Journal Mobile Options
Table of Contents
Vol. 57, No. 3, 2011
Issue release date: April 2011
Free Access
Gerontology 2011;57:203–210
(DOI:10.1159/000314963)

Properties of the ‘Timed Up and Go’ Test: More than Meets the Eye

Herman T.a · Giladi N.a, c · Hausdorff J.M.a, b, d
aLaboratory for Gait Analysis and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Departments of bPhysical Therapy, and cNeurology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; dHarvard Medical School, Boston, Mass., USA
email Corresponding Author

Abstract

Background: The ‘timed up and go’ test (TUG) is a simple, quick and widely used clinical performance-based measure of lower extremity function, mobility and fall risk. We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults. Objective: To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test (BBT) and the Dynamic Gait Index (DGI). Methods: The TUG, DGI and BBT were assessed in 265 healthy older adults (76.4 ± 4.3 years; 58.3% women) who participated in a 3-year prospective study. The Mini-Mental State Examination, digit span and verbal fluency measured cognitive function. The one-sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson’s correlation coefficients quantified associations. Results: The mean scores of the BBT, DGI and TUG were: 54.0 ± 2.4, 22.8 ± 1.5, 9.5 ± 1.7 s, respectively. The BBT and the DGI were not normally distributed (p < 0.001), but the TUG was (p = 0.713). The TUG times were mildly associated (p < 0.01) with digit span and verbal fluency and were related to future falls, while the BBT and the DGI were not. Conclusions: The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults. It does not suffer from ceiling effect limitations, is normally distributed and is apparently related to executive function. The BBT and the DGI do not share these beneficial properties. Perhaps the transferring and turning components of the TUG help to convert this relatively simple motor task into a more complex measure that also depends on cognitive resources.


 goto top of outline Key Words

  • Falls
  • Physical performance
  • Cognitive function
  • Balance
  • Gait
  • Aging
  • Mobility

 goto top of outline Abstract

Background: The ‘timed up and go’ test (TUG) is a simple, quick and widely used clinical performance-based measure of lower extremity function, mobility and fall risk. We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults. Objective: To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test (BBT) and the Dynamic Gait Index (DGI). Methods: The TUG, DGI and BBT were assessed in 265 healthy older adults (76.4 ± 4.3 years; 58.3% women) who participated in a 3-year prospective study. The Mini-Mental State Examination, digit span and verbal fluency measured cognitive function. The one-sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson’s correlation coefficients quantified associations. Results: The mean scores of the BBT, DGI and TUG were: 54.0 ± 2.4, 22.8 ± 1.5, 9.5 ± 1.7 s, respectively. The BBT and the DGI were not normally distributed (p < 0.001), but the TUG was (p = 0.713). The TUG times were mildly associated (p < 0.01) with digit span and verbal fluency and were related to future falls, while the BBT and the DGI were not. Conclusions: The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults. It does not suffer from ceiling effect limitations, is normally distributed and is apparently related to executive function. The BBT and the DGI do not share these beneficial properties. Perhaps the transferring and turning components of the TUG help to convert this relatively simple motor task into a more complex measure that also depends on cognitive resources.

