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Background: The Timed up and Go Test (TUG) is often used as a mobility measure in older people. However, it is unclear whether the TUG is useful for identifying fall risk in people with diabetes mellitus (DM) and which physical and cognitive/psychological factors influence the performance of this test. Objectives: To investigate whether slow TUG times (standard test and when performed with a secondary cognitive task (c-TUG)) are a risk factor for falls in older people with DM and to determine the relative contributions of a range of sensorimotor, balance and cognitive/psychological factors to TUG performance in this population. Methods: Community-dwelling people (n=103, mean age 61.57, SD=6.3) underwent the TUG and c-TUG tests as well as quantitative tests of vision, peripheral sensation, strength, reaction time, balance, cognition, and fear of falling. Participants were then followed up for falls for six months. Results: Negative binomial regression analyses revealed that each 1s increase in TUG and c-TUG times increased the risk of falling by 29% and 13%, respectively. Multiple regression analyses identified vibration sense (p<0.001), knee extension strength (p=0.001, r²=0.430), edge contrast sensitivity (p=0.002), neuropathy examination score (p=0.001, r²=0.498) and controlled leaning balance (p=0.033) as significant and independent explanatory predictors of TUG performance. The regression model for c-TUG was similar, vibration sense (p=0.042), knee extension strength (p=0.009, r²=0.256), neuropathy examination score (p=0.156, r²=0.272) and sway path-floor (p=0.042) except that the MOCA cognitive assessment (p=0.015) was included instead of edge contrast sensitivity. The combined explanatory variable models explained 43% and 26% of the variance in TUG and c-TUG times, respectively. Conclusions: Slow TUG and c-TUG times significantly increased the risk of falls in community-dwelling older people with DM. Poor TUG and c-TUG performances were related independently to decreased vibration sense, lower limb weakness, and poor balance, with the c-TUG additionally influenced by cognitive function.
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Introducción: Los sujetos con Artritis Reumatoidea (AR) tienen un elevado riesgo de caídas respecto a la población sana. El Timed Up and Go test (TUG) es utilizado para predecir el riesgo de caídas pero no ha sido validado en sujetos con AR. Objetivos: El objetivo primario fue establecer la validez predictiva y la validez concurrente a velocidad habitual y máxima segura en sujetos con diagnóstico de AR. El objetivo secundario fue establecer si el TUG tiene mayor valor predictivo evaluado a velocidad habitual o a velocidad máxima segura. Sujetos y método Los sujetos fueron ingresados mediante muestreo no probabilístico consecutivo. Para la validez concurrente se correlacionó el TUG con la Berg Balance Scale (BBS) y el Test de Marcha de 10 metros (TM10m). La validez predictiva fue calculada utilizando curva de características operativas para el receptor y el área bajo la curva. Resultados: Se evaluaron 115 participantes para la validez concurrente y 98 para la predictiva. Las correlaciones entre el TUG a velocidad habitual y el TUG a velocidad máxima segura con la BBS y el TM10m resultaron fuertes (rango de -0,65 a -0,78). La capacidad predictiva del TUG resultó baja tanto a velocidad habitual como a velocidad máxima segura. Conclusión: El TUG en sus dos versiones presentó una fuerte validez concurrente al ser comparado con la BBS y el TM10m. El TUG presentó una baja validez predictiva tanto a velocidad habitual como a velocidad máxima segura para predecir el riesgo de caídas en sujetos con AR.
Background: Subjects with Rheumatoid Arthritis (RA) have a high risk of falling. The Timed Up and Go test (TUG) is used to predict the risk of falls but it has not been validated in subjects with RA. Purpose: The primary objective was to establish the predictive validity and the concurrent validity of TUG at the preferred walking speed or fastest speed possible as a predictor of falls in subjects with RA. The secondary objective was to establish if the TUG has a higher predictive value evaluated at the preferred walking speed or fastest speed possible. Subjects and method: The subjects were admitted by consecutive non-probabilistic sampling. To establish the concurrent validity, the TUG was correlated with the Berg Balance Scale (BBS) and the 10-meter Walk Test (TM10m). Predictive validity was calculated using the operating characteristics curve for the receiver and the area under the curve. Results: 115 participants were evaluated for concurrent validity and 98 for predictive validity. The correlations between the usual speed TUG and fastest speed TUG with the BBS and the TM10m were strong (range from -0.65 to -0.78). The predictive capacity of the TUG was low at both normal speed and maximum safe speed. Conclusion: The TUG in its both versions presented a strong concurrent validity compared to the BBS and the TM10m.The TUG presented a low predictive validity both at normal speed and at maximum safe speed to predict the risk of falls in subjects with RA.
