been determined to be significant predictors of TUG performance. [6] The TUG was developed from a more comprehensive test, the Get-Up and Go Test. [7]

Research has shown the Timed up and Go test has excellent interrater (intraclass correlation coefficient [ICC] = .99) and intrarater reliability (ICC = .99). [8] The test score also correlates well with gait speed (r = -.55), scores on the Berg Balance Scale (r = -.72), and the Barthel Index (r = -.51). [8] Many studies have shown good test-retest reliability in specific populations such as community-dwelling older adults [9] and people with Parkinson’s disease. [10] [11]

Traditionally, the TUG test is being scored by the total time measured by a stopwatch. However, using wearable technology such as inertial measurement units (IMUs) can provide a more objective assessment of this test. [12] Furthermore, these wearables can extract several mobility parameters from different phases of TUG, such as the sit-to-stand phase [13] that allow a more detailed biomechanical analysis of the TUG test. In this case, subtle changes between patient populations can be detected in an objective manner. For instance, in a study, mobility parameters such as cadence, turning duration, and the angular velocity of the arm swing extracted from the IMUs could discriminate patients with early Parkinson's disease and their age-matched controls while the total time measured by the stopwatch failed to do so. [14]

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  1. "Timed Up and Go (TUG)". Minnesota Falls Prevention. Retrieved 2010-02-16.
  2. Podsiadlo, D; Richardson, S (1991). "The timed 'Up & Go': A test of basic functional mobility for frail elderly persons". Journal of the American Geriatrics Society. 39 (2): 142–8. doi:10.1111/j.1532-5415.1991.tb01616.x. PMID   1991946.
  3. Yim-Chiplis, P. K.; Talbot, L. A. (2000). "Defining and Measuring Balance in Adults". Biological Research for Nursing. 1 (4): 321–31. doi:10.1177/109980040000100408. PMID   11232210.
  4. "Timed Up and Go (TUG)". American College of Rheumatology. Retrieved 2010-02-16.
  5. "Timed-Up-and-Go (TUG) Test" (PDF). Alberta Health Services. Archived from the original (PDF) on 2013-03-19. Retrieved 2010-02-16.
  6. 1 2 3 Bischoff, Heike A.; Stähelin, Hannes B.; Monsch, Andreas U.; Iversen, Maura D.; Weyh, Antje; von Dechend, Margot; Akos, Regula; Conzelmann, Martin; et al. (2003). "Identifying a cut-off point for normal mobility: A comparison of the timed 'up and go' test in community-dwelling and institutionalised elderly women". Age and Ageing. 32 (3): 315–20. doi: 10.1093/ageing/32.3.315 . PMID   12720619.
  7. Nordin, Ellinor; Lindelöf, Nina; Rosendahl, Erik; Jensen, Jane; Lundin-Olsson, Lillemor (2008). "Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff's global judgement and fall history in evaluating fall risk in residential care facilities". Age and Ageing. 37 (4): 442–8. doi: 10.1093/ageing/afn101 . PMID   18515291.
  8. 1 2 Ng, Shamay S.; Hui-Chan, Christina W. (2005). "The Timed Up & Go Test: Its Reliability and Association with Lower-Limb Impairments and Locomotor Capacities in People with Chronic Stroke". Archives of Physical Medicine and Rehabilitation. 86 (8): 1641–7. doi:10.1016/j.apmr.2005.01.011. hdl: 10397/15645 . PMID   16084820.
  9. Shumway-Cook, A; Brauer, S; Woollacott, M (2000). "Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test". Physical Therapy. 80 (9): 896–903. PMID   10960937.
  10. Morris, Susan; Morris, Meg E; Iansek, Robert (2001). "Reliability of Measurements Obtained With the Timed 'Up & Go' Test in People With Parkinson Disease". Physical Therapy. 81 (2): 810–8. doi: 10.1093/ptj/81.2.810 . PMID   11175678.
  11. Thompson, Mary; Medley, Ann (1998). "Performance of Individuals with Parkinson's Disease on the Timed Up & Go". Journal of Neurologic Physical Therapy. 22 (1): 16–21. doi: 10.1097/01253086-199822010-00009 .
  12. Zampieri, Cris; Salarian, Arash; Carlson-Kuhta, Patricia; Nutt, John; Horak, Fay (2011). "Assessing mobility at home in people with early Parkinson's disease using an instrumented Timed Up and Go test". Parkinsonism and Related Disorders. 17 (4): 277–280. doi:10.1016/j.parkreldis.2010.08.001. PMC   2995832 .
  13. Atrsaei, Arash; Dadashi, Farzin; Hansen, Clint; Warmerdam, Elke; Mariani, Benoit; Maetzler, Walter; Aminian, Kamiar (2020). "Postural transitions detection and characterization in healthy and patient populations using a single waist sensor". Journal of NeuroEngineering and Rehabilitation. 17: 1–14. doi: 10.1186/s12984-020-00692-4 . PMC   7271521 .
  14. Salarian, Arash; Horak, Fay; Zampieri, Cris; Carlson-Kuhta, Patricia; Nutt, John; Aminian, Kamiar (2010). "iTUG, a sensitive and reliable measure of mobility". IEEE Transactions on Neural Systems and Rehabilitation Engineering. 18 (3): 303–310. doi:10.1109/TNSRE.2010.2047606. PMC   2922011 .