Original research
Validity of the Timed Up and Go Test as a Measure of Functional Mobility in Persons With Multiple Sclerosis

https://doi.org/10.1016/j.apmr.2015.12.031Get rights and content

Abstract

Objective

To examine the validity of the timed Up and Go (TUG) test as a measure of functional mobility in persons with multiple sclerosis (MS) by using a comprehensive framework based on construct validity (ie, convergent and divergent validity).

Design

Cross-sectional study.

Setting

Hospital setting.

Participants

Community-residing persons with MS (N=47).

Interventions

Not applicable.

Main Outcome Measures

Main outcome measures included the TUG test, timed 25-foot walk test, 6-minute walk test, Multiple Sclerosis Walking Scale-12, Late-Life Function and Disability Instrument, posturography evaluation, Activities-specific Balance Confidence scale, Symbol Digits Modalities Test, Expanded Disability Status Scale, and the number of steps taken per day.

Results

The TUG test was strongly associated with other valid outcome measures of ambulatory mobility (Spearman rank correlation, rs=.71–.90) and disability status (rs=.80), moderately to strongly associated with balance confidence (rs=.66), and weakly associated with postural control (ie, balance) (rs=.31). The TUG test was moderately associated with cognitive processing speed (rs=.59), but not associated with other nonambulatory measures (ie, Late-Life Function and Disability Instrument-upper extremity function).

Conclusions

Our findings support the validity of the TUG test as a measure of functional mobility. This warrants its inclusion in patients' assessment alongside other valid measures of functional mobility in both clinical and research practice in persons with MS.

Section snippets

Participants

Prospective participants were recruited from an active clinical neurology practice in the Midwest portion of the United States. The inclusion criteria were clinically definitive diagnosis of MS, age of ≥18 years, relapse-free for the past 30 days, and ability to walk with or without assistive devices (ie, unassisted, cane/crutch/walker use, but not restricted to a wheelchair). Furthermore, participants had to be willing to complete in-person assessments and wear an accelerometer over a 7-day

Sample characteristics

The sample was mostly female patients (89.4%) with a mean age of 53.0±11.4 years. Forty-two persons had relapsing-remitting MS (89.4%), and the sample had a mean duration of MS of 13.0±9.6 years. The demographic and clinical characteristics of this sample are similar to those of other samples of persons with moderate disability (ie, median EDSS score, 4.0).23, 36

Table 1 provides the descriptive characteristics of the outcome measures. The scores for participants in this study on the ambulatory

Discussion

To our knowledge, this is the first study to comprehensively validate the TUG test as a measure of FM in persons with MS. Validity was observed on the basis of the pattern of correlations between the TUG test and other valid ambulatory measures (ie, T25FW test, 6MWT, MSWS-12, EDSS, and average steps per day) and subcomponents of FS (ie, FS-Pyramidal and FS-Cerebellar). Validity was further established on the basis of the pattern of correlations between TUG test scores and objectively measured

Conclusion

Overall, the TUG test demonstrated strong convergent validity on the basis of the pattern of associations with other valid outcome measures of ambulation and moderate to strong divergent validity demonstrated by the pattern of associations with nonambulatory measures in persons with MS. Our findings support the validity of the TUG test as a measure of FM. This warrants its inclusion in FM assessments in both clinical and research practice that involves persons with MS.

Supplier

  • a.

    IBM Corp.

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  • Cited by (0)

    Disclosures: none.

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