Copyright © 2010 S. Karger AG, Basel


 goto top of outline References
  1. Podsiadlo D, Richardson S: The timed ‘Up & Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142–148.
  2. Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL: Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992;73:1073–1080.
  3. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;83(Suppl 2):S7–S11.
  4. Hatch J, Gill-Body KM, Portney LG: Determinants of balance confidence in community-dwelling elderly people. Phys Ther 2003;83:1072–1079.
  5. Hill K, Schwarz J, Flicker L, Carroll S: Falls among healthy, community-dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy. Aust NZ J Public Health 1999;23:41–48.
  6. Isles RC, Choy NL, Steer M, Nitz JC: Normal values of balance tests in women aged 20–80. J Am Geriatr Soc 2004;52:1367–1372.
  7. Okumiya K, Matsubayashi K, Nakamura T, Fujisawa M, Osaki Y, Doi Y, Ozawa T: The timed ‘up & go’ test is a useful predictor of falls in community-dwelling older people. J Am Geriatr Soc 1998;46:928–930.
  8. Shumway-Cook A, Brauer S, Woollacott M: Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896–903.
  9. Matinolli M, Korpelainen JT, Korpelainen R, Sotaniemi KA, Matinolli VM, Myllyla VV: Mobility and balance in Parkinson’s disease: a population-based study. Eur J Neurol 2009;16:105–111.
  10. Morris S, Morris ME, Iansek R: Reliability of measurements obtained with the Timed ‘Up & Go’ test in people with Parkinson disease. Phys Ther 2001;81:810–818.
  11. Montes J, Cheng B, Diamond B, Doorish C, Mitsumoto H, Gordon PH: The Timed ‘Up and Go’ test: predicting falls in ALS. Amyotroph Lateral Scler 2007;8:292–295.
  12. Walker C, Brouwer BJ, Culham EG: Use of visual feedback in retraining balance following acute stroke. Phys Ther 2000;80:886–895.
  13. Arnold CM, Faulkner RA: The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr 2007;7:17.
  14. Kristensen MT, Foss NB, Kehlet H: Factors with independent influence on the ‘timed up and go’ test in patients with hip fracture. Physiother Res Int 2009;14:20–41.

