Original article
The Timed Up & Go Test: Its Reliability and Association With Lower-Limb Impairments and Locomotor Capacities in People With Chronic Stroke

https://doi.org/10.1016/j.apmr.2005.01.011Get rights and content

Abstract

Ng SS, Hui-Chan CW. The Timed Up & Go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke.

Objectives

To examine test-retest reliability of the Timed Up & Go (TUG) test, its ability to differentiate subjects with chronic stroke from healthy elderly subjects, and its associations with ankle plantarflexor spasticity, ankle muscle strength, gait performance, and distance walked in 6 minutes in subjects with chronic stroke.

Design

Cross-sectional study.

Setting

University-based rehabilitation center in Hong Kong, China.

Participants

Ten healthy elderly subjects and 11 subjects with chronic stroke.

Interventions

Not applicable.

Main Outcome Measures

Time taken to complete the TUG test was recorded. Plantarflexor spasticity and ankle muscle strength were assessed, respectively, by the Composite Spasticity Scale and a load-cell together with electromyography. Gait parameters and walking endurance were measured respectively by walkway system (GAITRite II) and 6-minute walk test. Intraclass correlation coefficients (ICCs) were calculated as measures of reliability, and all correlation analyses were conducted using Spearman correlation coefficients.

Results

The TUG test showed excellent reliability (ICC>.95). Subjects with chronic stroke had significantly more spastic and weaker plantarflexors, slower walking speeds, and poorer walking endurance when compared with healthy elderly subjects (all P<.003). The strength of the affected ankle plantarflexors (ρ=–.860, P<.01), gait parameters (ρ range, .620–.900; P<.05), and walking endurance (ρ=–.960, P<.01) correlated with TUG scores.

Conclusions

The TUG scores were reliable, were able to differentiate the patients from the healthy elderly subjects, and correlated well with plantarflexor strength, gait performance, and walking endurance in subjects with chronic stroke.

Section snippets

Participants

As mentioned, the TUG scores had an extremely high ICC value of .99 in frail elderly (including stroke) subjects3; we therefore hypothesized that the ICC value of our study on stroke patients would be .95. A sample size of 10 subjects would be needed if 2 observations per subject were to achieve 80% power to detect an intraclass correlation of .95 with a significant level of .05.

Two groups of subjects participated in our study. Ten community-dwelling healthy elderly subjects (5 men, 5 women;

Reliability

All tested variables generally showed good to excellent reliability results (ICC range, .69–.99) (table 3). The test-retest correlation coefficients for TUG scores were .97 in the healthy elderly subjects and .95 in subjects with stroke (see table 3).

Differences Between Subject Groups

The spasticity in the ankle plantarflexors in the affected legs of subjects with stroke was significantly (P<.001) higher compared with their unaffected legs and with the mean scores of both legs in the healthy elderly subjects (table 4).

For MIVC,

TUG Test

This is the first systematic study to investigate the test-retest reliability of TUG scores in people with chronic stroke. Our results are encouraging, because we found excellent between-days test-retest reliabilities (ICC=.95) (see table 3) that were similar to those reported in most studies on the elderly population with sample sizes ranging from 10 to 30 (ICC range, .81–.99).3, 4, 5, 7 Our well-defined clinical protocol, which standardized the chair type, movement sequencing, and

Conclusions

Our results show that there was a high degree of test-retest reliability in TUG scores in elderly subjects with chronic stroke. These scores were capable of detecting differences in functional mobility between healthy elderly subjects and subjects with stroke. Of special interest are the novel findings of strong relations between the strength of ankle plantarflexors, some spatiotemporal gait parameters, the walking endurance assessed by the 6MWT, and TUG scores. These findings make the TUG test

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  • Supported by the Hong Kong Polytechnic University (Area of Strategic Development research grant no. A106).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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