Clinimetric properties of the performance-oriented mobility assessment. Reliability of Six Physical Performance Tests in Older People With Dementia Properties of the ‘Timed Up and Go’ Test: More than Meets the Eye The L test of functional mobility: measurement properties of a modified version of the timed "up & go" test designed for people with lower-limb amputations. Timed Up and Down Stairs Test: Preliminary Reliability and Validity of a New Measure of Functional Mobility Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. The foot function index with verbal rating scales (FFI-5pt): A clinimetric evaluation and comparison with the original FFI. 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 Reliability of measurements obtained with the Timed "Up & Go" test in people with Parkinson disease. Functional Gait Assessment: Concurrent, Discriminative, and Predictive Validity in Community-Dwelling Older Adults 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. Reliability and Minimal Detectable Change of Physical Performance Measures in Individuals With Pre-manifest and Manifest Huntington Disease Validation of the Timed Up and Go Test for Assessing Balance Variables in Adults Aged 65 and Older. Attention, frailty, and falls: the effect of a manual task on basic mobility. Effect of an Overground Training Session Versus a Treadmill Training Session on Timed Up and Go in Hemiparetic Patients Psychometric evaluation of the original and Canadian French version of the activities-specific balance confidence scale among people with stroke. Effects of the Direction of Turning on the Timed Up & Go Test with Stroke Subjects Effects of balance-focused interactive games compared to therapeutic balance classes for older women Body Weight–Supported Treadmill Training Is No Better Than Overground Training for Individuals with Chronic Stroke: A Randomized Controlled Trial The Timed Up and Go test: Predicting falls in ALS The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. A comparison of four functional tests in discriminating fallers from non-fallers in older people Predicting the probability of falls in community-dwelling elderly individuals using the trail-walking test
BACKGROUND AND PURPOSE The Performance-Oriented Mobility Assessment ( POMA ) is a widely used instrument that provides an evaluation of balance and gait . It is used clinical ly to determine the mobility status of older adults or to evaluate changes over time . To support the use of the POMA for these purpose s , the clinimetric properties ( in particular , responsiveness ) were determined . SUBJECTS Participants ( 78 % female ; mean age=84.9 years ) were living in either self-care or nursing-care residences .  Concurrent and discriminant validity were assessed with the total group ( N=245 ) , whereas reliability and responsiveness were determined with a sub sample ( n=30 ) . Fall-related predictive validity was assessed with a sub sample of 72 participants . METHODS In addition to the POMA , several reference performance tests were administered . The POMA was assessed on 2 consecutive days by 2 raters ( observers ) . The analyses included the calculation of Spearman rank correlation coefficients ( R ) , limits of agreement ( LOA ) with Bl and -Altman plots , minimal detectable changes at the 95 % confidence level ( MDC(95 ) ) , and sensitivity and specificity with regard to predicting falls . When possible , findings for the total scale ( POMA-T ) were complemented by findings for its balance subscale ( POMA-B ) and its gait subscale ( POMA-G ) . RESULTS The interrater and test-retest reliability for the POMA-T and the POMA-B were good ( R=.74-.93 ) , whereas for the POMA-G , the reliability values , although high as well , were systematic ally slightly lower ( R=.72-.89 ) . The Spearman correlations with the reference performance tests ( R=|.64|- |.68| ) indicated satisfactory concurrent validity for the POMA-T and the POMA-B , but the corresponding findings for the POMA-G ( R=|.52|- |.56| ) were less convincing . The discriminant validity values of the 3 scales were about the same . The LOA for the POMA-T were on the order of -4.0 to 4.0 for test-retest agreement and -3.0 to 3.0 for interrater agreement . On the basis of the MDC(95 ) values , it was concluded that changes in POMA-T scores at the individual level should be at least 5 points and that those at the group level ( n=30 ) should be at least 0.8 point to be considered reliable . Even when optimal cutoff points were used , sensitivity and specificity values ( varying between 62.5 % and 66.1 % ) for the POMA-T as well as for its 2 subscales indicated poor accuracy in predicting falls . DISCUSSION AND CONCLUSION The POMA-T and its subscale POMA-B have adequate reliability and validity for assessing mobility in older adults . The POMA-T is useful for demonstrating intervention effects at the group level . Changes within subjects , however , should be at least 5 points before being interpreted as reliable changes . The accuracy of the POMA-T in predicting falls is poor Background Physical performance tests are important for assessing the effect of physical activity interventions in older people with dementia , but their psychometric properties have not been systematic ally established within this specific population . Objective The purpose of this study was to determine the relative and absolute test-retest reliability of the  6-m walk test  , the  Figure-of-Eight Walk Test ( F8W ) , the  Timed “ Up & Go ” Test ( TUG )  , the  Frailty and Injuries : Cooperative Studies of Intervention Techniques–4  ( FICSIT–4 ) Balance Test , the  Chair Rise Test ( CRT )  , and the  Jamar dynamometer .  