Original articleUsing the Timed Up & Go Test in a Clinical Setting to Predict Falling in Parkinson's Disease
Section snippets
Participants
A cross-sectional study design was used from the National Parkinson Foundation's Quality Improvement Initiative Registry (NPF-QII). The data were obtained from 16 participating National Parkinson Foundation Centers of Excellence from within the United States. All participants signed informed consent.
All evaluations were done in the on medication state. Included were all patients registered in the NPF-QII between 2009 and 2010. The database query yielded a total of 2985 records available (1828
Results
Model 1 examined the prediction of falls from the TUG test, adjusting for all study covariates. The estimated models in the imputed data sets each represented a significant improvement above chance (χ2 range [df=17], 531.29–542.39, P<.001). Measures of association were generally low to moderate (Cox and Snell R2 range, .22–.23; Nagelkerke R2 range, .30–.31). In each of the 5 models, 74% of participants were accurately classified (chance classification =54%; thus, the obtained classification
Discussion
This study examined the use of TUG scores for predicting fall risk in patients with PD in the clinical setting. We hypothesized that the TUG test may be a viable and reliable clinical assessments tool in patients with PD and may predict those at increased risk of a fall during the course of their disease. Our results suggest that when adjusting for covariates including disease severity, quality of life, cognitive abilities, and arthritis, the TUG test correctly classified over 70% of the sample
Conclusions
The limitations in identifying those with PD at risk for a fall are noteworthy. The findings of this study suggest that the TUG test may be an accurate assessment tool to identity those at risk for a fall. In a clinical setting, where time is critical, a quick and readily available evaluation tool, such as the TUG test, is warranted to provide fall risk insight and hopefully limit adverse outcomes. Using a cut point based on the TUG test may serve as a means to implement a fall prevention plan.
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Supported by the National Parkinson Foundation.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.