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Humans , Arthritis, Rheumatoid , Accidental Falls , Risk AssessmentABSTRACT
Objective@#To explore the predictive value of the timed "up and go" test on falling of inpatients with stroke, providing objective reference for clinical fall risk evaluation.@*Methods@#A total of 62 stroke in patients who were treated in the department of Neurology of the Second Affiliated Hospital of Shantou University Medical College from January 2018 to June 2018 were selected by the convenience sampling method. The timed "up and go" test was used to record the walking function of stroke inpatients. An ROC curve was used to analyze the efficacy in predicting falls of stroke inpatients.@*Results@#The TUGT has demonstrated intraclass correlation coefficient (ICC) value of 0.963 (95%CI 0.938-0.978), and Cronbach alpha coefficient value of 0.983.The difference of the TUGT time between recurrent-fall stroke inpatients [15.69 (13.30, 19.87) seconds] and the patients without a history of falling [12.45 (10.08, 16.26) seconds] was statistically significant (Z=-2.585, P<0.05). Meanwhile, the difference of the TUGT time between male stroke inpatients [13.12 (10.23, 15.35) seconds] and female stroke inpatients [17.09 (12.98, 19.87) seconds] was also statistically significant (Z=-2.297, P<0.05). The TUGT time was significantly (P<0.05) positively correlated both with the fall history (rs=0.331) and gender (rs=0.294) in stroke inpatients. The result of ROC curve showed that the optimal TUGT cut-off point for predicting the fall of male stroke patients was 13.12 seconds with 0.696 for AUC, 78.6% for sensitivity and 68.2% for specificity (P<0.05).While the optimal TUGT cut-off point for predicting the fall of female stroke inpatients was 13.68 seconds with 0.691 for AUC, 73.3% for sensitivity and 65.6% for specificity (P<0.05).@*Conclusions@#Although TUGT has good feasibility in stroke inpatients, its predictive value for future falls of stroke inpatients is medium. The assessment and prediction of fall risk should be considered carefully by medical workers so as to reduce the occurrence of falls in stroke inpatients.
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Objective To explore the predictive value of the timed "up and go" test on falling of inpatients with stroke, providing objective reference for clinical fall risk evaluation. Methods A total of 62 stroke in patients who were treated in the department of Neurology of the Second Affiliated Hospital of Shantou University Medical College from January 2018 to June 2018 were selected by the convenience sampling method. The timed "up and go" test was used to record the walking function of stroke inpatients. An ROC curve was used to analyze the efficacy in predicting falls of stroke inpatients. Results The TUGT has demonstrated intraclass correlation coefficient (ICC) value of 0.963 (95% CI 0.938-0.978), and Cronbach alpha coefficient value of 0.983.The difference of the TUGT time between recurrent-fall stroke inpatients [15.69 (13.30, 19.87) seconds] and the patients without a history of falling [12.45 (10.08, 16.26) seconds] was statistically significant (Z=-2.585, P<0.05). Meanwhile, the difference of the TUGT time between male stroke inpatients [13.12 (10.23, 15.35) seconds] and female stroke inpatients [17.09 (12.98, 19.87) seconds] was also statistically significant (Z=-2.297, P<0.05). The TUGT time was significantly (P<0.05) positively correlated both with the fall history (rs=0.331) and gender (rs=0.294) in stroke inpatients. The result of ROC curve showed that the optimal TUGT cut-off point for predicting the fall of male stroke patients was 13.12 seconds with 0.696 for AUC, 78.6% for sensitivity and 68.2% for specificity (P<0.05). While the optimal TUGT cut-off point for predicting the fall of female stroke inpatients was 13.68 seconds with 0.691 for AUC, 73.3% for sensitivity and 65.6% for specificity (P<0.05). Conclusions Although TUGT has good feasibility in stroke inpatients, its predictive value for future falls of stroke inpatients is medium. The assessment and prediction of fall risk should be considered carefully by medical workers so as to reduce the occurrence of falls in stroke inpatients.
