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Journal ArticleDOI

The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons

01 Feb 1991-Journal of the American Geriatrics Society (John Wiley & Sons, Ltd)-Vol. 39, Iss: 2, pp 142-148

TL;DR: This study evaluated a modified, timed version of the “Get‐Up and Go” Test (Mathias et al, 1986) in 60 patients referred to a Geriatric Day Hospital and suggested that the timed “Up & Go’ test is a reliable and valid test for quantifying functional mobility that may also be useful in following clinical change over time.
Abstract: This study evaluated a modified, timed version of the "Get-Up and Go" Test (Mathias et al, 1986) in 60 patients referred to a Geriatric Day Hospital (mean age 79.5 years). The patient is observed and timed while he rises from an arm chair, walks 3 meters, turns, walks back, and sits down again. The results indicate that the time score is (1) reliable (inter-rater and intra-rater); (2) correlates well with log-transformed scores on the Berg Balance Scale (r = -0.81), gait speed (r = -0.61) and Barthel Index of ADL (r = -0.78); and (3) appears to predict the patient's ability to go outside alone safely. These data suggest that the timed "Up & Go" test is a reliable and valid test for quantifying functional mobility that may also be useful in following clinical change over time. The test is quick, requires no special equipment or training, and is easily included as part of the routine medical examination.
Topics: Timed Up and Go test (74%), Berg Balance Scale (52%), Poison control (50%), Tinetti test (50%)
Citations
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Journal ArticleDOI
TL;DR: Evidence is presented that performance measures can validly characterize older persons across a broad spectrum of lower extremity function and that performance and self-report measures may complement each other in providing useful information about functional status.
Abstract: Background A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities. Methods Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times. Results A wide distribution of performance was observed for each test. Each test and a summary performance scale, created by summing categorical rankings of performance on each test, were strongly associated with self-report of disability. Both self-report items and performance tests were independent predictors of short-term mortality and nursing home admission in multivariate analyses. However, evidence is presented that the performance tests provide information not available from self-report items. Of particular importance is the finding that in those at the high end of the functional spectrum, who reported almost no disability, the performance test scores distinguished a gradient of risk for mortality and nursing home admission. Additionally, within subgroups with identical self-report profiles, there were systematic differences in physical performance related to age and sex. Conclusion This study provides evidence that performance measures can validly characterize older persons across a broad spectrum of lower extremity function. Performance and self-report measures may complement each other in providing useful information about functional status.

6,318 citations


Journal ArticleDOI
02 Mar 2013-The Lancet
TL;DR: Developing more efficient methods to detect frailty and measure its severity in routine clinical practice would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care.
Abstract: Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care.

4,062 citations


Journal ArticleDOI
01 Jan 2019-Age and Ageing
TL;DR: An emphasis is placed on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarc Openia diagnosis, and provides clear cut-off points for measurements of variables that identify and characterise sarc openia.
Abstract: Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

3,248 citations


Cites methods from "The Timed “Up & Go”: A Test of Basi..."

  • ...For the TUG test, individuals are asked to rise from a standard chair, walk to a marker 3 m away, turn around, walk back and sit down again [89]....

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Journal ArticleDOI
01 Sep 2000-Physical Therapy
TL;DR: The TUG is a sensitive and specific measure for identifying community-dwelling adults who are at risk for falls and the ability to predict falls is not enhanced by adding a secondary task when performing the TUG.
Abstract: Background and Purpose. This study examined the sensitivity and specificity of the Timed Up & Go Test (TUG) under single-task versus dual-task conditions for identifying elderly individuals who are prone to falling. Subjects. Fifteen older adults with no history of falls (mean age578 years, SD56, range565‐ 85) and 15 older adults with a history of 2 or more falls in the previous 6 months (mean age586.2 years, SD56, range576 ‐95) participated. Methods. Time taken to complete the TUG under 3 conditions (TUG, TUG with a subtraction task [TUG cognitive], and TUG while carrying a full cup of water [TUG manual]) was measured. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. Results. The TUG was found to be a sensitive (sensitivity587%) and specific (specificity587%) measure for identifying elderly individuals who are prone to falls. 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 communitydwelling adults who are at risk for falls. The ability to predict falls is not enhanced by adding a secondary task when performing the TUG. [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;80:896 ‐903.]