These tests are used to assess gait speed , dynamic balance , functional mobility , static balance , lower-limb strength , and grip strength , respectively . Design This investigation was a prospect i ve , nonexperimental study . Methods Older people with dementia ( n=58 , age range=70–92 years ) performed each test at baseline and again after 1 week . Intraclass correlation coefficients ( ICC ) , st and ard error of measurement ( SEM ) , minimal detectable change ( MDC ) , and log-transferred limits of agreement of Bl and -Altman plots were calculated . Results The relative reliability of the F8W , TUG , and Jamar dynamometer was excellent ( ICC=.90–.95 ) and good for the 6-m walk test , FICSIT–4 , and CRT ( ICC=.79–.86 ) . The SEMs and MDCs were large for all tests . The absolute reliability of the TUG and CRT was significantly influenced by the level of cognitive functioning ( as assessed with the Mini-Mental State Examination [ MMSE ] ) . Limitations The specific etiology of dementia was not obtained . Conclusions The physical performance tests evaluated are useful for detecting differences in performance between older people with mild to moderate dementia and , therefore , are suitable for cross-sectional or controlled intervention studies . They appear less suitable to monitor clinical ly relevant intra-individual performance changes . Future studies should focus on the development of more sensitive tests and the identification of criteria for clinical ly relevant changes in this rapidly growing population Background : The  ‘ timed up and go ’ test ( TUG ) is a simple , quick and widely used clinical performance-based measure of lower extremity function , mobility and fall risk . We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults . Objective : To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test ( BBT ) and the Dynamic Gait Index ( DGI ) . Methods : The  TUG , DGI and BBT  were assessed in 265 healthy older adults ( 76.4 ± 4.3 years ; 58.3 % women ) who participated in a 3-year prospect i ve study . The  Mini-Mental State Examination , digit span and verbal fluency measured cognitive function . The one- sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson ’s correlation coefficients quantified associations . Results : The mean scores of the BBT , DGI and TUG were : 54.0 ± 2.4 , 22.8 ± 1.5 , 9.5 ± 1.7 s , respectively . The BBT and the DGI were not normally distributed ( p < 0.001 ) , but the TUG was ( p = 0.713 ) . The TUG times were mildly associated ( p < 0.01 ) with digit span and verbal fluency and were related to future falls , while the BBT and the DGI were not . Conclusions : The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults . It does not suffer from ceiling effect limitations , is normally distributed and is apparently related to executive function . The BBT and the DGI do not share these beneficial properties . Perhaps the transferring and turning components of the TUG help to convert this relatively simple motor task into a more complex measure that also depends on cognitive re sources BACKGROUND AND PURPOSE Walk tests provide essential outcome information when assessing ambulation of individuals with lower-limb amputation and a prosthetic device . Existing tests have limitations such as ceiling effects or insufficient challenge . The objective of this study was to assess the reliability and validity of data for a clinical measure of basic mobility , the L Test of Functional Mobility  ( L Test ) . SUBJECTS For this method ological study , 93 people with unilateral amputations ( 74 % transtibial , 26 % transfemoral ; 78 % male , 22 % female ; mean age=55.9 years ) were consecutively recruited from an outpatient clinic . Twenty-seven subjects returned for retesting . METHODS To assess concurrent validity , subjects completed the L Test , Timed " Up & Go " Test ( TUG ) , 10-Meter Walk Test , and 2-Minute Walk Test , followed by the Activities-specific Balance Confidence scale , Frenchay Activities Index ( FAI ) , and mobility subscale of the Prosthetic Evaluation Question naire ( PEQ-MS ) . Amputation cause and level , walking aid use , automatic stepping , and age variables were used to assess discriminant validity . RESULTS Intraclass correlation coefficients were .96 for interrater reliability and .97 for intrarater reliability , and minimal bias existed upon retesting . The magnitude of concurrent validity correlations ( r ) was very high between the L Test data and data for other walk tests and fair to moderate between the L Test data and data for self-report measures . The L Test discriminated between all groups as hypothesized . DISCUSSION AND CONCLUSION The L Test is a 20-m test of basic mobility skills that includes 2 transfers and 4 turns . It demonstrated excellent measurement properties in this study Purpose : The reliability and validity of a new test , the Timed Up and Down Stairs ( TUDS ) , were examined in children with and without cerebral palsy ( CP ) . Methods : A convenience sample of 47 children age eight to 14 years participated , 20 with CP and 27 with typical development ( TD ) . Using intraclass correlation coefficients ( ICC ) , interrater , intrarater , and test – retest reliability of the TUDS were examined by two raters simultaneously testing nine children , by one rater who then rescored at a later time a video of the testing of 24 children , and by one rater testing 25 children twice with a two-hour separation , respectively . Concurrent validity was examined using Spearman rank correlations between TUDS scores and performance on the Timed Up and Go ( TUG ) , the Functional Reach Test ( FRT ) , and a Timed One Legged Stance ( TOLS ) , which were completed in a r and om order on all children . Construct validity was examined by correlation and Kruskal-Wallis analysis of variance of scores across ages and three functional level groups . Results : The TUDS demonstrated excellent intrarater , interrater , and test – retest reliability [ ICC ( 2,1 ) ≥0.94 ] and moderate to high concurrent validity ( Spearman rs = 0.78 , −0.57 , and −0.77 , with the TUG , FRT , and TOLS , respectively ) . Age accounted for 37 % and 56 % of the variance in the TUDS for the TD group and for the Gross Motor Function Classification Scale level I CP group , respectively . Significant differences in TUDS scores were found between all three functional level groups . Conclusion : The TUDS has adequate reliability and validity in children with and without CP and appears to complement current clinical measures of functional mobility and balance . Further investigations on across larger age ranges and sample s are warranted OBJECTIVES To compare the practicality , reliability , validity , and responsiveness of the timed up and go ( TUG ) , one-leg st and ( OLS ) , functional reach ( FR ) , and Tinetti balance ( TB ) performance measures in people aged 65 and older . DESIGN A prospect i ve study . SETTING Shin-Sher Township of Taichung County , west- central Taiwan . PARTICIPANTS Twelve hundred community-dwelling older people . MEASUREMENTS During an initial assessment at their residences , participants were interviewed for demographics , cognition , fall history , use of a walking aid , and activities of daily living ( ADLs )  , in addition to completing the four balance tests . Falls were ascertained by telephone every 3 months for a 1-year follow-up ; the four balance measures and ADLs were also reassessed at the end of the follow-up year . RESULTS Of the four balance measures , the OLS had the lowest participation rate , and participation of people who were cognitively impaired had fallen in the previous year , used a walking aid , or suffered from an ADL disability was lower than for their counterparts . The time to complete the tests ranged from 58 seconds for OLS , to 160 seconds for the TB . All four balance measures exhibited excellent test-retest reliability and discriminant validity but poor responsiveness to fall status . The TB showed better discriminant , convergent , and predictive validities and responsiveness to ADL changes than the other three tests . CONCLUSION According to psychometric properties , the most suitable performance measure for evaluating balance in community-dwelling older people was the TB , followed by the TUG OBJECTIVE To assess the clinimetric value of the Dutch version of the Foot Function Index ( FFI ) in comparison with the original FFI using verbal rating scales ( FFI-5pt ) rather than visual analog scales ( VAS ) . METHODS A prospect i ve study was performed on 206 patients with nontraumatic forefoot complaints . Scoring , internal consistency , and construct validity of the FFI-5pt were compared with those of the original FFI , which rates all items on VAS . We also studied agreement between the scores at baseline and after one and 8 weeks and the scale scores with regard to sex , age , presence of osteoarthritis , limitation of mobility , bodily pain , and poor physical functioning ( using SF-36 ) . RESULTS Some items were not applicable ; removal of these items left 2 scales ( Pain and Disability ) with high internal consistency ( alpha = 0.88 to 0.94 ) and good agreement between both versions ( intraclass correlation coefficient 0.64 to 0.79 ) . Principal component analysis with varimax rotation using a forced 2 factor model fitted well ( 65 % explained variance ) . Test-retest reliability was high ( ICC 0.70 to 0.83 ) , while the stability over 8 weeks was lower , but still good ( ICC 0.63 to 0.71 ) . Responsiveness to change was low to moderate . However , a small number of patients reported an overall change ( 19 % ) . Scores of patients with limited mobility and poor physical health ( SF-36 ) were higher than those of patients with fewer physical problems , indicating good concurrent validity . CONCLUSION The FFI-5pt is a suitable generic measure . Its clinimetric properties are comparable with those of the original FFI . Its administration and data entry are less time consuming . However , responsiveness has to be more exactly assessed in an intervention study Background : With the increasing incidence of Alzheimer disease ( AD ) , determining the validity and reliability of outcome