Timed Up and Go
Lauren Walters SPT, Megan Ralstin, SPT, Marissa Taylor, SPT
Introduction1
• Timed Up and Go (TUG)
• Purpose:
– To measure the probability for falls
among older adults
– To measure the progress of
balance, sit to stand and walking
• Initially designed for elderly
persons, but is validated for use
in other populations. vectorshock.com
Introduction2
• Original Version:
– The “Get Up and Go” test was developed by
Mathias, Nayak, and Issacs in 1986
• Current Version
– Adapted in 1991 by Podsiadlo and Richardson to
address poor inter-rater reliability for intermediate
scoring patients
– Subtests have since been developed to look more
closely at specific patient limitations
Introduction1
• ICC has been reported as high in elderly
populations and those with Alzheimer's or
Parkinson’s (.92-.99)
• Construct validity has been shown by
correlating TUG scores with gait speed,
postural sway, step length and step frequency.
• The sensitivity and specificity have been
reported to be 87%.
Methods3
Setup:
• Measure and mark a 3 meter (9.8 feet) walkway
• Place a standard height chair with arm rests (seat height
46cm, arm height 67cm) at the beginning of the walkway
• The patient wears their regular footwear
• Any assistive device is placed within reach but not touched
by the patient
pmr.org
Methods3
Instructions:
• Instruct the patient to sit on the chair and place their back
against the chair and rest their arms on the chair’s arms
• The patient should walk to the line, turn around at the line, walk
back to the chair, and sit down
• Instruct the patient to walk at a comfortable and safe walking
speed
• When the patient is ready, say “Go”
• The stopwatch should start when you say go, and should be
stopped with the patient’s buttocks touch the seat
*The PT should first demonstrate to the patient, and then
allow the patient a trial run before performing the timed trial
Methods1
Observations:
• Note any gait abnormalities that may indicate
an increased risk of fall:
– Slow tentative pace
– Loss of balance
– Short strides
– Little or no arm swing
– Steadying self on walls
– Shuffling
– En bloc turning
– Not using assistive device properly
Demonstration!
Your turn!
Choose one of the validated populations and any
needed AD and have one partner act out the
scenario and have the second partner grade.
Population options: Elderly persons or those
with: Parkinson’s Disease, Multiple Sclerosis, Hip
fracture, Alzheimer’s, CVA, TKR or THR, or
Huntington Disease
Scoring3, 4
• Score = time required
to complete (seconds)
• ≥ 12 seconds indicates
a high fall risk
• MDC:
– Parkinson's: 3.5 sec freepik.com
– Alzheimers: 4.09 sec
Threshold Values3
physiopedia.com
Interpretation2
• Reliable and valid
test for quantifying
functional mobility
• Scores used to
predict functional
mobility skill
strokeengine.an
Discussion
Advantages Disadvantages
• Simple and easy set up • Construct validity
• Fast and easy to score requires it to be coupled
• Requires few items with other outcomes
• Validated in wide variety • Patient doesn’t
of studies demonstrate a wide
• Can be used to predict variety of skills
functional mobility skill • Very low ceiling if they
• Very easy to grade are ambulatory
References
1. Timed Up and Go Test (TUG). Physiopedia.
https://www.physio-
pedia.com/Timed_Up_and_Go_Test_(TUG). Accessed May
10, 2021.
2. Zeltzer AL. Timed Up and Go (TUG). Stroke Engine.
https://strokengine.ca/en/assessments/timed-up-and-go-tug/.
Published August 19, 2008. Accessed May 10, 2021.
3. Timed Up and Go. Shirley Ryan Ability Lab.
https://www.sralab.org/rehabilitation-measures/timed-and-go.
Accessed May 10, 2021.
4. Timed up and Go (TUG). Center for Disease Control and
Prevention. https://www.cdc.gov/steadi/pdf/TUG_test-
print.pdf. Accessed May 10, 2021.