    External Resources

  15. Yeung TS, Wessel J, Stratford PW, MacDermid JC: The timed up and go test for use on an inpatient orthopaedic rehabilitation ward. J Orthop Sports Phys Ther 2008;38:410–417.
  16. Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001;49:664–672.
  17. Sletvold O, Tilvis R, Jonsson A, Schroll M, Snaedal J, Engedal K, Schultz-Larsen K, Gustafson Y: Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment. Dan Med Bull 1996;43:350–359.
  18. Giladi N, Herman T, Reider-Groswasser II, Gurevich T, Hausdorff JM: Clinical characteristics of elderly patients with a cautious gait of unknown origin. J Neurol 2005;252:300–306.
  19. Vereeck L, Wuyts F, Truijen S, Van de Heyning P: Clinical assessment of balance: normative data, and gender and age effects. Int J Audiol 2008;47:67–75.
  20. Steffen TM, Hacker TA, Mollinger L: Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed ‘Up & Go’ Test, and gait speeds. Phys Ther 2002;82:128–137.
  21. Rockwood K, Awalt E, Carver D, MacKnight C: Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 2000;55:M70–M73.
  22. Nordin E, Lindelof N, Rosendahl E, Jensen J, Lundin-Olsson L: Prognostic validity of the Timed ‘Up & Go’ test, a modified Get-‘Up & Go’ test, staff’s global judgement and fall history in evaluating fall risk in residential care facilities. Age Ageing 2008;37:442–448.
  23. Whitney SL, Marchetti GF, Schade A, Wrisley DM: The sensitivity and specificity of the Timed ‘Up & Go’ and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. J Vestib Res 2004;14:397–409.
  24. Bischoff HA, Stahelin HB, Monsch AU, Iversen MD, Weyh A, von Dechend M, Akos R, Conzelmann M, Dick W, Theiler R: Identifying a cut-off point for normal mobility: a comparison of the timed ‘Up & Go’ test in community-dwelling and institutionalised elderly women. Age Ageing 2003;32:315–320.
  25. Trueblood PR, Hodson-Chennault N, McCubbin A, Youngclarke D: Performance and impairment-based assessments among community-dwelling elderly: sensitivity and specificity. Issues on Aging 2001;24:2–6.
  26. Whitney JC, Lord SR, Close JC: Streamlining assessment and intervention in a falls clinic using the Timed ‘Up & Go’ Test and Physiological Profile Assessments. Age Ageing 2005;34:567–571.
  27. Thrane G, Joakimsen RM, Thornquist E: The association between timed up and go test and history of falls: the Tromsø study. BMC Geriatr 2007;7:1.
  28. Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B, Lew RA, Conzelmann M: Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 2003;18:343–351.
  29. Kerse N, Peri K, Robinson E, Wilkinson T, von Randow M, Kiata L, Parsons J, Latham N, Parsons M, Willingale J, Brown P, Arroll B: Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial. BMJ 2008;337:a1445.
  30. Auriel E, Hausdorff JM, Herman T, Simon ES, Giladi N: Effects of methylphenidate on cognitive function and gait in patients with Parkinson’s disease: a pilot study. Clin Neuropharmacol 2006;29:15–17.
  31. Ben Itzhak R, Giladi N, Gruendlinger L, Hausdorff JM: Can methylphenidate reduce fall risk in community-living older adults? A double-blind, single-dose cross-over study. J Am Geriatr Soc 2008;56:695–700.
  32. Shumway-Cook A, Woollacott M: Motor Control: Theory and Applications. Baltimore, Wilkins & Wilkins, 1995.
  33. Boulgarides LK, McGinty SM, Willett JA, Barnes CW: Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther 2003;83:328–339.
  34. Garland SJ, Stevenson TJ, Ivanova T: Postural responses to unilateral arm perturbation in young, elderly, and hemiplegic subjects. Arch Phys Med Rehabil 1997;78:1072–1077.