measures for people with this disease is necessary . Objective : The goals of this study were to assess test-retest reliability of data for the Timed “ Up & Go ” Test ( TUG ) , the  Six-Minute Walk Test  ( 6MWT ) , and gait speed and to calculate minimal detectable change ( MDC ) scores for each outcome measure . Performance differences between groups with mild to moderate AD and moderately severe to severe AD ( as determined by the Functional Assessment Staging [ FAST ] scale ) were studied . Design : This was a prospect i ve , nonexperimental , descriptive method ological study . Methods : Background data collected for 51 people with AD included : use of an assistive device , Mini-Mental Status Examination scores , and FAST scale scores . Each participant engaged in 2 test sessions , separated by a 30- to 60-minute rest period , which included 2 TUG trials , 1 6MWT trial , and 2 gait speed trials using a computerized gait assessment system . A specific cuing protocol was followed to achieve optimal performance during test sessions . Results : Test-retest reliability values for the TUG , the 6MWT , and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately ( intraclass correlation coefficients ≥.973 ) ; however , individual variability of performance also was high . Calculated MDC scores at the 90 % confidence interval were : TUG=4.09 seconds , 6MWT=33.5 m ( 110 ft ) , and gait speed=9.4 cm/s . The 2 groups were significantly different in performance of clinical tests , with the participants who were more cognitively impaired being more physically and functionally impaired . Limitations : A single research er for data collection limited sample numbers and prohibited blinding to dementia level . Conclusions : The TUG , the 6MWT , and gait speed are reliable outcome measures for use with people with AD , recognizing that individual variability of performance is high . Minimal detectable change scores at the 90 % confidence interval can be used to assess change in performance over time and the impact of treatment BACKGROUND AND PURPOSE The Timed " Up & Go " Test ( TUG ) is used to measure the ability of patients to perform sequential locomotor tasks that incorporate walking and turning . This study investigated the retest reliability , interrater reliability , and sensitivity of scores obtained with the TUG in detecting changes in mobility in subjects with idiopathic Parkinson disease ( PD ) . SUBJECTS The performance of 12 people with PD was compared with that of 12 age-matched comparison subjects without PD . METHODS The subjects with PD completed 5 trials of the TUG after withdrawal of levodopa for 12 hours ( " off " phase of the medication cycle ) as well as an additional 5 trials 1 hour after levodopa was administered ( " on " phase of the medication cycle ) . They were scored on the Modified Webster Scale at both sessions . The comparison subjects also performed 5 TUG trials . All trials were videotaped and timed by 2 experienced raters . The videotape was later rated by 3 experienced clinicians and 3 inexperienced clinicians . RESULTS For the subjects with PD , within-session performance was highly consistent , with correlations ( r ) ranging from.80 to.98 for the " off " phase and from.73 to.99 for the " on " phase . The performance of the comparison subjects across the 5 trials was also highly consistent ( r=.90-.97 ) . Comparisons showed differences between trials 1 and 2 on the TUG for both groups . Removal of data for trial 1 ( the practice trial ) further enhanced retest reliability . There was close agreement in TUG scores among raters despite different levels of experience ( intraclass correlation coefficient [3,1]=.87-.99 ) . Mean TUG scores were different between the " on " and " off " phases of the levodopa cycle and between subjects with PD and comparison subjects during the " on " phase . CONCLUSION AND DISCUSSION Retest reliability and interrater reliability of the TUG measurements were high , and the measurements reflected changes in performance according to levodopa use . The TUG can also be used to detect differences in performance between people with PD and elderly people without PD Background The Functional Gait Assessment ( FGA ) is a reliable and valid measure of gait-related activities . Objective The purpose of this study was to determine the concurrent , discriminative , and predictive validity of the FGA in community-dwelling older adults . Design This was a prospect i ve cohort study . Methods Thirty-five older adults aged 60 to 90 years completed the Activities-specific Balance Confidence Scale ( ABC ) , Berg Balance Scale ( BBS ) , Dynamic Gait Index ( DGI ) , Timed “ Up & Go ” Test ( TUG ) , and Functional Gait Assessment ( FGA ) during one session . Falls were tracked by having participants complete a monthly fall calendar for 6 months . Spearman correlation coefficients were used to determine concurrent validity among the ABC , BBS , TUG , DGI , and FGA . To determine the optimum scores to classify fall risk , sensitivity ( Sn ) , specificity ( Sp ) , and positive and negative likelihood ratios ( LR+ and LR− ) were calculated for the FGA in classifying fall risk based on the published criterion scores of the DGI and TUG and for the FGA , TUG , and DGI in identifying prospect i ve falls . Receiver operator curves with area under the curve were used to determine the effectiveness of the FGA in classifying fall risk and of the DGI , TUG , and FGA in identifying prospect i ve falls . Results The FGA correlated with the ABC ( r=.053 , P<.001 ) , BBS ( r=.84 , P<.001 ) , and TUG ( r=−.84 , P<.001 ) . An  FGA  score of ≤22/30 provides both discriminative and predictive validity . The FGA ( scores ≤22/30 ) provided 100 % Sn , 72 % Sp , LR+ of 3.6 , and LR− of 0 to predict prospect i ve falls . Limitations The study was limited by the length of time of follow-up and the small sample size that did not allow for evaluation of criterion scores by decade . Conclusions The FGA with a cutoff score of 22/30 is effective in classifying fall risk in older adults and predicting unexplained falls in community-dwelling older adults BACKGROUND AND PURPOSE The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities . The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults . SUBJECTS Ninety-six community-dwelling elderly people ( 61 - 89 years of age ) with independent functioning performed 4 clinical tests . METHODS Data were collected on the  Six-Minute Walk Test ( 6MW ) , Berg Balance Scale ( BBS ) , and Timed Up & Go Test ( TUG ) and during comfortable- and fast-speed walking ( CGS and FGS ) . Intraclass correlation coefficients ( ICCs ) were used to determine the test-retest reliability for the 6MW , TUG , CGS , and FGS measurements . Data were analyzed by gender and age ( 60 - 69 , 70 - 79 , and 80 - 89 years ) cohorts , similar to previous studies . Means , st and ard deviations , and 95 % confidence intervals for each measurement were calculated for each cohort . RESULTS The 6MW , TUG , CGS , and FGS measurements showed high test-retest reliability ( ICC [2,1]=.95-.97 ) . Mean test scores showed a trend of age-related declines for the 6MW , BBS , TUG , CGS , and FGS for both male and female subjects . DISCUSSION AND CONCLUSION Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW , BBS , TUG , CGS and FGS . Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons Background Clinical intervention trials in people with Huntington disease ( HD ) have been limited by a lack of reliable and appropriate outcome measures . Objective The purpose of this study was to determine the reliability and minimal detectable change ( MDC ) of various outcome measures that are potentially suitable for evaluating physical functioning in individuals with HD . Design This was a multicenter , prospect i ve , observational study . Methods Participants with pre-manifest and manifest HD ( early , middle , and late stages ) were recruited from 8 international sites to complete a battery of physical performance and functional measures at 2 assessment s , separated by 1 week . Test-retest reliability ( using intraclass correlation coefficients ) and MDC values were calculated for all measures . Results Seventy-five individuals with HD ( mean age=52.12 years , SD=11.82 ) participated in the study .  Test-retest reliability was very high ( > .90 ) for participants with manifest HD for the Six-Minute Walk Test ( 6MWT ) , 10-Meter Walk Test , Timed “ Up & Go ” Test ( TUG ) , Berg Balance Scale ( BBS ) , Physical Performance Test ( PPT ) , Barthel Index , Rivermead Mobility Index , and Tinetti Mobility Test ( TMT ) . Many MDC values suggested a relatively high degree of inherent variability , particularly in the middle stage of HD . Minimum detectable change values for participants with manifest HD that were relatively low across disease stages were found for the BBS ( 5 ) , PPT ( 5 ) , and TUG ( 2.98 ) . For individuals with pre-manifest HD ( n=11 ) , the 6MWT and Four Square Step Test had high reliability and low MDC values . Limitations The sample size for the pre-manifest HD group was small . Conclusions The BBS , PPT , and TUG appear most appropriate for clinical trials aim ed at improving physical functioning in people with manifest HD . Further research in people with pre-manifest HD is necessary The Timed Up and Go ( TUG ) test is recommended by the U.S. Centers for Disease Control and Prevention as an easy to administer clinical test to evaluate a senior citizen 's fall risk . Limited evidence has been presented in the literature validating the TUG test . In this study , the authors sought to assess correlations between the TUG test and various balance markers utilizing the OptoGait system .  A total of 51 healthy seniors completed r and omized trials of the TUG test and a gait test utilizing  OptoGait photoelectric technology .  