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. 2010 Feb;81(2):171-6.
doi: 10.1136/jnnp.2009.173740. Epub 2009 Sep 2.

The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease

Cris Zampieri  1 , Arash Salarian, Patricia Carlson-Kuhta, Kamiar Aminian, John G Nutt, Fay B Horak
Affiliations

The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease

Cris Zampieri et al. J Neurol Neurosurg Psychiatry. 2010 Feb.

Abstract

The Timed Up and Go (TUG) test has been used to assess balance and mobility in Parkinson's Disease (PD). However, it is not known if this test is sensitive to subtle abnormalities present in early stages of the disease, when balance and gait problems are not clinically evident but may be detected with instrumented analysis of movement. We hypothesise that postural transitions and arm swing during gait will be the most sensitive characteristics of the TUG for early PD. In the present study, we instrumented the TUG test (iTUG) using portable inertial sensors, and extended the walking distance from 3 m (traditional TUG) to 7 m. Twelve subjects with early-to-moderate, untreated PD and 12 healthy individuals participated. Our findings show that although the stopwatch measure of TUG duration did not detect any abnormalities in early-to-mid-stage PD, the peak arm swing velocity on the more affected side, average turning velocity, cadence and peak trunk rotation velocity were significantly slower. These iTUG parameters were also correlated with the Unified Parkinson's Disease Rating Motor Scale. Thus, the iTUG test is sensitive to untreated PD and could potentially detect progression of PD and response to symptomatic and disease-modifying treatments.

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Conflict of interest statement

This potential conflict of interest has been reviewed and managed by OHSU.

Figures

Figure 1
Figure 1
Comparison in total performance time between untreated subjects with PD and control subjects on the traditional, 3-meter TUG test (A) and the 6-meter iTUG test (B). Differences are not significant. Vertical bars are standard errors.
Figure 2
Figure 2
The receiver operating characteristics (ROC) curve for peak arm swing velocity of the more affected side (MAS), cadence, peak trunk rotation velocity, and average turning velocity.
Figure 3
Figure 3
The relationship between UPDRS Motor Scores and iTUG parameters in the PD group. (A) correlation between UPDRS scores and Peak Arm Swing Velocity, (B) UPDRS scores and Cadence, (C) UPDRS scores and Average Turning Velocity. Each PD subject is represented with a different symbol. Vertical dashed lines delimit the range of values for the control group, 1 SD above and below the average. Patients with different levels of mobility deficits = formula image
See this image and copyright information in PMC

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