Speed Testing: Timed Up and Go

The Time Up and Go (TUG) test is a simple and commonly used clinical assessment of mobility and balance in older adults. It involves measuring the time it takes for an individual to stand up from a chair, walk three meters, turn around, walk back to the chair, and sit down again. The TUG test is often used as a screening tool to identify individuals who may be at risk of falls or have mobility issues. Overall, the TUG test is a quick and reliable tool for assessing mobility and balance, and it can be used in a variety of settings, including clinics, hospitals, and long-term care facilities.

Here is a step-by-step procedure for performing the Time Up and Go (TUG) test:

1. Explain the procedure to the individual and ensure they understand what they need to do.
2. Ask the individual to sit on a chair with armrests, with their back against the chair back and their feet flat on the floor.
3. When the individual is ready, start the stopwatch and ask them to stand up from the chair and walk at a comfortable pace to a line on the floor 3 meters away. The line should be clearly marked and visible to the individual.
4. When the individual reaches the line, ask them to turn around and walk back to the chair.
5. When the individual reaches the chair, ask them to turn around and sit down.
6. Stop the stopwatch as soon as the individual is seated.
7. Record the time it took for the individual to complete the test.
8. Repeat the test two more times to ensure consistency of results, with a break of a few minutes between each trial.
9. Calculate the average time of the three trials.
10. If necessary, modify the test by adding a cognitive task or another challenge to assess dual-task performance.

The normal result of the Time Up and Go (TUG) test varies depending on age, sex, and other factors such as health status and mobility level. However, in general, a TUG score of 10 seconds or less is considered normal for older adults, while scores above 14 seconds may indicate mobility issues or an increased risk of falls. 

The sensitivity and specificity of the TUG test for predicting falls vary depending on the population being assessed and the cutoff score used. A systematic review and meta-analysis of studies on the TUG test found that it has moderate sensitivity and specificity for predicting falls in older adults, with a pooled sensitivity of 0.66 and a pooled specificity of 0.70. However, the authors noted that more research is needed to fully understand the predictive value of the TUG test in different populations and settings.

References:

1. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148. doi:10.1111/j.1532-5415.1991.tb01616.x
2. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903. doi: 10.1093/ptj/80.9.896
3. Whitney SL, Marchetti GF, Schade AI. The reliability and validity of the Four Square Step Test for people with balance deficits secondary to a vestibular disorder. Arch Phys Med Rehabil. 2006;87(2):268-273. doi: 10.1016/j.apmr.2005.10.005
4. Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29(2):64-68. doi: 10.1519/00139143-200608000-00004
5. Bloem BR, Steijns JA, Smits-Engelsman BC. An update on falls. Curr Opin Neurol. 2003;16(1):15-26. doi: 10.1097/00019052-200302000-00004