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.
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
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 .