Correlations among mean and SD values for these variables and TUG performance were calculated . Utilizing a Bonferroni adjustment and an alpha level of .05 , eight significant correlations of a moderately strong degree ( absolute r scores between .51 and .78 ) emerged . Correlation results indicate that the TUG test is a valid tool for screening balance deficits that lead to increased fall risk in senior citizens OBJECTIVE To investigate the effect of a second task on balance and gait maneuvers used in everyday life . Our hypothesis was that those who were more distracted by a familiar manual task performed concurrently with functional maneuvers were more frail and more prone to falls . DESIGN A cross-sectional design with prospect i ve follow-up for falls . SETTING Sheltered accommodation in Umeå , Sweden . PARTICIPANTS Forty-two residents ( 30 women , 12 men ; mean age + /- SD = 79.7 + /- 6.1 years ) , ambulant with or without a walking aid , able to follow simple instructions and able to carry a tumbler . MEASUREMENTS  Timed Up & Go ( TUG ) , i.e. , the time taken to rise from an armchair , walk 3 meters , turn round , and sit down again . TUG was repeated with an added manual task ( TUGmanual ) , which was to carry a glass of water while walking . The Montgomery-Asberg Depression Rating Scale , Barthel Index , Functional Reach , Mini-Mental State Examination , and Line Bisection test were used to assess for frailty . The subjects were followed-up prospect ively regarding falls indoors for a period of 6-months . RESULTS Subjects with a time difference ( diffTUG ) between TUGmanual and TUG of > or = 4.5 seconds were considered to be distracted by the second task . Ten subjects had a difference in time of > or = 4.5 seconds . These subjects were more frail , and seven of them fell indoors during the follow-up period ( odds ratio 4.7 , 95%Confidence Interval ( CI ) 1.5 - 14.2 ) . CONCLUSION The time difference between the TUGmanual and the TUG appears to be a valid marker of frailty and a useful tool for identifying older persons prone to falling Abstract Background : Timed Up and Go ( TUG ) performance is reduced following stroke . Gait training improves gait-related activities in hemiparetic patients . However , no study has compared the impact of a single overground training session with a treadmill training session on gait-related activities ( assessed by TUG ) . Objective : To compare the immediate effect of a single overground training session versus a single treadmill training session on TUG performance in hemiparetic patients . Methods : In this r and omized controlled clinical trial , 56 hemiparetic patients were r and omized to 1 or 2 distinct groups : a single gait training session overground ( O group ) or on a treadmill ( T group ) . Time taken to perform the TUG ( in seconds ) was assessed before and immediately after the completion of each session . Results : Time taken to perform the TUG decreased significantly , and to a similar extent , in both groups following the training session ( O group , 5.9 % ; T group , 5.2 % ) . Conclusions : An overground training session and a treadmill training session were equally effective in improving TUG performance in hemiparetic patients . Hemiparetic patients should be encouraged to walk regularly overground including turns for 20 minutes without stopping . This is an easy and inexpensive self-rehabilitation method to improve functional gait-related activities involved in the TUG test OBJECTIVE To evaluate the internal and absolute reliability and construct validity of the Activities-Specific Balance Confidence ( ABC ) scale and a new Canadian French version ( ABC-CF ) of it among people with stroke . DESIGN Cross-sectional data from a r and omized controlled trial . SETTING Community . PARTICIPANTS Ninety-one people with a residual walking deficit between 57 and 386 days poststroke . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES The ABC and ABC-CF scales , Berg Balance Scale ( BBS ) , comfortable and maximum gait speeds , Timed Up & Go ( TUG ) test , 6-minute walk test ( 6MWT ) , Barthel Index , physical function scale of the Medical Outcomes Study 36-Item Short-Form Health Survey , Geriatric Depression Scale ( GDS ) , and the EQ-5D visual analog scale ( EQ VAS ) . RESULTS Internal consistency ( Cronbach alpha ) was .94 and .93 and the st and ard error of measurement was 5.05 and 5.13 for the ABC ( n=51 ) and the ABC-CF ( n=35 ) scales , respectively . Spearman rho values ranged from .30 to .60 for the ABC scale and from .45 to .68 on the ABC-CF scale for associations with scores on the BBS , comfortable and maximum gait speeds , TUG , 6MWT , Barthel Index , physical function scale , GDS , and EQ VAS . CONCLUSIONS Evidence of internal and absolute reliability and of construct validity of the ABC and the ABC-CF scales supports their use for cross-sectional measurements of balance self-efficacy among community-dwelling people in the first year poststroke Abstract Purpose : To compare the  Timed Up & Go ( TUG ) test between subjects with and without hemiparesis , considering the direction toward which they turned , and to determine the potential clinical variables that could explain possible observed differences between the groups and /or the turning directions . Method : Twenty-two hemiparetic and 22 matched control subjects performed the TUG twice , with each one turning in both directions .  