Our Experience on Tug Test as Diagnostic Marker in Peripheral Vestibular Diseases
Authors: Kalavathi C Lakshmi 
Published: August 2023

Background: Vestibular dysfunction in elderly screened with Timed Up and Go (TUG) test, is fast, simple way to assess fall risk, lower limb mobility, and function in clinical settings. This study was initiated to assess improvement of patient symptoms and postural control after performing Epley's maneuver using the Timed Up and test. Incorporation of the TUG test in this study provided a comprehensive evaluation of the effects of Epley's maneuver on both symptom relief and functional mobility. It allowed for objective measurements and quantifiable data to assess the effectiveness of the intervention, providing valuable insights for clinical decision-making and patient management. Methods: Prospective observational study was carried out on 100 patients aged 65 years and above suffering with peripheral vertigo were performed with "timed up and go" (TUG) test. We Propose Cutoff point of 13.5 seconds proposed as standard for identifying at risk of falling after particle repositioning maneuver. This decision was based on several factors and considerations specific to our study population and objectives. By setting a cut-off value of 13.7 seconds, we tried to achieve better balance between sensitivity and specificity, ensuring a more accurate identification of the target parameter in our study population. Results: In our study we observed from the results that the mean age of the patients in study was 69.6 years. A study population of 62 (62.0%) males and a number of 38(38.0%) females were considered for the study. Clinical findings of the study revealed that for patients suffering with dizziness it was observed that 29(29.0%) of patients had dizziness of less than 6 months, 24(24.0%) of the patients had dizziness for 6-12 months, 23(23.0%) patients had dizziness for >2 years, and 22(22.0%) of patients had dizziness for 1-2 years. Based on frequency of dizziness attacks it was observed that 53(53.0%) of study population had dizziness every day and 47(47.0%) had dizziness every week. Based on the duration of dizziness in the study population 29(6.0%6) of them had dizziness for few seconds only, 25(25.0%) of them had dizziness lasting for few minutes to hours, and 23(23.0%) of study population had continuous dizziness. In the study population 28(28.0%) had dizziness on lying down, 24(24.0%) had dizziness on turning, and 22(22.0%) had dizziness on lying down and turning. Also 84(84.0%) of these population had body instability, 73(73.0%) had vomiting during dizziness, 71(71.0%) had anxiety related to dizziness, 67(67.0%) had associated symptoms of nausea during attacks, 65(65.0%) of study population had associated tinnitus, 61(61.0%) among the study population had disordered sleep. Also it was observed that 59(59.0%) had headache, 56(56.0%) had sensation of fainting, 39(39.0%) had pallor & hearing loss, 38(38.0%) had sensation of pressure, and 29(29.0%) had sweating as associated clinical symptoms during the attacks of dizziness. Re-assessment after Epley’s maneuver reveals reduction in majority clinical findings. TUG test findings show mean initial assessment score of 15.3 + 3.02, after Epley’s maneuver was 12.3 + 3.34 with mean difference of 3.01 with p-value (<0.001). Discussion and Conclusion: Epley’s maneuver is useful to reduce clinical symptoms with peripheral vestibular disorders as assessed by TUG test in elderly