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OBJECTIVES: In post-menopausal women with osteoporosis, insufficient vitamin D levels decrease calcium fixation in the bones and calcium transport in the sarcoplasmic reticulum, which impairs muscle strength, possibly leading to detrimental consequences for the preservation of functional capacity and postural balance, fall prevention, and fracture risk. The aim of this study was to evaluate the association between vitamin D levels and knee muscle strength, postural balance and functional mobility among postmenopausal women with osteoporosis. METHODS: This cross-sectional study included 63 osteoporotic older women (aged 60.6±3.1 years). The subjects completed the Timed Up and Go Test to measure functional mobility, and postural balance was assessed on the AccuSway Plus portable force platform. Maximal strength was tested using an isokinetic dynamometer for knee flexion and extension. The subjects were assessed as a group and were divided into quartiles according to their vitamin D levels. Clinicaltrials.gov: NCT02771834. RESULTS: Vitamin D status was independently associated with the normalized peak torque of the knee extensors (β=0.59; p=0.04) and Timed Up and Go Test (β=-0.07; p<0.001). No between-group differences were observed in the demographic and clinical variables or postural balance; however, significant differences were observed in the Timed Up and Go Test, and the group with the highest vitamin D levels exhibited better performance than the group with the lowest vitamin D levels (p<0.001). CONCLUSION: The serum vitamin D levels were independently associated with normalized knee extension strength and functional mobility in postmenopausal women with osteoporosis.
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Humans , Female , Middle Aged , Aged , Vitamin D/analogs & derivatives , Osteoporosis, Postmenopausal/blood , Postural Balance/physiology , Muscle Strength/physiology , Knee Joint/physiology , Vitamin D/blood , Osteoporosis, Postmenopausal/physiopathology , Cross-Sectional StudiesABSTRACT
OBJECTIVE: To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. METHODS: A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. RESULTS: SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. CONCLUSION: This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.
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Aged , Humans , Accidental Falls , Cross-Sectional Studies , Mass ScreeningABSTRACT
Objective:To explore the efficiency of timed up and go test (TUGT) and maximum walking speed test (MWST) on evaluating stroke patients' motor function.Method:Fifty stroke patients were assessed with TUGT,MWST,Berg balance scale (BBS),Barthel Index (BI) and Fugl-meyer assessment.The levels of association among five methods were examined with Pearson correlation coefficients.The predictive efficiency was analyzed by using receiver operating characteristic curve (ROC).Result:The significant negative correlation was shown between TUG and BBS,BI and FMA score (P ＜ 0.05) and the same significant negative correlation was shown between MWST and BBS,BI and FMA score (P＜0.05).The Pearson correlation coefficients of TUG was higher than the MWST's.The area under the ROC curve for the TUG was significantly higher than that of the MWST.Conclusion:The TUG is closely correlated with the balance ability,moto function and active of daily living in stroke patients.The TUG could serve as a screening tool for detection of individuals with stroke.
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Objective To evaluate the physical functions of community-dwelling older adults, and analyze the related factors. Methods From September to October, 2016, 80 adults over 55-year-old in one community in Wuhan, Hubei, China were selected with convenience sampling. General situation was collected through questionnaires. Physical functions were measured by tests of grip strength, Five-Times-Sit-to-Stand Test (FTSST), modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and TimedUp and GoTest (TUGT). Their correlation was analyzed. Results The average grip strength of the participants was (27.46 ± 9.66) kg; the average time of FTSST was (11.58 ± 4.03) s;there was only one (1.25%) participant observed with an impairment in mCTSIB;the average time of TUGT was (9.05±3.47) s. Grip strength was correlated with gender (r=-0.669), education level (r=0.238), the score of Mini-Mental State Examina-tion (MMSE) (r=-0.302) and activities of daily living (ADL) (r=-0.344) (P<0.05). The time of FTSST was correlated to gender (r=0.274), the score of MMSE (r=0.243) and ADL (r=0.321) (P<0.05). The time of TUGT was correlated to gender (r=0.255), education level (r=-0.362), income level (r=-0.245), the score of Self-rating Depression Scale (r=0.223), the score of MMSE (r=0.328) and ADL (r=0.354) (P<0.05). Conclusion The levels of grip strength, FTSST and TUGT are related to the demographic characters in community-dwell-ing older adults. Little abnormity has been found in mCTSIB.
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Objective:To explore the efficiency of timed up and go test (TUGT) and maximum walking speed test (MWST) on evaluating stroke patients' motor function.Method:Fifty stroke patients were assessed with TUGT,MWST,Berg balance scale (BBS),Barthel Index (BI) and Fugl-meyer assessment.The levels of association among five methods were examined with Pearson correlation coefficients.The predictive efficiency was analyzed by using receiver operating characteristic curve (ROC).Result:The significant negative correlation was shown between TUG and BBS,BI and FMA score (P ＜ 0.05) and the same significant negative correlation was shown between MWST and BBS,BI and FMA score (P＜0.05).The Pearson correlation coefficients of TUG was higher than the MWST's.The area under the ROC curve for the TUG was significantly higher than that of the MWST.Conclusion:The TUG is closely correlated with the balance ability,moto function and active of daily living in stroke patients.The TUG could serve as a screening tool for detection of individuals with stroke.
