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.
Citations
More filters
TL;DR: These commonly used gait performance tests are highly reliable and can be recommended to evaluate improvements in various aspects of gaitperformance in individuals with chronic mild to moderate hemiparesis after stroke.
Abstract: Objective: To assess the reliability of 6 gait performance tests in individuals with chronic mild to moderate post-stroke hemiparesis. Design: An intra-rater (between occasions) test-retest reliability study. Subjects: Fifty men and women (mean age 58 6.4 years) 6–46 months post-stroke. Methods: The Timed “Up & Go” test, the Comfortable and the Fast Gait Speed tests, the Stair Climbing ascend and descend tests and the 6-Minute Walk test were assessed 7 days apart. Reliability was evaluated with the intraclass correlation coefficient (ICC 2,1), the Bland & Altman analysis, the standard error of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%). Results: Test-retest agreements were high (ICC2,1 0.94–0.99) with no discernible systematic differences between the tests. The standard error of measurement (SEM%), representing the smallest change that indicates a real (clinical) improvement for a group of individuals, was small (9%). The smallest real difference (SRD%), representing the smallest change that indicates a real (clinical) improvement for a single individual, was also small (13–23%). Conclusion: These commonly used gait performance tests are highly reliable and can be recommended to evaluate improvements in various aspects of gait performance in individuals with chronic mild to moderate hemiparesis after stroke.
1,001 citations
Cites background from "The Timed “Up & Go”: A Test of Basi..."
...The TUG (23) is a modified version of the “Get-Up and Go” test (28)....
[...]
...The TUG (23) was developed primarily to evaluate basic functional mobility in frail elderly persons....
[...]
TL;DR: A single intervention with vitamin D plus calcium over a 3‐month period reduced the risk of falling by 49% compared with calcium alone, andMusculoskeletal function improved significantly in the Cal+D‐group (p = 0.0094).
Abstract: Specific receptors for vitamin D have been identified in human muscle tissue. Cross-sectional studies show that elderly persons with higher vitamin D serum levels have increased muscle strength and a lower number of falls. We hypothesized that vitamin D and calcium supplementation would improve musculoskeletal function and decrease falls. In a double-blind randomized controlled trial, we studied 122 elderly women (mean age, 85.3 years; range, 63-99 years) in long-stay geriatric care. Participants received 1200 mg calcium plus 800 IU cholecalciferol (Cal+D-group; n = 62) or 1200 mg calcium (Cal-group; n = 60) per day over a 12-week treatment period. The number of falls per person (0, 1, 2-5, 6-7, >7 falls) was compared between the treatment groups. In an intention to treat analysis, a Poisson regression model was used to compare falls after controlling for age, number of falls in a 6-week pretreatment period, and baseline 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D serum concentrations. Among fallers in the treatment period, crude excessive fall rate (treatment - pretreatment falls) was compared between treatment groups. Change in musculoskeletal function (summed score of knee flexor and extensor strength, grip strength, and the timed upg p < 0.01) based on the fall categories stated above. Among fallers of the treatment period, the crude average number of excessive falls was significantly higher in the Cal-group (p = 0.045). Musculoskeletal function improved significantly in the Cal+D-group (p = 0.0094). A single intervention with vitamin D plus calcium over a 3-month period reduced the risk of falling by 49% compared with calcium alone. Over this short-term intervention, recurrent fallers seem to benefit most by the treatment. The impact of vitamin D on falls might be explained by the observed improvement in musculoskeletal function.
955 citations
Cites methods from "The Timed “Up & Go”: A Test of Basi..."
...The TUG test, reported by Podsiadlo and Richardson, is a measure of functional mobility including muscle strength, gait speed, and balance.((29)) The TUG test is measured is seconds, and the smallest value of three trials was documented....
[...]
TL;DR: This paper reviews and compares existing commercial products to provide a comprehensive outlook of current development status and possible emerging technologies of wearable accelerometry-based motion detectors.
Abstract: Characteristics of physical activity are indicative of one's mobility level, latent chronic diseases and aging process. Accelerometers have been widely accepted as useful and practical sensors for wearable devices to measure and assess physical activity. This paper reviews the development of wearable accelerometry-based motion detectors. The principle of accelerometry measurement, sensor properties and sensor placements are first introduced. Various research using accelerometry-based wearable motion detectors for physical activity monitoring and assessment, including posture and movement classification, estimation of energy expenditure, fall detection and balance control evaluation, are also reviewed. Finally this paper reviews and compares existing commercial products to provide a comprehensive outlook of current development status and possible emerging technologies.
937 citations
Cites background from "The Timed “Up & Go”: A Test of Basi..."
...For example, the timed up-and-go test (TUG-T) is a simple test for evaluating one’s ability to perform a sequence of basic activities, and the result of the TUG-T can be a predictor for risk of falling [4]....
[...]
TL;DR: This investigation investigated the usefulness of the sign “stops walking when talking” in predicting falls and found that some frail elderly patients stop walking when they start a conversation with a walking companion, presumably because walking demands attention and they stop when they are expected to do two things at once.
936 citations
TL;DR: In both active and inactive ambulatory persons aged > or =60 y, 25(OH)D concentrations between 40 and 94 nmol/L are associated with better musculoskeletal function in the lower extremities than are concentrations < 40 nmol /L.
934 citations
Cites background from "The Timed “Up & Go”: A Test of Basi..."
...In addition, a significant improvement in grip strength, knee extensor and flexor strength, and the timed “up and go” test (35) was observed in the group treated with vitamin D plus calcium (summedmusculoskeletal score:P 0....
[...]
References
More filters
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.
76,181 citations
01 Jan 2002
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
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
5,148 citations
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).
3,081 citations
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...
2,418 citations