  35. Yogev-Seligmann G, Hausdorff JM, Giladi N: The role of executive function and attention in gait. Mov Disord 2008;23:329–342.
  36. Hausdorff JM, Schweiger A, Herman T, Yogev-Seligmann G, Giladi N: Dual-task decrements in gait: contributing factors among healthy older adults. J Gerontol A Biol Sci Med Sci 2008;63:1335–1343.
  37. Srygley JM, Mirelman A, Herman T, Giladi N, Hausdorff JM: When does walking alter thinking? Age and task associated findings. Brain Res 2009;1253:92–99.
  38. Srygley JM, Herman T, Giladi N, Hausdorff JM: Self-report of missteps in older adults: a valid proxy of fall risk? Arch Phys Med Rehabil 2009;90:786–792.
  39. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  40. Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373–383.
  41. Fahn S, Elton R, Members of the UPDRS Development Committee: Unified Parkinson’s disease rating scale; in Fahn S, Marsden CD, Calne D, Goldstein M (eds): Recent Developments in Parkinson’s Disease. Florham Park, Macmillan Health Care Information, 1987, pp 153–163.
  42. Kave G: Phonemic fluency, semantic fluency, and difference scores: normative data for adult Hebrew speakers. J Clin Exp Neuropsychol 2005;27:690–699.
  43. Lezak MD: Executive Function. New York, Oxford University Press, 1983.
  44. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17:37–49.
  45. Spielberger C, et al: State-Trait Anxiety Inventory. Self-evaluation questionnaire (form Y); in: Manual for the State-Trait Anxiety Inventory. Palo Alto, Consulting Psychologist Press, 1983.
  46. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W: Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci 1996;51:M37–M43.
  47. Powell LE, Myers AM: The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci 1995;50A:M28–M34.
  48. Shumway-Cook A, Baldwin M, Polissar NL, Gruber W: Predicting the probability for falls in community-dwelling older adults. Phys Ther 1997;77:812–819.
  49. Tinetti ME, Liu WL, Claus EB: Predictors and prognosis of inability to get up after falls among elderly persons. JAMA 1993;269:65–70.
  50. Tinetti ME, Doucette J, Claus E, Marottoli R: Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc 1995;43:1214–1221.
  51. Mackenzie L, Byles J, D’Este C: Validation of self-reported fall events in intervention studies. Clin Rehabil 2006;20:331–339.
  52. Janssen WG, Bussmann HB, Stam HJ: Determinants of the sit-to-stand movement: a review. Phys Ther 2002;82:866–879.
  53. Nordin E, Rosendahl E, Lundin-Olsson L: Timed ‘Up & Go’ test: reliability in older people dependent in activities of daily living – focus on cognitive state. Phys Ther 2006;86:646–655.
  54. Pettersson AF, Engardt M, Wahlund LO: Activity level and balance in subjects with mild Alzheimer’s disease. Dement Geriatr Cogn Disord 2002;13:213–216.
  55. Pettersson AF, Olsson E, Wahlund LO: Motor function in subjects with mild cognitive impairment and early Alzheimer’s disease. Dement Geriatr Cogn Disord 2005;19:299–304.
  56. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB: Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995;332:556–561.
  57. Tanji H, Gruber-Baldini AL, Anderson KE, Pretzer-Aboff I, Reich SG, Fishman PS, Weiner WJ, Shulman LM: A comparative study of physical performance measures in Parkinson’s disease. Mov Disord 2008;23:1897–1905.
  58. Weiss A, Herman T, Plotnik M, Brozgol M, Maidan I, Giladi N, Gurevich T, Hausdorff JM: Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson’s disease? Med Eng Phys 2010;32:119–125.
  59. Herman T, Mirelman A, Giladi N, Schweiger A, Hausdorff JM: Executive control deficits as a prodrome to falls in healthy older adults. J Gerontol A Biol Sci Med Sci, in press.