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Objective To explore the effectiveness of the timed up and go test (TUGT) and the maximum walking speed test (MWST) in evaluating stroke patients' motor function.Methods Twenty-two stroke patients were assessed using the TUGT and MWST,and the temporal-spatial parameters of their gait were also assessed.The correlations among the TUGT times,walking speed and the gait parameters were quantified using Pearson correlation coefficients.Results The TUGT time was (18.57±7.41) s,significantly correlated with step length and velocity (P＜0.05).Walking speed showed a significant positive correlation with step length,velocity and step length (P＜ 0.05).The TUGT times were negatively correlated with walking speed (r=-0.712,P=0.000).Conclusion The MWST and TUGT both can assess stroke patients' motor function effectively.
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Objective : To determine whether or not the time difference index of the Timed Up and Go test (TUG) and the imagined TUG (iTUG), which reflects motor imagery capacity, has utility in predicting falls in patients with stroke. Method : A follow-up study of falls occurring over the 6-month period after discharge was performed in 47 patients with stroke. Baseline values were evaluated at discharge for subject age, sex, disease name, paralysis side, disease duration, fall history, whether a gait assistive device was used, mini-mental state examination (MMSE), TUG, and the time difference (delta time) between TUG and iTUG. A logistic regression analysis was performed using the number of falls and evaluation results, and the predictive factors for falls were extracted. Results : Thirty-three patients were followed for the entire 6-month period, and the fall rate was 48.5%. According to the results of the analysis, only delta time was a significant fall factor (<i>p</i><0.01), and the cutoff value for fall prediction was 0.88%. Conclusion : Our results show that delta time could be used to identify the likelihood of a fall occurrence over the 6-month period after discharge in patients with stroke.
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Objective To explore the relevance between gait speed and muscle strength of lower extremities, or several kinds of physical functional tests. Methods 341 community-dwelling individuals (160 males, 181 females) aged 65-94 years were selected. They were divid-ed into suspected sarcopenia group (n=137) and normal group (n=204) by their gait speed less or more than 0.8 m/s. It was compared be-tween both groups with the basic physical characteristics, strength of iliopsoas, quadriceps, hamstrings and tibialis anterior, and the scores of One Leg Standing Test, Berg Balance Scale, Functional Gait Assessment, Functional Stretch Test and Timed Up and Go Test. Results The subjects were older in the suspected sarcopenia group than in the normal group. The difference of body weight, height were not statistically significant between groups. The strength of the muscles in bilateral lower limbs was not significantly different between both groups (P>0.05), while the gait speed positively correlated with the strength of iliopsoas, quadriceps and hamstrings (r=0.121-0.227, P0.05). Gait speed positively correlated with the scores of One Leg Standing Test, Berg Balance Scale, Functional Gait Assessment, Functional Stretch Test (P<0.05), and negatively correlated with the score of Timed Up and Go Test (r=-0.502, P<0.001). The scores of all the tests were significantly different between 2 groups (P<0.05), except that of Functional Stretch Test (P=0.28). Conclu-sion Sarcopenia diagnosis is not only depended on the strength of muscle of lower extremity, but also their functions.
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[Objective]We report herein the use of acupuncture to counteract gait disturbance in a patient with Parkinson's disease (PD). A portable gait rhythmogram was used to objectively demonstrate gait improvements. <BR>[Case]Case:A 72-year-old woman, who a 64 experienced a tremor of the right hand and was diagnosed with PD. Symptoms improved with anti-PD medication, but at 71 years old, she experienced heaviness of the neck and shoulders and stiffness of the anterior thighs, and her step length decreased. Acupuncture therapy was initiated to relieve these symptoms. <BR>Present illness:On examination, she presented a wobbly gait, cold feet, and reported frequent falling. Heaviness in the neck and shoulders extended from the neck to the suprascapular region, and increasing heaviness resulted in a forward-flexed posture and decreased step length. Muscle hypertonia of the quadriceps muscles was bilaterally observed, explaining the perceived stiffness in the thighs. She was at stage III on the Hoehn and Yahr Scale. <BR>Acupuncture therapy:Acupuncture therapy was performed weekly for 12 weeks to alleviate the muscle hypertonia associated with muscular rigidity. Acupuncture points comprised the points in the muscle hypertonia where tenderness was observed, including BL 10, DU 16, ST 32, SP 10 and ST 34. <BR>Evaluation:A portable gait rhythmogram was used to measure the ground reaction force (GRF), velocity and step length. Dynamic balance functions and PD symptoms, were respectively evaluated using the Timed Up and Go Test (TUGT) and Unified Parkinson's Disease Rating Scale (UPDRS). Evaluations were conducted on initial examination and after the 12th therapy session.<BR>[Results]After the fourth session, perceived stiffness in the neck, shoulder region and thighs decreased. all frequency decreased from 5 times/day to 3times/day (4th session) and then once/day (7th session). There were no falls after the 8th session. Reduction in gait disturbance was objectively observed as follows:Increases were observed in GRF (0.15 to 0.17 m/s 2), gait velocity (49 to 53m/min), and step length (47 to 49 cm), while TUGT time decreased (11.8 to 9.5 s). Improvements in PD symptoms were also observed with decreased UPDRS score (41 to 28 points).<BR>[Discussion and Conclusion]The use of acupuncture therapy achieved improvements in Parkinson-related gait disturbance (objectively demonstrated using a portable gait rhythmogram). Acupuncture improved not only gait disorder but also other PD symptoms.
