Six-Foot-Get-Up-and-Go
Test
Group 11
What is the “Six-Foot-Get-Up-and-Go” Test?
The “Six Foot Get Up and Go” or “Timed Up and
Go” (TUG) test is a criterion-referenced test that
measures speed, mobility, and balance. The test is
performed by timing how quickly and easily one
can rise from a chair, walk forward six feet, turn
around, walk back and sit down.
Maryssa Ruster
Six-Foot-Up-and-Go-Test
Designed to test: Most Commonly Used:
● Routine screening for fall
1. Speed risk
● Elderly patients
2. Agility
● By physical therapists for
3. Balance those in rehabilitation
Maryssa Ruster
Demonstration of
the Test
Maryssa Ruster
Criterion Reference
● Assessed based on time needed to complete the task
● Under 10 seconds: Normal mobility
● 11-20 seconds: Within normal limits for frail/disabled patients
● Over 20 seconds: Needs assistance and further examination
● Over 30 seconds: Fall risk
Natalie Ramseier
Reliability Ashleigh Rye
The reliability of this test can be demonstrated in two studies we reviewed...
❖ In the first study, conducted by the United States VA, 14 stroke patients and 25 nondisabled elderly patients
were recruited to complete the “Get Up and Go” test. Each participant had sensors strapped to their bodies to
measure iTUG metrics like gait sped, cadence , stride length and increased left/ right asymmetry. Participants
were required to complete the Get up and Go test three times, given a 15 minute rest, and then asked to repeat
the test three more times. These tests were completed at either the Institute of Human Movement Sciences and
Sport at ETH Zurich Switzerland or at The Rehabilitation center in Valens Switzerland. The results showed
that out of the 14 computed iTUG metrics, 12 showed excellent test-retest reliability expressed by high
intraclass correlation coefficients, also known as ICC, that ranged from 0.855 to 0.994. Only the “sit to walk
velocity” and “duration” reported a lower reliability coefficients (0.431 and 0.674). These values known as
ICC metrics, are described by this article as a statistic “commonly used to determine the consistency or
reproducibility between repeated measurements.” Interpretation of the ICC values within this test were
according to Shrout and Fleiss, in which values greater than 0.75 indicate excellent test- retest reliability,
0.75- 0.40 indicate fair to good reliability and less than 0.40 indicates poor reliability. Furthermore,
Heteroscedasticity of this test was measured by calculating the score value of the Pearson correlation
coefficient (r^2). If r^2 values are above 0.1 then data is said to be heteroscedastic. Within this study
specifically they reported well below that.
Reliability
❖ The second test was completed at the Gait Laboratory at Kingston Centre where each subject was over
50 and hospital inpatients undergoing assessment by the treating neurologist. Each subject was asked
to complete 5 repetitions of the Touch and Go test 12 hours following their medication, for example if the
patient receives their medication at 6:00 pm, they could participate at 6:00 am. To perform the test, Each
patient was asked to “stand and walk at a comfortable speed to the end of the tape, turn around, walk
back to the chair and sit down.” Each trial was videotaped. This test was completed with many goals in
mind but one was to quantify the reliability of measurements obtained with this test. The ICC of this test
found was 0.99 and the TUG times correlated moderately well with gait speed (r=−.55), scores on the
Berg Balance Scale (r=−.72), and the Barthel Activities of Daily Living Index (r=−.51). This would indicate
no signs of heteroscedasticity.
These tests data collectively show that the Six-Foot-Up-and-Go Test has high
reliability. When conducting this test, your results should be nearly the same each
time the same patient completes it.
Ashleigh Rye
Validity
Validity for the Up and Go Test can be examined in two particular studies that we used:
The Prognostic Validity of the Timed Up and Go Test With a Dual Task for Predicting the Risk of Falls in
the Elderly
In this study, the researchers measured 120 patients between the ages of 60 and 87, with an average age of 72.2
years, who lived at home with a standard 3m Up and Go Test. The test was conducted again 12 months later as well.
This specific test had an overall specificity of 0.70. Based on the performance of the subjects, researchers determined
that while TUG test is reliable, more research should be done to determine whether it is a valid measure of fall risk
prediction due to a lack of outside factors that may have an influence on an individual’s fall risk. Often times people are
not just walking from point a to point b. TUG does not test any extra tasks happening at the same time, and thus
cannot be a truthful predictor.
Hannah Scott
Validity
Validity for the Up and Go Test can be examined in two particular studies that we used:
Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff's global judgement and fall
history in evaluating fall risk in residential care facilities
In this particular study, a group of Swedish researchers implemented a cohort study with a six month follow
up to determine fall risk in a group of 183 patients all with ages 65+ at a residential facility in Sweden.
None of the patients had prior disabilities. The researchers used both the traditional up and go test as well as
a modified up and go test (GUG-m) which is a judgement-test. The GUG-m differs from TUG in regards to
the fact it is a subjective test versus an objective one. By using receiver operating characteristic (ROC)
curves, the researchers were able to determine both sensitivity and specificity for both forms of the test. For
TUG, it was determined there was a high sensitivity and a low specificity. For GUG-m, it was the opposite,
with a low sensitivity and a high specificity. Based on this particular study, the researchers determined that
TUG is a moderate determiner for fall risk, but that GUG-m falls to the risk of poor inter-rater reliability. In
conclusion, while GUG-m may seem like a truthful predictor for the rate of falls, you must raise concern for
any potential bias.
Hannah Scott
Validity
In conclusion, based on the articles examined to determine validity, it is safe to say
that the “Six Foot Get Up and Go” or ‘TUG” test is a moderately truthful predictor
for fall risk of elderly patients. Overall, though the TUG test should not be used
solely for determining fall risk, the test can provide guidance to rule out fall risk.
Hannah Scott
Sources
Hofheinz, Martin, and Mibs, Michael. “The Prognostic Validity of the Timed Up and Go Test With a Dual Task for Predicting the
Risk of Falls in the Elderly.” Gerontology & Geriatric Medicine, 16 Mar. 2016, SAGE Publications,
www.ncbi.nlm.nih.gov/pmc/articles/PMC5119801/.
Morris, Susan, et al. “Reliability of Measurements Obtained With the Timed ‘Up & Go’ Test in People with Parkinson Disease.” OUP
Academic, 1 Feb. 2001, pp.810-818, Oxford University Press, academic.oup.com/ptj/article/81/2/810/2829548.
Nordin, Ellinor et al. “Prognostic Validity of the Timed Up-and-Go Test, a Modified Get-Up-and-Go Test, Staff’s Global Judgement
and Fall History in Evaluating Fall Risk in Residential Care Facilities.” OUP Academic, vol. 37 no. 4, 30 May 2008, pp. 442-
448, Oxford University Press, academic.oup.com/ageing/article/37/4/442/40977
Wüest, Seline D. et al. “Journal of Rehabilitation Research & Development (JRRD).” Reliability and Validity of the Inertial Sensor-
Based Timed “Up and Go” Test in Individuals Affected by Stroke, vol. 53 no. 5, 2016, pp. 599-610,
www.rehab.research.va.gov/jour/2016/535/jrrd-2015-04-0065.html
