File Name: test timed up and go .zip
The original purpose of the TUG was to test basic mobility skills of frail elderly persons.
- Timed Up and Go test
- Fillable Form 1: The Timed Up and Go (TUG) (Health Quality and Safety Commission New Zealand)
- Timed Up and Go test
The Timed Up and Go TUG is a timed test of functional mobility in which the participant stands up from a standard armchair, walks to a line on the floor 3 m away, turns around, walks back to the chair, and sits down.
Test timed up and go and its correlation with age and functional exercise capacity in asymptomatic women. The Timed Up and Go test TUG is widely used and valid in chronic patients, but rarely addressed in asymptomatic individuals. To assess the reliability, the age-related changes and the correlation between TUG and the Functional Exercise Capacity FEC adjusted for non-institutionalized middle-aged and elderly women. TUG adapted for asymptomatic women is reliable and able to assess the decline of physical mobility with advancing age and it also crucial to the FEC. In clinical practice, the use of field tests is a quick and inexpensive alternative to evaluate the functionality and mobility trunk and lower limbs in performing daily activities, such as walking 1 , 2 , 3 , 4 , 5 , 6 , and support the adoption of measures and preventive strategies in attention to health care 2 , 7.
Timed Up and Go test
Background and Purpose. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. For both groups of older adults, simultaneous performance of an additional task increased the time taken to complete the TUG, with the greatest effect in the older adults with a history of falls.
The TUG scores with or without an additional task cognitive or manual were equivalent with respect to identifying fallers and nonfallers. Conclusions and Discussion. The results suggest that the TUG is a sensitive and specific measure for identifying community-dwelling adults who are at risk for falls.
The ability to predict falls is not enhanced by adding a secondary task when performing the TUG. Time taken to complete the test is strongly correlated to level of functional mobility. Although the TUG has been shown to be useful for predicting level of functional mobility, its validity for identifying community-dwelling older adults who are at risk for falls is unknown.
Functional mobility is a term used to reflect the balance and gait maneuvers used in everyday life eg, getting in and out of a chair, walking, turning. Recent research has suggested that assessment of balance under multi-task conditions may be a more sensitive indicator of balance problems and falls than assessment of balance in a single-task context. Lundin-Olsson and colleagues 6 investigated the effect of performing multiple tasks on balance, mobility, and falls in frail older adults who lived in an institutional setting.
Physical frailty is defined by severely impaired strength, mobility, balance, and endurance. They modified the TUG to add a manual task TUG manual ie, carrying a glass of water and found that frail older adults who had a time difference of greater than 4.
They concluded that the difference in time between the TUG and TUG manual is useful for identifying institutionalized elderly people who are prone to falls.
Thus, another goal of our study was to determine whether, in community-dwelling older adults, the TUG performed under dual-task conditions was a more sensitive and specific predictor of falls than the TUG measure alone. In a previous study using a simultaneous task paradigm, we studied the effects of 2 types of secondary tasks a spatial orientation task versus a language task on postural control during stance under 2 surface conditions firm versus compliant.
In contrast, in the older nonfallers, the effect of a secondary task was dependent on the difficulty of the postural task. In the less challenging postural condition standing on a firm surface , neither cognitive task affected balance; however, there was a significant increase in postural sway when cognitive tasks were performed in the more challenging postural condition standing on a compliant foam surface.
Finally, the older adults with balance problems and a history of recurrent falls swayed more when performing either secondary task even in the less challenging postural condition. Results from that study suggest that the effect of a secondary task on postural control was dependent on the balance abilities of the subject, the difficulty of the balance task, and the type of secondary task being performed.
Certain types of secondary tasks performed in conjunction with the TUG may be more sensitive predictors of falls than others. Therefore, another goal of this study was to compare the sensitivity and specificity of 2 conditions of TUG performance cognitive versus manual in identifying community-dwelling older adults who are at risk for falls.
Our hypotheses were 1 that, although the TUG itself would be a sensitive predictor of falls, the dual-task TUG would be a more sensitive predictor of falls than the TUG alone and 2 that the TUG with the addition of a cognitive task TUG cognitive would be a more specific and sensitive predictor of falls than the TUG manual.
Thirty community-dwelling older adults living in the greater Seattle area were enrolled in the study after giving informed consent. The participants were volunteers recruited from subjects involved in previous aging studies that were carried out by the first author. The inclusion criteria were that the subjects had to be aged 65 years or older, living independently in the community, able to walk 9.
