Jesse Phalanukorn

The Timed Up and Go (TUG) Test

Problem:

  1. The purpose of the Timed Up and Go (TUG) Test is to assess a person’s mobility and risk of falling by observing the various requirements that enable us to walk. Many people, especially older adults, who suffer from knee injuries or those who are recovering from procedures such as knee or hip replacements do not realize how restricted their mobility has actually become. This test allows the administrator to efficiently and effectively asses mobility and provide recommendations as so fitting.

Refining the Problem

  1. The TUG test is an assessment that can be used in many settings with just about any age, gender, or ability level. Although this assessment tool is applicable to young athletes who suffer from lower extremity sports injuriesto aging adults, the test is commonly used for the older to elderly population in physical therapy settings. The TUG test is a prominent mobility test with this target population due to its ease in administration and ability for participants to safely complete it. However, the administrator of the test must use their own judgment to identify if the participant is a suitable candidate for the test in terms of ability and risk and provide the proper support if necessary.
  2. The Timed Up and Go Test is a formative and summative evaluation, especially in the physical therapy setting. Prior to any physical therapy exercise program, this test can be used to as a baseline value to compare to as progress is made throughout each therapy session. This also is a test that allows physical therapists to tailor workouts that are more appropriate for each patient’s individual restrictions and abilities. This is also used as a post test to see if the patients reached their goals and improved their completion time, motions, and other requirements to walk from the original TUG test that was administered in the first session. Overall, this test is a great pre and post assessment tool to help identify and diagnose patient dysfunctions and also to serve as a good comparative tool from start to finish.
  3. The TUG test evaluates numerous aspects of patient mobility including postural stability, gait, stride length, sway, and speed. Postural stability is important because it allows the administrator to see whether or not a patient can maintain their center of mass within specific boundaries. It also allows them to assess patient balance and posture which play a major role in fall risk. Observing a patients gait and stride length provides clues for early diagnosis of numerous disorders such as cerebral palsy or Parkinson’s disease and also the patient’s range of motion in the lower extremities.Looking at a patient’s sway also gives insight into their center of gravity and balance. Finally, evaluating their speed shows their comfort level with walking and if all of the other aspects are within normal limits. Together, all components can determine whether or not patients fall above or below the average time the test takes for normal, healthy participants. All of these aspects, evaluating balance and range of motion, help to identify a patient’srisk of falling. Each of these components will be evaluated during a timed interval and assessed on an individual basis.

Instrumentation and Methodology

  1. My scale will evaluate the various aspects of mobility;postural stability, gait, stride length, sway, and speed, and rank them on a scale ranging from 3 – 0. A score of 3 indicates that there is sever or obvious dysfunction with the component being assessed. A score of 2 indicates that there is significant or considerably obvious dysfunction with the component under evaluation. A score of one 1 indicates that there may be a slight or minimally obvious dysfunction with the component being observed. A score of 0 indicates that there no obvious or observable dysfunctions with the component being measured and that the patient falls under the national standard norms. Due to the severity of dysfunction indicated by scores of 3 – 2, a patient would need to immediately address the issue to minimize the risk of falling. A score of 1 would be a good indicator that the patient needs some work to decrease their risk of falling however improvements may be simply addressed through the use of cues. Finally a score of 0 would indicate that there is minimal or no concern with fall risk that is out of the ordinary.
  2. The TUG test requires minimal equipment and can be easily performed in various settings. The test requires a chair with arm rests, a cone or other form of spot marker, a stopwatch, and approximately 15 feet of space. Patients are advised to wear clothing and footwear that they would normally wear and any form of walking aid that they use on a daily basis. To set up this test you need to place the arm char in a fixed position and set up the cone 10 feet from the front base of the chair. You then have the patient sit in the chair and listen to the following instructions: When I say “GO,” stand up and walk to the marked spot at a normal pace, turn, walk back to the chair at a normal pace, and sit back down. As soon as the assessor says go, begin timing the test until they are sitting completely back in the chair. Any adult who take 12 seconds or longer to complete this test are at a high risk of falling. For proper assessment, the administrator of the test should be an educated health professional that can comfortably identify and asses the aspects of mobility being tested.

Analysis of Results

  1. A score of 2 - 3in any category would be considered a failing grade and an area of high concern. In this case, the patient would be strongly advised to participate in a physical therapy program to minimize their risk of falling. A score of 1 – 0 in any category would be considered passing, however the aspectswhich patients score a 1in should be addressed during home workouts or simple exercisesthat patients can do on their own. Upon completion of a physical therapy program, patients would be recommended to join a fitness center or continue following the same workouts to maintain their balance, stability, gait, and strength so that they do not lapse back to a fall risk state again.