The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke

Abstract

Objectives: To examine test-retest reliability of the Timed Up & Go (TUG) test, its ability to differentiate subjects with chronic stroke from healthy elderly subjects, and its associations with ankle plantarflexor spasticity, ankle muscle strength, gait performance, and distance walked in 6 minutes in subjects with chronic stroke.

Design: Cross-sectional study.

Setting: University-based rehabilitation center in Hong Kong, China.

Participants: Ten healthy elderly subjects and 11 subjects with chronic stroke.

Interventions: Not applicable.

Main outcome measures: Time taken to complete the TUG test was recorded. Plantarflexor spasticity and ankle muscle strength were assessed, respectively, by the Composite Spasticity Scale and a load-cell together with electromyography. Gait parameters and walking endurance were measured respectively by walkway system (GAITRite II) and 6-minute walk test. Intraclass correlation coefficients (ICCs) were calculated as measures of reliability, and all correlation analyses were conducted using Spearman correlation coefficients.

Results: The TUG test showed excellent reliability (ICC>.95). Subjects with chronic stroke had significantly more spastic and weaker plantarflexors, slower walking speeds, and poorer walking endurance when compared with healthy elderly subjects (all P<.003). The strength of the affected ankle plantarflexors (rho=-.860, P<.01), gait parameters (rho range, .620-.900; P<.05), and walking endurance (rho=-.960, P<.01) correlated with TUG scores.

Conclusions: The TUG scores were reliable, were able to differentiate the patients from the healthy elderly subjects, and correlated well with plantarflexor strength, gait performance, and walking endurance in subjects with chronic stroke.