Timed Up and Go TUG Test

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

 

Timed Up and Go (TUG) Test

Overview & Objectives

• Definition: A standardized functional test evaluating dynamic balance and mobility.

• Primary Applications:

  • Assessment of functional mobility (rising, ambulating, turning, transfers).

  • Fall-risk screening, particularly in geriatric populations.

  • Direct observation of transitional movements: chair rise, forward gait, turning, return gait, and sitting down.

Equipment & Setup

• Apparatus:

  • Standard armchair.

  • Stopwatch / timing device.

  • Clear marker/line placed 3 meters (~10 feet) directly in front of the chair.

• Patient Requirements:

  • Wears regular, everyday footwear.

  • Permitted to use customary walking aids (e.g., cane, walker).

Examination Protocol & Technique

• Familiarization: Patient is allowed one unrecorded practice trial to ensure comprehension.

• Standardized Instruction: “When I say go, stand up from the chair, walk to the line at your normal pace, turn around, walk back to the chair at your normal pace, and sit down.”

• Kinematic Sequence:

  1. Seated in armchair.

  2. Stand up.

  3. Walk forward 3 meters at habitual pace.

  4. Turn around at the line.

  5. Walk back to the chair.

  6. Sit down fully.

• Timing Parameters:

  • Initiation: Triggered on the verbal command “Go”.

  • Termination: Stopped the moment the patient’s buttocks make contact with the chair seat.

  • Units: Recorded in elapsed seconds.

• Patient Safety: An assistant or examiner must remain in close proximity throughout the test to prevent falls, especially in patients with evident gait instability.

Clinical Interpretation & Diagnostic Metrics

• Cut-Off Threshold: $>12$ seconds indicates an increased risk of falls in older adults.

• Reported Diagnostic Values:

  • Sensitivity: 80%

  • Specificity: 100%

• Clinical Considerations:

  • Falls in the elderly are multifactorial, involving environmental hazards and activity-related triggers.

  • Increased completion time correlates with higher risks of musculoskeletal injury and secondary functional activity limitation.

Master Revision Summary

• Clinical Purpose: Dynamic mobility assessment and fall-risk stratification.

• Distance: 3 meters (~10 feet) from an armchair.

• Pace: Normal / customary walking speed.

• Assistive Devices: Routine walking aids allowed.

• Practice: One practice run allowed prior to measurement.

• Pathological Cut-Off: $>12$ seconds denotes high fall risk in elderly patients.

• Reported Accuracy: 80% sensitivity, 100% specificity.