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BACKGROUND: The incidence and prevalence of gait disturbance increases as age increases. The importance of cognitive aspects of gait disturbances has been studied in various types of dementia and MCI. This study was performed to identify relationship between cognitive impairment and change in gait, and investigate specific domains of cognitive function that may have affects in gait disturbance. METHODS: Three hundred eighty three participants over 60 years old volunteered for the study. Three stages evaluation were performed, dementia screening and timed up and go test (TUG), work up for cognitive impairment and dementia, and classifying cognitive impairment and dementia into subcategories by evaluating cause of the disease. To evaluate cognitive impairment, MMSE-KC (MMSE in the Korean version of the CERAD assessment packet) and Korean version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) assessment were used. One hundred forty one people were excluded from study and 242 people were analyzed. Timed Up and Go test (TUG) was performed for evaluation of gait disturbance. Relationship in every subcategory of CERAD-K and TUG was studied by correlation and multiple logistic analysis. RESULTS: Of the 242 participants, 122 were without cognitive impairment, 51 had mild cognitive impairment, 56 had Alzheimer's disease and 13 had vascular dementia. These four groups showed different results in TUG. Normal group had the lowest values in TUG compare to other groups significantly. MMSE score also correlated with the value of TUG (r=-0.528, p<0.001). Every subcategory of CERAD-K score had significant correlation with the value of TUG. But there were no specific subcategory that had predominant effect in TUG. Only age was an independently significant factor influencing TUG (p<0.05). CONCLUSIONS: This study shows that increase in age and impairment in cognitive function has an association with gait disturbance. Therefore clinician should be concerned about cognitive factors for evaluation of a patient who has gait disturbance.
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Humans , Alzheimer Disease , Dementia , Dementia, Vascular , Gait , Incidence , Mass Screening , Methods , Cognitive Dysfunction , PrevalenceABSTRACT
Objective To investigate the discriminant validity and relativity of three scales applied in fall risk estimation for senile patients.Methods The timed up and go test (TUGT),the Morse Fall Scale (MFS) and the Berg Balance Scale (BBS) were used by two trained testers to evaluate the fall risk of 161 senile in-patients.The patients were divided into a falling group and a no-fall group based on their history of falling in the previous one year.Student's t-test was applied to compare the discriminant validity of the TUGT,MFS and BBS.Spearman's correlation coefficient was calculated to analyze the correlation among the three scales.Results The scores of patients in the falling group on the three scales were significantly different from those of the no-falls group.The correlation coefficients among the three scales were in the range 0.680-0.888.Conclusion The TUGT,MFS and BBS all showed high sensitivity and good discrimination in fall risks estimation for senile patients.The results with the three scales were highly correlated.Because the emphasis of these three scales is different,a suitable scale should be selected in clinical practice according to the characteristics of the senile patient.
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@#ObjectiveTo explore the relationship between the motor cognitive ability and the incidence of fall in the aged people. MethodsAccording to the fall experience within a year, 91 aged people were divided into 2 groups: fall group and non-fall group. They were tested using the Timed Up and Go Test (TUGT) with the eyes opening or closing. The anticipated time, actual time and the difference were recorded. ResultsThere were significant differences between these 2 groups in the eye-closed anticipated time, actual time, the difference of eye-open anticipated time and eye-closed anticipated time, the difference of eye-open anticipated time and actual time (P<0.05). ConclusionThe motor cognitive ability of the falled elderly more depends on their vision. The motor cognitive disability is one of the factors resulted in fall in aged people.