 goto top of outline Author Contacts

Jeffrey M. Hausdorff, PhD
Laboratory for Gait Analysis and Neurodynamics
Tel-Aviv Sourasky Medical Center
6 Weizman Street, Tel Aviv 64239 (Israel)
Tel. +972 3 697 4958, Fax +972 3 697 4911, E-Mail jhausdor@tasmc.health.gov.il


 goto top of outline Article Information

Received: January 26, 2010
Accepted: March 19, 2010
Published online: May 20, 2010
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 2, Number of References : 59


 goto top of outline Publication Details

Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)

Vol. 57, No. 3, Year 2011 (Cover Date: April 2011)

Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Background: The ‘timed up and go’ test (TUG) is a simple, quick and widely used clinical performance-based measure of lower extremity function, mobility and fall risk. We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults. Objective: To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test (BBT) and the Dynamic Gait Index (DGI). Methods: The TUG, DGI and BBT were assessed in 265 healthy older adults (76.4 ± 4.3 years; 58.3% women) who participated in a 3-year prospective study. The Mini-Mental State Examination, digit span and verbal fluency measured cognitive function. The one-sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson’s correlation coefficients quantified associations. Results: The mean scores of the BBT, DGI and TUG were: 54.0 ± 2.4, 22.8 ± 1.5, 9.5 ± 1.7 s, respectively. The BBT and the DGI were not normally distributed (p < 0.001), but the TUG was (p = 0.713). The TUG times were mildly associated (p < 0.01) with digit span and verbal fluency and were related to future falls, while the BBT and the DGI were not. Conclusions: The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults. It does not suffer from ceiling effect limitations, is normally distributed and is apparently related to executive function. The BBT and the DGI do not share these beneficial properties. Perhaps the transferring and turning components of the TUG help to convert this relatively simple motor task into a more complex measure that also depends on cognitive resources.



 goto top of outline Author Contacts

Jeffrey M. Hausdorff, PhD
Laboratory for Gait Analysis and Neurodynamics
Tel-Aviv Sourasky Medical Center
6 Weizman Street, Tel Aviv 64239 (Israel)
Tel. +972 3 697 4958, Fax +972 3 697 4911, E-Mail jhausdor@tasmc.health.gov.il


 goto top of outline Article Information

Received: January 26, 2010
Accepted: March 19, 2010
Published online: May 20, 2010
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 2, Number of References : 59


 goto top of outline Publication Details

Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)

Vol. 57, No. 3, Year 2011 (Cover Date: April 2011)

Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Podsiadlo D, Richardson S: The timed ‘Up & Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142–148.
  2. Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL: Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992;73:1073–1080.
  3. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;83(Suppl 2):S7–S11.
  4. Hatch J, Gill-Body KM, Portney LG: Determinants of balance confidence in community-dwelling elderly people. Phys Ther 2003;83:1072–1079.
  5. Hill K, Schwarz J, Flicker L, Carroll S: Falls among healthy, community-dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy. Aust NZ J Public Health 1999;23:41–48.
  6. Isles RC, Choy NL, Steer M, Nitz JC: Normal values of balance tests in women aged 20–80. J Am Geriatr Soc 2004;52:1367–1372.
  7. Okumiya K, Matsubayashi K, Nakamura T, Fujisawa M, Osaki Y, Doi Y, Ozawa T: The timed ‘up & go’ test is a useful predictor of falls in community-dwelling older people. J Am Geriatr Soc 1998;46:928–930.
  8. Shumway-Cook A, Brauer S, Woollacott M: Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896–903.
  9. Matinolli M, Korpelainen JT, Korpelainen R, Sotaniemi KA, Matinolli VM, Myllyla VV: Mobility and balance in Parkinson’s disease: a population-based study. Eur J Neurol 2009;16:105–111.
  10. Morris S, Morris ME, Iansek R: Reliability of measurements obtained with the Timed ‘Up & Go’ test in people with Parkinson disease. Phys Ther 2001;81:810–818.
  11. Montes J, Cheng B, Diamond B, Doorish C, Mitsumoto H, Gordon PH: The Timed ‘Up and Go’ test: predicting falls in ALS. Amyotroph Lateral Scler 2007;8:292–295.
  12. Walker C, Brouwer BJ, Culham EG: Use of visual feedback in retraining balance following acute stroke. Phys Ther 2000;80:886–895.
  13. Arnold CM, Faulkner RA: The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr 2007;7:17.
  14. Kristensen MT, Foss NB, Kehlet H: Factors with independent influence on the ‘timed up and go’ test in patients with hip fracture. Physiother Res Int 2009;14:20–41.