2,719 citations


Journal ArticleDOI
01 Aug 2002-Gait & Posture
TL;DR: New clinical assessment methods incorporating dual-task paradigms are helpful in revealing the effect of disease on the ability to allocate attention to postural tasks and appear to be sensitive measures in both predicting fall risk and in documenting recovery of stability.
Abstract: Research on the relationship between attention and the control of posture and gait is a new and expanding area with studies on young adults revealing the role of cognitive factors in the control of balance during standing and walking. The use of dual task paradigms to examine the effect of age related changes in attentional requirements of balance control and age-related reductions in stability when performing a secondary task has shown that these are important contributors to instability in both healthy and balance-impaired older adults. The attentional demands of balance control vary depending on the complexity of the task and the type of secondary task being performed. New clinical assessment methods incorporating dual-task paradigms are helpful in revealing the effect of disease (e.g. Parkinson's disease) on the ability to allocate attention to postural tasks and appear to be sensitive measures in both predicting fall risk and in documenting recovery of stability.

2,145 citations


Cites background from "The Timed “Up & Go”: A Test of Basi..."

  • ...Time taken to complete the test is strongly correlated to level of functional mobility [29]....

    [...]


References
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01 Jan 2002-
Abstract: EXAMINATION of the mental state is essential in evaluating psychiatric patients.1 Many investigators have added quantitative assessment of cognitive performance to the standard examination, and have documented reliability and validity of the several “clinical tests of the sensorium”.2*3 The available batteries are lengthy. For example, WITHERS and HINTON’S test includes 33 questions and requires about 30 min to administer and score. The standard WAIS requires even more time. However, elderly patients, particularly those with delirium or dementia syndromes, cooperate well only for short periods.4 Therefore, we devised a simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely. It is “mini” because it concentrates only on the cognitive aspects of mental functions, and excludes questions concerning mood, abnormal mental experiences and the form of thinking. But within the cognitive realm it is thorough. We have documented the validity and reliability of the MMS when given to 206 patients with dementia syndromes, affective disorder, affective disorder with cognitive impairment “pseudodementia”5T6), mania, schizophrenia, personality disorders, and in 63 normal subjects.

70,887 citations


Journal ArticleDOI
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.

70,718 citations


Journal ArticleDOI
01 Dec 1987-Biometrics

5,145 citations


Journal ArticleDOI
Mary E. Tinetti1Institutions (1)
TL;DR: A practical performance-oriented assessment of mobility is described that incorporates useful features of both approaches and the recommended evaluation centers on the more effective use of readily (and frequently) obtained clinical data.
Abstract: M any people experience a decline in mobility with aging. The multiple chronic diseases and disabilities responsible for this decline also may predispose to falling. This decline is well recognized by clinicians caring for elderly patients. The Canadian Task Force on the Periodic Health Examination not only recognized the problem, but concluded that assessing physical, social, and psychologic functions as they impact on “Progressive Incapacity with Aging” was the most important assessment for patients over age 75.’ Prominent among their list of potentially preventable impairments were locomotory, sensory, and cognitive functions, each of which is intricately related to mobility. The Canadian Task Force further stated that protection of abilities should be emphasized over diagnosis. They believed that establishing the optimal content of the assessment was a high research priority. The purpose of the following discussion is to address the question of content of a functional mobility assessment appropriate for elderly patients. The limitations of relying solely on either a disease-oriented or a gait analytic approach are outlined. A practical performance-oriented assessment of mobility is described that incorporates useful features of both approaches. The recommended evaluation centers on the more effective use of readily (and frequently) obtained clinical data. Although limited to a discussion of ambulation as the expected mode of mobility (necessary because of space limitations), many of the concepts apply to other modes as well (eg, wheelchair).

2,882 citations


Journal ArticleDOI
TL;DR: The goal for this study was to develop a measure of balance appropriate for elderly individuals and there was a high degree of internal consistency, a Cronbach's alpha of .96, which indicates the movements reflect a single underlying dimension.
Abstract: The goal for this study was to develop a measure of balance appropriate for elderly individuals. In total, 38 patients, ranging in age from 60 to 93 years, and 32 professionals, including nurses, physicians, and physical and occupational therapists were surveyed in three distinct phases to develop the content. Reliability of the measure was assessed by having physical therapists evaulate the videotaped performances of geriatric subjects at two different points in time. The intraclass correlation coefficients measuring the inter and intra rater reliability for the test as a whole were .98 and .99 respectively. The correlation coefficients for the individual items ranged from .71 to .99. In addition, there was a high degree of internal consistency, a Cronbach's alpha of .96, which indicates the movements reflect a single underlying dimension. The scale consists of 14 movements common in everyday life. It is easy to administer and score and has measurement properties that are better than expected for a new i...

2,194 citations


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No. of citations received by the Paper in previous years
YearCitations
202210
2021958
2020921
2019808
2018759
2017874