Although the TUG has been used extensively for over a decade, normative reference values from large samples of elders have not been published. This study sought to remedy this shortcoming by consolidating the findings of multiple studies conducted in diverse settings. Specifics of the studies differed, but meta-analysis suggested that the data from the studies were homogeneous. Consequently, data from the entire sample might provide a reasonable estimate of normal TUG performance. This finding notwithstanding, analysis of age subgroups identified reference values that were more homogeneous. The upper limit of the confidence intervals of these age groups can be used to note performance that is worse than average. Specifically, TUG times are worse than average if they exceed: 9.0 seconds for 60 to 69 year olds, 10.2 seconds for 70 to 79 year olds, and 12.7 seconds for individuals 80 to 99 year olds. Individuals with such slow times may warrant interventions directed at improving their strength, balance, and/or mobility.
The clinical value of the aforementioned notwithstanding, the findings have limitations. First, there were procedural differences in the studies. Although the distance walked was always 3.0 meters or 10 feet (which do not differ appreciably), the chairs used and instructions provided varied considerably. Notably, these differences did not preclude homogeneity within and between age groups. Consequently, the reference values can be used for normative purposes. Second, while the consolidation of data from multiple studies resulted in sample sizes larger than provided by individual studies, the sample size for individuals 60 to 69 years of age remained quite limited. Third, while the normative reference values presented in this study have utility, they are not substitutes for criterion values purveyed as predictors of risk for various untoward outcomes (eg, falls).34,35
This study provides normative reference values for the TUG. The values can be used to identify elders with deficits (possibly subclinical) in mobility and its underlying determinants (ie, strength and balance).
I greatly appreciate the provision of more specific/clarified data by the following individuals: Kenneth Rockwood, MD; Geraldine Pellecchia, PhD, Roberta Newton, PhD, and Jennifer Nitz, PhD.
1. Podsiadlo D, Richardson S. The Timed Up & Go: A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc.
2. Mathias S, Nayak USL, Isaacs B. Balance in the elderly patient: The “Get-up and Go” test. Arch Phys Med Rehabil.
3. Lin M-R, Hwang H-F, Hu M-H, Wu H-D I, Wang Y-W, Huang F-C. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc.
4. Simmonds MJ, Olson SL, Jones S, et al. Psychometric characteristics and clinical usefulness of physical performance
tests in patients with low back pain. Spine.
5. Payette H, Hanusaik N, Boutier V, Morais JA, Gay-Donald K. Muscle strength and functional mobility in relation to lean body mass in free-living frail elderly women. Eur J Clin Nutr.
6. Bennie S, Bruner K, Dizon A, Fritz H, Goodman B, Peterson S. Measurements of balance: comparison of the Timed “Up and Go” test and Functional Reach test with the Berg Balance Scale. J Phys Ther Sci.
7. Freter SH, Fruchter N. Relationship between timed ‘up and go’ and gait time in an elderly orthopaedic rehabilitation population. Clin Rehabil.
8. van Hedel HJ, Wirz M, Dietz V. Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests. Arch Phys Med Rehabil.
9. Hughes C, Osman C, Woods AK. Relationship among performance on stair ambulation, Functional Reach, and Timed Up and Go tests in older adults. Issues on Aging.
10. Bischoff HA, Stähelin HB, Monsch AU, et al. Identifying a cut-off point for normal mobility: a comparison of the timed ‘up and go’ test in community-dwelling and institutionalized elderly women. Age Ageing.
11. Shumway-Cook, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther.
12. Nikolaus T, Bach M, Oster P, Schlierf G. Prospective value of self-report and performance-based tests of functional status for 18-month outcomes in elderly patients. Aging Clin Exp Res.
13. Rothstein JM, Echternach JL. Primer on Measurement: An Introductory Guide to Measurement Issues.
Alexandria, Va: American Physical Therapy Association; 1993.
14. Statistical Program for the Social Sciences. Chicago, Ill: SPSS, Inc; 2001.
16. Isles RC, Low Choy NL, Steer M, Nitz JC. Normal values of balance tests in women aged 20-80. J Am Geriatr Soc.
17. Steffen TM, Hacker TA, Mollinger L. Age- and genderrelated test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and Gait Speeds. Phys Ther.
18. Lusardi MM, Pellecchia GL, Schulman M. Functional performance in community living older adults. J Geriatr Phys Ther.
19. Bohannon RW, Schaubert K. Long-term reliability of the Timed Up-and-Go Test among community-dwelling elders. J Phys Ther Sci.
20. Medley A, Thompson M. The effect of assistive devices on the performance of community dwelling elderly on the Timed Up and Go Test. Issues on Aging.
21. Campbell CM, Rowse JL, Ciol MA, Shumway-Cook A. The effect of cognitive demand on Timed Up and Go performance in older adults with and without Parkinson disease. Neurol Report.
22. Arnadottir SA, Mercer VS. Effects of footwear on measurements of balance and gait in women between the ages of 65 and 93 years. Phys Ther.
23. Lin M-R, Hwang H-F, Hu M-H, Wu H-D I, Wang Y-W, Huang F-C. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc.
24. Daubney ME, Culham EG. Lower-extremity muscle force and balance performance in adults aged 65 years and older. Phys Ther.
25. Wall JC, Bell C, Campbell S, Davis J. The Timed Get-up-and Go test revisited: measurement
of component tasks. J Rehabil Res Dev.
26. Newton RA. Validity of the multi-directional reach test: A practical measure for limits of stability in older adults. J Gerontol: Med Sci.
2001; 56A: M248-M252.
27. Janssen HCJP, Samson MM, Meeuwsen IBAE, Duursma SA, Verhaar HJJ. Strength, mobility and falling in women referred to a geriatric outpatient clinic. Aging Clin Exp Res.
28. Edelberg HK, Shallenberger E, Hausdorff JM, Wei JY. One-year follow-up of medication management capacity in highly functioning older adults. J Gerontol: Med Sci.
29. Eekhof JAH, DeBock GH, Schaapveld K, Springer MP. Short report: Functional mobility assessment at home. Canadian Fam Physician.
30. Davis JW, Ross PD, Preston SD, Nevitt MC, Wasnich RD. Strength, physical activity, and body mass index: relationship to performance-based measures and activities of daily living among older Japanese women in Hawaii. J Am Geriatr Soc.
31. 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. Austr NZ J Public Health.
32. 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: Med Sci.
33. 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.
34. Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the Timed Up and Go and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. J Vestib Res.
35. Bergland A, Jarnio GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res.