The Timed Up and Go Test.

Posted on by Jesse Santiano, M.D.

Who Benefits from This Article?

  1. Anyone planning to get old.
  2. Anyone who knows or is taking care of elderly people.
  3. The Senior, Elderly, or the Young Once.

Why do the Timed Up and Go Test (TUG) test?

The TUG test predicts the risk of falls. Weakness is a reflection of sarcopenia or loss of muscle mass that puts a person at risk for falls.

How to do the TUG test? (Timed Up and Go Test).

From the University of Nebraska Medical Center:

1. Equipment: arm chair, tape measure, tape, watch.
2. Begin the test with the subject sitting correctly (hips all of the way to the back of the seat) in a chair with arm rests. The chair should be stable and positioned such that it will not move when the subject moves from sit to stand. The subject is allowed to use the arm rests during the sit – stand and stand – sit movements.
3. Place a piece of tape or other marker on the floor 3 meters away from the chair so that it is easily seen by the subject. (You may also use the wall to touch then turn back.)
4. Instructions: On the word “GO” the subject will stand up, walk to the line on the floor, turn around and walk back to the chair and sit down. Walk at the regular pace.
5. Start timing on the word “GO” and stop timing when the subject is seated again correctly in the chair with their back resting on the back of the chair.

Other Instructions
1. The subject wears their regular footwear, may use any gait aid that they usually use during ambulation (cane or walker), but may not be assisted by another person. There is no time limit. They may stop and rest (but not sit down) if they need to.

2. The subject should be given a practice trial that is not timed before testing.

What Do The Numbers Mean?

Normal healthy elderly usually complete the task in ten seconds or less. Very frail or weak elderly with reduced mobility may take 2 minutes or more. Results correlate with gait speed, balance, functional level, the ability to go out, and can follow change over time.
Normal Reference Values by Age
Age Group                                  Time in Seconds
60 – 69 years                               8.1 (7.1 – 9.0)
70 – 79 years                               9.2 (8.2 – 10.2)
80 – 99 years                               11.3 (10.0 – 12.7)
If the subject takes longer than the average values, then there is a higher risk of falls.

The Dangers of Falls

Falling in the elderly can lead to fractures and head injuries. The most common fractures seen in the emergency room are hip, wrist, rib, and upper arm fractures. Most fractures will require a consultation with an orthopedic surgeon if there is a need for surgery.
If the elderly are on blood thinners like aspirin, warfarin, Pradaxa, for example, then there is a significant risk of internal bleeding on the head, chest, and the abdomen. An intracranial bleed mandates a brain surgeon and bleeding inside the belly needs a general surgeon’s evaluation.
Any injuries that will require hospitalization can expose the elderly to the development of blood clots in the legs that can go to the lungs. Hospital-acquired infections like pneumonia and urinary tract infections are also a significant concern.
Hospital-acquired infections are more challenging to treat and frequently require intravenous antibiotics. That means longer hospitalization. The medicines used are also more expensive.
After hospitalization, weeks of physical therapy are needed to regain the previous ambulatory status.
There are other conditions related to frailty brought about by the decrease in muscle mass associated with aging, as discussed in this article about sarcopenia.
So how can the TUG test be used to prevent falls?

Putting a Twist on the TUG

Since the TUG test has objective parameters that are controlled. (Same distance to cover during each examination). The subject can “train” to improve their TUG test numbers.

Here is short instructional on how to prevent falls

The second YouTube video presents a more detailed exercise on the squat. The squat engages the muscles of the lower back and abdomen, buttocks, thighs, and the legs. The largest muscle groups in the body. Practicing the squat by itself is time-efficient because it involves many muscles in a short time.

The third video presents more detail about how to improve walking stability and starts at 7:34. The beginning of the video shows the risk and dangers of falling.

After doing the exercises, do the TUG test again. See if the numbers improve! Lower numbers mean a lower risk of falls.

Don’t forget to run the above exercises with your doctors before trying them out.

A printable PDF file on how to do the TUG test is available here.

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Thanks for reading.

Related Readings:

  1. How Does Exercise Prolong Life?
  2. The Benefits of Resistance Training
  3. The Surprising Benefits of Sweating
  4. The Good and Faithful Servant
  5. Effect of Short Term Exercise on Mortality
  6. What are Exerkines?
  7. Exercise Guidelines
  8. Why do You Need an Excellent Performance Status?
  9. How to be Active from Sedentary
  10. How to Do Intermittent Fasting

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