Measures of the strength and tonus of the quadriceps , gait speed , balance , and fear of falling were also collected . Results : Stroke subjects were slower in the TUG than the control group , independent of the direction toward which they turned ( F = 45.87 ; p < .001 ) . For both groups , similar performances were observed when turning toward the paretic and nonparetic/matched sides ( F = 0.50 ; p = .48 ) . The absolute differences between the two TUG trials were greater for the stroke subjects ( p = .001 ) and were significantly correlated with gait speed , balance , and fear of falling ( −0.69 < r < − 0.52 ; p < .013 ) , with fear of falling being the only variable retained in the regression model ( R2 = 0.44 ; p = .001 ) . For the control subjects , no significant correlations were found . Conclusions : The larger differences between the two TUG trials for the stroke subjects illustrated the impact of the turning direction on test performance . These differences were not related to hemiparesis , but to the fear of falling ABSTRACT Objective The prospect i ve pre – post control study was design ed to evaluate the effect of introducing balance-focused interactive virtual-reality games to community-dwelling older women to improve their agility , balance and functional mobility . Method The study was set in a senior citizens ’ club in Cheras , Kuala Lumpur , Malaysia . The participants were 36 community-dwelling older women . Participants were r and omly divided into either a group undertaking balance-focused virtual-reality games or a group doing therapeutic balance exercises . The program lasted 6 weeks and was conducted twice a week for 40 min during each session . As the main outcome measures , the results of the Ten Step Test ( TST ) , postural sway ( overall performance index , OPI ) and the Timed Up and Go test ( TUG ) were measured pre- and post-intervention to evaluate agility , balance and functional mobility , respectively . Results Although both groups improved in OPI ( F = 4.63 , p < 0.001 ) , TST ( F = 46.15 , p < 0.001 ) and TUG ( F = 52.57 , p = 0.03 ) , combined time and group interaction only improved in the TUG ( F = 4.54 , p < 0.05 ) . No significant differences between the two groups were found in terms of TST ( F = 0.02 , p = 0.86 ) , OPI ( F = 0.66 , p = 0.42 ) , and TUG ( F = 0.11 , p = 0.74 ) . Conclusion Older people could improve their agility , balance and functional mobility by complementing therapeutic balance exercises with active participation in interactive virtual-reality games at home or in the community Abstract Background : Body weight-supported treadmill training ( BWSTT ) has produced mixed results compared with other therapeutic techniques . Objective : The purpose of this study was to determine whether an intensive intervention ( intensive mobility training ) including BWSTT provides superior gait , balance , and mobility outcomes compared with a similar intervention with overground gait training in place of BWSTT . Methods : Forty-three individuals with chronic stroke ( mean [ SD ] age , 61.5 [ 13.5 ] years ; mean [ SD ] time since stroke , 3.3 [ 3.8 ] years ) , were r and omized to a treatment ( BWSTT , n = 23 ) or control ( overground gait training , n = 20 ) group . Treatment consisted of 1 hour of gait training ; 1 hour of balance activities ; and 1 hour of strength , range of motion , and coordination for 10 consecutive weekdays ( 30 hours ) . Assessment s ( step length differential , self-selected and fast walking speed , 6-minute walk test , Berg Balance Scale [ BBS ] , Dynamic Gait Index [ DGI ] , Activities-specific Balance Confidence [ ABC ] scale , single limb stance , Timed Up and Go [ TUG ] , Fugl-Meyer [ FM ] , and perceived recovery [ PR ] ) were conducted before , immediately after , and 3 months after intervention . Results : No significant differences ( α = 0.05 ) were found between groups after training or at follow-up ; therefore , groups were combined for remaining analyses . Significant differences ( α = 0.05 ) were found pretest to posttest for fast walking speed , BBS , DGI , ABC , TUG , FM , and PR . DGI , ABC , TUG , and PR results remained significant at follow-up . Effect sizes were small to moderate in the direction of improvement . Conclusions : Future studies should investigate the effectiveness of intensive interventions of duration s greater than 10 days for improving gait , balance , and mobility in individuals with chronic stroke There are few functionally meaningful clinical measures used to guide management of patients with ALS . Falls are common , can be debilitating , and result in increased health care costs . We assessed the performance and ability to predict falls of the  Timed Up and Go ( TUG ) test  , which quantifies walking ability , in a prospect i ve longitudinal study . Thirty‐one patients underwent six monthly TUG , ALSFRS‐R , forced vital capacity , muscle testing ( MMT ) and quality of life assessment s. Linear and generalized linear mixed effects models assessed the associations among variables and ability to predict falls . The increase in TUG time was linear over six months , and TUG time was negatively associated with ALSFRS‐R ( p⩽0.001 ) and MMT scores ( p⩽0.001 ) . The TUG test was the only variable that was associated with the chance of falling ( p = 0.024 ) ; patients with TUG times of 14 s had a 10 % chance of falling during the study . In conclusion , TUG performance declined linearly in this longitudinal study , was correlated with st and ard outcome measures , and predicted falls . The TUG test can guide management of patients with ALS ; a time of 14 s can be used to prompt the recommendation for mobility aids to prevent falls BACKGROUND AND PURPOSE To be useful for clinical research , an outcome measure must be feasible to administer and have sound psychometric attributes , including reliability , validity , and sensitivity to change . This study characterizes the psychometric properties of the Stroke Impact Scale ( SIS ) Version 2.0 . METHODS Version 2.0 of the SIS is a self-report measure that includes 64 items and assesses 8 domains ( strength , h and function , ADL/IADL , mobility , communication , emotion , memory and thinking , and participation ) . Subjects with mild and moderate strokes completed the SIS at 1 month ( n=91 ) , at 3 months ( n=80 ) , and at 6 months after stroke ( n=69 ) . Twenty-five subjects had a replicate administration of the SIS 1 week after the 3-month or 6-month test . We evaluated internal consistency and test-retest reliability . The validity of the SIS domains was examined by comparing the SIS to existing stroke measures and by comparing differences in SIS scores across Rankin scale levels . The mixed model procedure was used to evaluate responsiveness of the SIS domain scores to change . RESULTS Each of the 8 domains met or approached the st and ard of 0.9 alpha-coefficient for comparing the same patients across time . The intraclass correlation coefficients for test-retest reliability of SIS domains ranged from 0.70 to 0.92 , except for the emotion domain ( 0.57 ) . When the domains were compared with established outcome measures , the correlations were moderate to strong ( 0.44 to 0.84 ) . The participation domain was most strongly associated with SF-36 social role function . SIS domain scores discriminated across 4 Rankin levels . SIS domains are responsive to change due to ongoing recovery . Responsiveness to change is affected by stroke severity and time since stroke . CONCLUSIONS This new , stroke-specific outcome measure is reliable , valid , and sensitive to change . We are optimistic about the utility of measure . More studies are required to evaluate the SIS in larger and more heterogeneous population s and to evaluate the feasibility and validity of proxy responses for the most severely impaired patients Purpose : Which functional tests on mobility and balance can better screen older people at risk of falls is unclear . This study aims to compare the  Berg Balance Scale ( BBS ) , Tinetti Mobility Score ( TMS ) , Elderly Mobility Scale ( EMS ) and Timed Up and Go test ( TUG )  in discriminating fallers from non-fallers in older people . Method : This was a case-control study involving one rater who conducted a mobility and balance assessment on subjects using the four functional tests in r and om sequence .  Subjects recruited included 17 and 22 older people with a history of single and multiple falls respectively from a public Falls Clinic , and 39 community-dwellers without fall history and whose age , sex and BMI matched those of the fallers . All subjects underwent the mobility and balance assessment within one day . Results : Single fallers performed better than multiple fallers in all four functional tests but were worse than non-fallers in the BBS , TMS and TUG . The BBS demonstrated the best discriminating ability , with high sensitivity and specificity . The BBS item ` pick up an object from the floor ' was the best at screening fallers . Conclusion : BBS was the most powerful functional test of the four in discriminating fallers from non-faller Background Falling is a common problem in the fast-growing elderly population .  Multitasking or engaging in two or more activities at the same time is common in daily living . Objective To determine the usefulness of the  trail-walking test ( TWT ) for predicting a fall in community-dwelling elderly individuals . Methods This was a prospect i ve study in which the TWT was used to evaluate the risk of falling among a group of community-dwelling elderly individuals ( n = 171 ) with a mean age of 80.5 ± 5.6 years . The following tests were conducted :  TWT , trail-making test ( TMT ) , timed-up- and -go test ( TUG ) , functional reach ( FR ) test , one-leg st and ing ( OLS ) test , and 10-m walking time test . Test – retest reliability was assessed by repeating the TWT within 2 weeks of the first trial , and there was a 1-year follow-up . Stepwise logistic regression analysis was used to analyze whether the TWT , TMT , TUG , FR , OLS , or 10-m walking tests predicted falling . Results The test – retest reliability  of TWT was high ( intraclass correlation coefficient 0.945 , p < 0.001 ) . Fifty-nine participants ( 34.5 % ) had reported a fall during the year preceding the 1-year follow-up . The stepwise logistic regression analysis revealed that only the TWT was significantly related to falling ( odds ratio 1.160 , 95 % confidence interval 1.107–1.214 ; p < 0.001 ) . In total , 77.8 % of cases were correctly classified . Conclusion When reliability and validity were considered , the TWT was most useful test of those evaluated for assessing the risk of fall among our elderly cohort
Conclusion : The TUG can be recommended for measuring basic mobility skills after stroke in patients who are able to walk .
Abstract Objective : To systematic ally review and summarize the clinimetric properties , including reliability , validity , and responsiveness , the procedures used , and the meanings of the scores in the Timed Up and Go Test ( TUG ) .
The TUG is a performance test that identifies problems with functional mobility in patients with stroke .