Criteria for inclusion in the group of older adults with a history of falls included a self-report of 2 or more falls within the past 6 months.
A fall was defined as any event that led to an unplanned, unexpected contact with a supporting surface. We excluded falls resulting from unavoidable environmental hazards such as a chair collapsing. In addition, we excluded people who had only 1 fall within 6 months in order to maximize the possibility of selecting a sample of older adults with recurrent fall problems.
Further criteria for the older adults in the faller category included an absence of known neurological or musculoskeletal diagnosis that could account for possible imbalance and falls, such as cerebrovascular accident, Parkinson disease, cardiac problems, transient ischemic attacks, or lower-extremity joint replacements.
After informed consent was obtained, subjects completed a health status questionnaire providing information on age, residential status, marital status, medical history, current coexisting medical conditions, self-reported history of imbalance, type of assistive device used for ambulation, and use of prescription medications.
This information was used to characterize the demographics and health status of subjects participating in the study. In order to verify our classification of the 2 groups based on balance abilities, balance was measured using 1 self-report instrument and 2 performance-based measures. The Activities-specific Balance Confidence Scale ABC is a self-report measure of balance that people can use to rate their perceived confidence related to balance when performing common activities of daily living.
The result was a score ranging from 10 to In a previous study examining the psychometric properties of the ABC on older adults living in the community, the ABC test-retest correlation r was. Subjects then underwent a minute performance-based evaluation of balance and mobility function.
Balance was evaluated using the Berg Balance Scale, which rates performance from 0 cannot perform to 4 normal performance on 14 different tasks, including ability to sit, stand, reach, lean over, turn and look over each shoulder, turn in a complete circle, and step.
Mobility was evaluated by asking subjects to walk for 3 minutes at their preferred speed. Distance walked was measured, and speed for self-paced gait was determined. Subject demographics and clinical test results are summarized in Table 1.
The tasks were presented in random order. When performing the TUG, subjects were given verbal instructions to stand up from a chair, walk 3 m as quickly and as safely as possible, cross a line marked on the floor, turn around, walk back, and sit down.
Those subjects who used an assistive device when walking in the community were requested to use that device. In the TUG cognitive , subjects were asked to complete the test while counting backward by threes from a randomly selected number between 20 and In the TUG manual , subjects were asked to complete the test while carrying a full cup of water.
Subjects were given one TUG practice trial to familiarize themselves with the task. Two raters measured performance by timing the TUG in all 3 conditions. Histograms and descriptive statistics were calculated to determine distributions, detect outliers, and consider the need for transformations. A logarithmic transformation was performed on time data due to nonnormality, the result of positively skewed data.
A multivariate analysis of variance MANOVA was then performed to determine whether group differences existed on the transformed time measures. Scores were averaged over the 3 trials. A logistic regression procedure was used to determine the cutoff value for each timed test that maximized sensitivity and specificity and predicted the probability of fallers at.
All of these analyses were performed with SAS 6. These analyses were performed using SPSS 8. Table 2 compares the time taken to complete the TUG in all 3 conditions for both groups of subjects. Using this analysis, there was still a difference in time taken to complete the TUG between the 2 groups, suggesting that the differences found in older subjects were not due to age alone, but rather due to balance status. The time taken to complete the TUG with no device was 9. These results are illustrated in Figure 1.
Figure 2 compares the performance of individuals within each of the 2 groups on the 3 tasks. Table 3 displays the increase in time taken to complete the TUG in the 2 secondary task conditions for each of the 2 groups. Discriminate analysis indicated that the 3 measures TUG, TUG manual , and TUG cognitive were equivalent with respect to classifying fallers and nonfallers, suggesting that all 3 tests were comparable for identifying community-dwelling older adults who are prone to falls.
In Table 4 , we compare the sensitivity and specificity for each of the 3 tests in predicting falls in community-dwelling older adults. Using difference scores between the dual-task TUG and the single-task TUG to determine probability for falls resulted in lower prediction rates than when the actual test scores were used. Cutoff levels that maximized both sensitivity and specificity and had a predicted probability of. As shown in Table 5 , older adults who took On the TUG manual , classification of older adults as fallers using the time score of The relationship between fall status and time taken to perform the TUG in the 3 conditions is shown in Figure 3.
