Timed Up and Go Test (TUG)
Objective
To determine fall risk and measure progress of balance, sit to stand, and walking.
Intended Population
This test was initially designed for elderly persons, but is used for people with Parkinsons, Multiple Sclerosis, hip fracture, Alzheimer, CVA, and others.
Method of Use
The patient starts in a seated position, stands up upon therapist’s command, walks 3 meters, turns around, walks back to the chair and sits down. The time stops when the patient is seated. The subject is allowed to use an assistive device, and a practice trial should be completed before the timed trial. Be sure to document the assistive device used.
Cut-off time for high risk of falls: Cut-off times to classify subjects as high risk for falling vary based on the study and
participants. By using regression analysis Shumway-Cook used 14 seconds as the cut-off. Thus, if a subject took 14
seconds or longer he or she was classified as high-risk for falling.1
Materials Needed: one chair with armrest, stopwatch, tape (to mark 3 meters).
Evidence
Reliability:
Intratester and intertester reliability have been reported as high in elderly populations, from .92-.99.2 However, reliability in community-dwelling populations has been found to be moderate (.56).2 In people with Alzheimers disease reliability is high (ICC = .985-.988).3 A study by Huang et al4 reported an ICC of 0.80.
Validity:
Construct validity has been shown by correlating TUG scores with gait speed (Pearson r = .75), postural sway (Pearson r = -.48), step length (Pearson r = -.74), Barthel Index (Pearson r = -.79), and step frequency (Pearson r = -.59).2
Sensitivity and Specificity:
The sensitivity and specificity have been reported to be 87% each in a study by Shumway-Cook et al in 2000.1
Minimally Detectable Change:
The MDC was 4.09 seconds in patients with Alzheimers.3 In patients with Parkinson's the MDC was 3.5 seconds.4
Links
References
1. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000;80(9):896-903.
2. Steffen T, Hacker T, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther. 2002;82(2):128-137.
3. Ries J, Echternach J, Nof L, Blodgett M. Test-retest reliability and minimal detectable change scores for the timed "up & go" test, the six-minute walk test, and gait speed in people with alzheimer disease. Phys Ther. 2009;89(6):569-579.
4. Huang S, Hsieh C, Wu R, Tai C, Lin C, Lu W. Minimal detectable change of the timed "up & go" test and the dynamic gait index in people with parkinson disease. Phys Ther. 2011;91(1):114-121.