    External Resources

  15. Yeung TS, Wessel J, Stratford PW, MacDermid JC: The timed up and go test for use on an inpatient orthopaedic rehabilitation ward. J Orthop Sports Phys Ther 2008;38:410–417.
  16. Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001;49:664–672.
  17. Sletvold O, Tilvis R, Jonsson A, Schroll M, Snaedal J, Engedal K, Schultz-Larsen K, Gustafson Y: Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment. Dan Med Bull 1996;43:350–359.
  18. Giladi N, Herman T, Reider-Groswasser II, Gurevich T, Hausdorff JM: Clinical characteristics of elderly patients with a cautious gait of unknown origin. J Neurol 2005;252:300–306.
  19. Vereeck L, Wuyts F, Truijen S, Van de Heyning P: Clinical assessment of balance: normative data, and gender and age effects. Int J Audiol 2008;47:67–75.
  20. Steffen TM, Hacker TA, Mollinger L: Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed ‘Up & Go’ Test, and gait speeds. Phys Ther 2002;82:128–137.
  21. Rockwood K, Awalt E, Carver D, MacKnight C: Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 2000;55:M70–M73.
  22. Nordin E, Lindelof N, Rosendahl E, Jensen J, Lundin-Olsson L: Prognostic validity of the Timed ‘Up & Go’ test, a modified Get-‘Up & Go’ test, staff’s global judgement and fall history in evaluating fall risk in residential care facilities. Age Ageing 2008;37:442–448.
  23. Whitney SL, Marchetti GF, Schade A, Wrisley DM: The sensitivity and specificity of the Timed ‘Up & Go’ and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. J Vestib Res 2004;14:397–409.
  24. Bischoff HA, Stahelin HB, Monsch AU, Iversen MD, Weyh A, von Dechend M, Akos R, Conzelmann M, Dick W, Theiler R: Identifying a cut-off point for normal mobility: a comparison of the timed ‘Up & Go’ test in community-dwelling and institutionalised elderly women. Age Ageing 2003;32:315–320.
  25. Trueblood PR, Hodson-Chennault N, McCubbin A, Youngclarke D: Performance and impairment-based assessments among community-dwelling elderly: sensitivity and specificity. Issues on Aging 2001;24:2–6.
  26. Whitney JC, Lord SR, Close JC: Streamlining assessment and intervention in a falls clinic using the Timed ‘Up & Go’ Test and Physiological Profile Assessments. Age Ageing 2005;34:567–571.
  27. Thrane G, Joakimsen RM, Thornquist E: The association between timed up and go test and history of falls: the Tromsø study. BMC Geriatr 2007;7:1.
  28. Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B, Lew RA, Conzelmann M: Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 2003;18:343–351.
  29. Kerse N, Peri K, Robinson E, Wilkinson T, von Randow M, Kiata L, Parsons J, Latham N, Parsons M, Willingale J, Brown P, Arroll B: Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial. BMJ 2008;337:a1445.
  30. Auriel E, Hausdorff JM, Herman T, Simon ES, Giladi N: Effects of methylphenidate on cognitive function and gait in patients with Parkinson’s disease: a pilot study. Clin Neuropharmacol 2006;29:15–17.
  31. Ben Itzhak R, Giladi N, Gruendlinger L, Hausdorff JM: Can methylphenidate reduce fall risk in community-living older adults? A double-blind, single-dose cross-over study. J Am Geriatr Soc 2008;56:695–700.
  32. Shumway-Cook A, Woollacott M: Motor Control: Theory and Applications. Baltimore, Wilkins & Wilkins, 1995.
  33. Boulgarides LK, McGinty SM, Willett JA, Barnes CW: Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther 2003;83:328–339.
  34. Garland SJ, Stevenson TJ, Ivanova T: Postural responses to unilateral arm perturbation in young, elderly, and hemiplegic subjects. Arch Phys Med Rehabil 1997;78:1072–1077.
  35. Yogev-Seligmann G, Hausdorff JM, Giladi N: The role of executive function and attention in gait. Mov Disord 2008;23:329–342.
  36. Hausdorff JM, Schweiger A, Herman T, Yogev-Seligmann G, Giladi N: Dual-task decrements in gait: contributing factors among healthy older adults. J Gerontol A Biol Sci Med Sci 2008;63:1335–1343.
  37. Srygley JM, Mirelman A, Herman T, Giladi N, Hausdorff JM: When does walking alter thinking? Age and task associated findings. Brain Res 2009;1253:92–99.
  38. Srygley JM, Herman T, Giladi N, Hausdorff JM: Self-report of missteps in older adults: a valid proxy of fall risk? Arch Phys Med Rehabil 2009;90:786–792.
  39. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  40. Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373–383.
  41. Fahn S, Elton R, Members of the UPDRS Development Committee: Unified Parkinson’s disease rating scale; in Fahn S, Marsden CD, Calne D, Goldstein M (eds): Recent Developments in Parkinson’s Disease. Florham Park, Macmillan Health Care Information, 1987, pp 153–163.
  42. Kave G: Phonemic fluency, semantic fluency, and difference scores: normative data for adult Hebrew speakers. J Clin Exp Neuropsychol 2005;27:690–699.
  43. Lezak MD: Executive Function. New York, Oxford University Press, 1983.
  44. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17:37–49.
  45. Spielberger C, et al: State-Trait Anxiety Inventory. Self-evaluation questionnaire (form Y); in: Manual for the State-Trait Anxiety Inventory. Palo Alto, Consulting Psychologist Press, 1983.
  46. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W: Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci 1996;51:M37–M43.
  47. Powell LE, Myers AM: The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci 1995;50A:M28–M34.
  48. Shumway-Cook A, Baldwin M, Polissar NL, Gruber W: Predicting the probability for falls in community-dwelling older adults. Phys Ther 1997;77:812–819.
  49. Tinetti ME, Liu WL, Claus EB: Predictors and prognosis of inability to get up after falls among elderly persons. JAMA 1993;269:65–70.
  50. Tinetti ME, Doucette J, Claus E, Marottoli R: Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc 1995;43:1214–1221.
  51. Mackenzie L, Byles J, D’Este C: Validation of self-reported fall events in intervention studies. Clin Rehabil 2006;20:331–339.
  52. Janssen WG, Bussmann HB, Stam HJ: Determinants of the sit-to-stand movement: a review. Phys Ther 2002;82:866–879.
  53. Nordin E, Rosendahl E, Lundin-Olsson L: Timed ‘Up & Go’ test: reliability in older people dependent in activities of daily living – focus on cognitive state. Phys Ther 2006;86:646–655.
  54. Pettersson AF, Engardt M, Wahlund LO: Activity level and balance in subjects with mild Alzheimer’s disease. Dement Geriatr Cogn Disord 2002;13:213–216.
  55. Pettersson AF, Olsson E, Wahlund LO: Motor function in subjects with mild cognitive impairment and early Alzheimer’s disease. Dement Geriatr Cogn Disord 2005;19:299–304.
  56. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB: Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995;332:556–561.
  57. Tanji H, Gruber-Baldini AL, Anderson KE, Pretzer-Aboff I, Reich SG, Fishman PS, Weiner WJ, Shulman LM: A comparative study of physical performance measures in Parkinson’s disease. Mov Disord 2008;23:1897–1905.
  58. Weiss A, Herman T, Plotnik M, Brozgol M, Maidan I, Giladi N, Gurevich T, Hausdorff JM: Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson’s disease? Med Eng Phys 2010;32:119–125.
  59. Herman T, Mirelman A, Giladi N, Schweiger A, Hausdorff JM: Executive control deficits as a prodrome to falls in healthy older adults. J Gerontol A Biol Sci Med Sci, in press.