In all 3 conditions, this relationship was nonlinear. We investigated the sensitivity and specificity of the TUG under both single and dual task conditions in identifying fall prone older adults living in the community.
Our results indicate that the TUG itself is a sensitive and specific indicator of whether falls occur in community-dwelling older adults. Thus, we believe the TUG is a relatively simple screening test that takes only minutes to complete, and we contend that it appears to be a valid method for screening for both level of functional mobility and risk for falls in community-dwelling elderly people. Results from the discriminate analysis suggest that older adults who take longer than 14 seconds to complete the TUG have a high risk for falls.
Our cutoff value of 14 seconds is different from that of Podsiadlo and Richardson, 1 who found that a cutoff value of greater than 30 seconds was best for predicting functional dependence among older adults. The differences in time values may reflect the differences in subjects used in the 2 studies. Podsiadlo and Richardson's study included older adults with a wide range of neurologic pathologies. In contrast, we studied community-dwelling, frail older adults, but we excluded older adults with known neurologic diseases.
Our finding that all 3 tests TUG, TUG manual , and TUG cognitive were comparable in determining the likelihood of falling in community-dwelling older adults did not support our hypothesis that measurement of mobility under multi-task conditions would be a more sensitive indicator of likelihood for falls.
This finding is not consistent with LundinOlsson and colleagues' 6 finding that comparing mobility performance between single-task and dual-task conditions was a more useful way of predicting future falls in institutionalized elderly people. There are 2 dissimilarities between these studies that could explain these differences. First, Lundin-Olsson and colleagues studied a population of frail older adults living in an assisted-living environment. We examined older adults who, despite having balance impairments, were living independently within the community.
Second, in LundinOlsson and colleagues' study, predictors of future falls were sought. In contrast, we were looking for measures that are useful for identifying individuals with a likelihood of falling. It may be that, although difference scores are not useful in a discriminate function, they may remain useful as predictors of future falls in some populations of elderly individuals.
Results from this study confirm that simultaneous performance of a secondary task had a deleterious effect on functional mobility. This effect was independent of the type of secondary task performed either manual or cognitive. These findings do not support our hypothesis that cognitive tasks would affect mobility more than manual tasks.
Given the incidence and consequences of falls among older adults, screening methods that identify elderly individuals who are prone to falls and who may benefit from interventions designed to improve balance and decrease falls and risk for falls are critical.
Results from our study suggest that the TUG is a simple screening test that is a sensitive and specific measure of probability for falls among older adults. The authors acknowledge Robin High, Statistical Consultant, for his statistical expertise.
Podsiadlo D , Richardson S. J Am Geriatr Soc. Google Scholar. Dual task assessment of reorganization in persons with lower limb amputation. Arch Phys Med Rehabil. Attentional demands for static and dynamic equilibrium.
Fillable Form 1: The Timed Up and Go (TUG) (Health Quality and Safety Commission New Zealand)
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. It uses the time that a person takes to rise from a chair, walk three meters, turn around degrees, walk back to the chair, and sit down while turning degrees. During the test, the person is expected to wear their regular footwear and use any mobility aids that they would normally require. 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. Residential status and physical mobility status have been determined to be significant predictors of TUG performance. Traditionally, the TUG test is being scored by the total time measured by a stopwatch.
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Background and Purpose: The Timed Up and Go TUG test is widely employed in the examination of elders, but definitive normative reference values are lacking. Study specifics and data were consolidated and examined for homogeneity. View on Wolters Kluwer.
TUG alone-from sitting in a chair, stand up, walk 3 meters, turn around, walk back, and sit down.. TUG Cognitive-complete the task while counting backwards from a randomly selected number between 20 and TUG manual-complete the task while carrying a full cup of water. The time taken to complete the task is strongly correlated to level of functional mobility, i. The cutoff levels for TUG is Validity Measures Older adults who take longer than 14 seconds to complete the TUG have a high risk for falls. This cutoff is different from Podsiadlo and Richardson, which is 30 seconds.
Timed Up and Go test
Background and Purpose. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. For both groups of older adults, simultaneous performance of an additional task increased the time taken to complete the TUG, with the greatest effect in the older adults with a history of falls. The TUG scores with or without an additional task cognitive or manual were equivalent with respect to identifying fallers and nonfallers. Conclusions and Discussion.
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