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Timed Up and Go (TUG)
Availability
Please visit this website for more information about the instrument: Timed Up and Go
Classification
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure of functional mobility. It is not recommended for use in people who use a wheelchair or who are non-ambulatory.
 
Supplemental: Amyotrophic Lateral Sclerosis (ALS), Cerebral Palsy (CP), Facioscapulohumeral Muscular Dystrophy (FSHD), Huntington's Disease (HD), Multiple Sclerosis (MS), Myotonic Dystrophy (DM), Neuromuscular Disease (NMD) and Spinal Cord Injury (SCI)-Pediatric (age 3 and over)
 
Exploratory: Congenital Muscular Dystrophy (CMD), Spinal Muscular Atrophy (SMA)
Short Description of Instrument
The original purpose of the Timed-Up-and Go (TUG) was to test basic mobility skills of frail elderly participants. The TUG has been used in other populations, including patients with arthritis, stroke, and vertigo. The participant wears their regular footwear and uses their customary walking aid (none, cane, walker). No physical assistance is given. The participant walks through the test once before being timed to become familiar with the test. Either a stopwatch or a wristwatch with a second hand can be used to time the trial. The Tug administration time is 15 minutes or less.
Comments/Special Instructions
NeuroRehab Specific: Suitable for most neurorehabilitation populations where an assessment of functional mobility is indicated. This measure has conceptual overlap with gait speed and with the 5x Sit-To-Stand Test. Research teams should consider which is most appropriate for their study question and design.
Scoring and Psychometric Properties
Scoring: The timed "Up and Go" test on the command "Go" measures, in seconds, the time taken by an individual to stand up from a standard armchair (approximate seat height of 46 cm [18in], arm height 65 cm [25.6 in]), walk 3 meters at a comfortable speed (118 inches, approximately 10 feet), turn, walk back to the chair, and sit down. The participant should have one practice trial that is not included in the score. Participants are timed (in seconds) when performing the TUG 3 conditions:
1. TUG alone-from sitting in a chair, stand up, walk 3 meters, turn around, walk back, and sit down.
2. TUG Cognitive-complete the task while counting backwards from a randomly selected number between 20 and 100.
3. TUG manual-complete the task while carrying a full cup of water. The time taken to complete the task is strongly correlated to level of functional mobility, (i.e., the more time taken, the more dependent in activities of daily living).
 
Psychometric Properties: Inter-rater reliability is high within the same day, three-rater intra-class correlation coefficient of 0.992. Intra-rater reliability over longer periods (up to 132 days) is not as high with a reliability of 0.749. Test - retest (2-7 days) standard error of measurement has been measured as 1 second. Moderate to high correlations observed with scores on Berg Balance Scale, gait speed, stair climbing and Barthel Index of Activities of Daily Living Scale.
Rationale/Justification
This test is recommended for individuals with SCI, Stroke, and Parkinson's Disease (Stage I, II and III).
 
Strengths: The TUG requires no special equipment or training, is quick to administer, and is easily included as part of the routine medical examination. Given the simplicity of the instructions, the TUG can be administered in different languages with informal translations (Tremblay et al., 2004)
 
Weaknesses: It is not appropriate to use the TUG for individuals with severe cognitive impairments, that prevent understanding of the tasks. (Rockwood et al., 2000) The TUG must be administered through direct observation of task completion. A proxy respondent cannot complete it. The TUG is also a limited measure assessing few aspects of balance.
 
"The cutoff levels for TUG is 13.5 seconds or longer with an overall correct prediction rate of 90%; for TUG manual is 14.5 seconds or longer with a 90% correct prediction rate; and TUG cognitive is 15 seconds or longer with an overall correct prediction rate of 87%." (Shumway-Cook, et al., 2000)
 
SCI-Pediatric specific: Studies investigating typically developing children as well as children with cerebral palsy and traumatic brain injury found it is a good tool to assess mobility in the pediatric population, as young as 3 years of age. The child must be able to follow directions. It has not been evaluated specifically with children with SCI.
 
NeuroRehab Specific: Easily performed and clinically relevant; requires multiple aspects of motor function. Good psychometric properties, easy to administer, has three conditions that map well onto functional scenarios. Comprehensive in that it includes measures of gait, turning, and sit to stand.
References
Key References:
 
Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil. 1986 Jun;67(6):387-9.
 
Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991 Feb;39(2):142-8.
 
Additional Reference:
 
Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr. 2014 Feb 1;14:14.
 
Bischoff HA, Stähelin HB, Monsch AU, Iversen MD, Weyh A, von Dechend M, et al. Identifying a cut-off point for normal mobility: a comparison of the timed "up and go" test in community-dwelling and institutionalised elderly women. Age Ageing. (2003)
32:315-20.
 
Rockwood K, Awalt E, Carver D, MacKnight C. Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci. 2000 Feb;55(2):M70-3.
 
Shumway-Cook, A., Brauer, S., & Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Physical Therapy, 80(9), 896-903.
Tremblay, L. E., Savard, J., Casimiro, L., Tremblay, M. (2004). Repertoire des Outils d'Evaluation en Francais pour la Readaptation, Regroupement des intervenantes et intervenants francophones en sante et enservices sociaux de l'Ontario, Ottawa.
 
Wall JC, Bell C, Campbell S, Davis J. The Timed Get-up-and-Go test revisited: measurement of the component tasks. J Rehabil Res Dev. 2000 Jan-Feb;37(1):109-13.
 
Huntington's Disease References:
 
Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil. 1986;67(6):387-389.
 
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.
 
Rao AK, Muratori L, Louis ED, Moskowitz CB, Marder KS. Clinical measurement of mobility and balance impairments in Huntington's disease: validity and responsiveness. Gait Posture. 2009;29(3):433-436.
 
SCI-Pediatric References:
 
Nicolini-Panisson RD & Donadio MV. Timed "Up & Go" test in children and adolescents. Rev Paul Pediatr. 2013;31(3):377-383.
 
Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol. 2005;47(8):518-524.
 
Document last updated October 2024