“Timed up and go” test: indication and procedure

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The Timed Up and Go (TUG) test is a screening test used by healthcare professionals to determine the risk of falling. It requires very little equipment, and takes less than 3 minutes to administer. This article details the test, and discusses the interpretation of the results.

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Definition and indications

The "Timed up and go" aims to determine the probability of falling, mainly in the elderly. In addition to the geriatric population, it is also validated for the following populations:

  • Parkinson's disease
  • multiple sclerosis
  • hip fracture
  • Alzheimer's disease,
  • CVA
  • total knee replacement or total hip and knee replacement
  • Huntington's disease.

Finally, the test can be used to measure progress in static and dynamic balance (eg after completing an exercise program involving walking and moving from standing to sitting).

The TUG has the advantage of being easy to explain and put into practice (with almost no materials required). Its metrological qualities (specificity, sensitivity, validity, etc.) are reliable, and the test provides useful results for reducing the risk of falling in people at risk. However, it is unable to clearly predict the risk of falling ( unlike other tests that have better predictive abilities).

Procedure

The equipment required for the execution of the test is a chair with armrest, a stopwatch and an adhesive tape (to mark 3 meters of distance from the chair).

To perform the "Timed Up and Go", patients wear their usual shoes and even can use a walking aid if necessary (such as a cane). The procedure is simple: The patient begins in a seated position, then stands up on the examiner's command. He must then walk 3 meters, turn 180 degrees, then return to the chair where he sits. Time stops when the patient is fully seated.

Note: The patient may benefit from a trial before having their performance timed. For safety, it is preferable to stay close to the patient to avoid a fall.

There are some alternatives to “Timed Up and Go” to better assess the patient's risk of falling. For example, the “manual TUG” involves the test taker carrying a glass of water in one hand while performing the standard TUG. On the other hand, the cognitive TUG is performed by asking the patient to count backwards in increments of 3 (for example: 100, 97, 94, 91, etc.) while performing the conventional TUG test.

Performance

The time elapsed from the start of the test until the patient returns to a seated position constitutes the “Timed Up and Go” score. An elderly person who takes ≥ 12-14 seconds to perform the TUG is at significant risk of falling. According toother sources, the interpretation can be made as follows:

  • ≤ 10 seconds: Patient shows a result within normal limits
  • ≤ 20 seconds: The patient has adequate mobility, and could go out on their own without technical assistance
  • ≤ 30 seconds: Patient has mobility issues, requires walking assistance and is not independent.

Besides time, the examiner can observe several other things like the patient's posture, gait, stride length, stability, arm movement, etc.

For example, a slow, hesitant gait may indicate other neurological disorders that require further evaluation. The same is true for loss of balance, short strides, block rotation of the trunk, improper use of technical aids, etc.

References

  • https://www.physio-pedia.com/Timed_Up_and_Go_Test_(TUG)
  • https://www.cdc.gov/steadi/pdf/TUG_test-print.pdf

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