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).
Community-residing persons with MS (N=47).
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.
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).
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.
List of abbreviations:6MWT (6-minute walk test), ABC (Activities-specific Balance Confidence), ALEF (advanced lower extremity function), BLEF (basic lower extremity function), EDSS (Expanded Disability Status Scale), FM (functional mobility), FS (functional systems), LL-FDI (Late-life Function and Disability Instrument), MS (multiple sclerosis), MSWS-12 (Multiple Sclerosis Walking Scale-12), SDMT (Symbol Digit Modalities Test), T25FW (timed 25-foot walk), TUG (timed Up and Go), UEF (upper extremity function)
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National Multiple Sclerosis Society. MS symptoms. Available at: http://www.nationalmssociety.org/. Accessed January 1, 2015.
- Disability progression and its association with walking impairment in multiple sclerosis.Neurodegener Dis Manag. 2014; 2014: 491-500
- Measuring the impact of MS on walking ability: the 12-Item MS Walking Scale (MSWS-12).Neurology. 2003; 60: 31-36
- Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners.Patient. 2011; 4: 189-201
- Impact of mobility impairment in multiple sclerosis 2—patients' perspectives.Eur Neurol Rev. 2011; 6: 115-120
- Health-related quality of life in a population-based sample of people with multiple sclerosis in Stockholm County.Mult Scler. 2006; 12: 605-612
- “Restricting choices and limiting independence”: social and economic impact of multiple sclerosis upon households by level of disability.Chronic Illn. 2008; 4: 160-172
- Impact of loss of mobility on instrumental activities of daily living and socioeconomic status in patients with MS.Curr Med Res Opin. 2010; 26: 493-500
- Clinical and laboratory studies of falls in old people: prospects for prevention.Clin Geriatr Med. 1985; 1: 513-524
- Walking in the real world: concepts related to functional gait.N Z J Physiother. 2007; 35: 126-130
- Cognitive processing speed is related to fall frequency in older adults with multiple sclerosis.Arch Phys Med Rehabil. 2013; 94: 1567-1572
- Cognitive function is associated with the development of mobility impairments in community-dwelling elders.Am J Geriatr Psychiatry. 2011; 19: 571-580
- Assessing walking disability in multiple sclerosis.Mult Scler J. 2012; 18: 914-924
- Ambulation and multiple sclerosis.Phys Med Rehabil Clin N Am. 2013; 24: 325-336
- The timed “Up & Go”: a test of basic functional mobility for frail elderly persons.J Am Geriatr Soc. 1991; 39: 142-148
- Clinical relevance using timed walk tests and “timed up and go” testing in persons with multiple sclerosis.Physiother Res Int. 2007; 12: 105-114
- Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake.J Nutr Health Aging. 2005; 9: 347-351
- Clinical and laboratory measures of postural balance in an elderly population.Arch Phys Med Rehabil. 1992; 73: 1073-1080
- Selecting rehabilitation outcome measures for people with multiple sclerosis.Int J MS Care. 2015; 17: 181-189
- Core outcome measures for exercise studies in people with multiple sclerosis: recommendations from a multidisciplinary consensus meeting.Mult Scler. 2014; 20: 1641-1650
- The timed “Up and Go” test: reliability and validity in persons with unilateral lower limb amputation.Arch Phys Med Rehabil. 1999; 80: 825-828
- Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests.Arch Phys Med Rehabil. 2005; 86: 190-196
- Further validation of the Six-Spot Step Test as a measure of ambulation in multiple sclerosis.Gait Posture. 2015; 41: 222-227
- Validity of six balance disorders scales in persons with multiple sclerosis.Disabil Rehabil. 2006; 28: 789-795
- The significant change for the Timed 25-foot Walk in the multiple sclerosis functional composite.Mult Scler. 2000; 6: 286-290
- Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls.Mult Scler. 2008; 14: 383-390
- Accelerometry as a measure of walking behavior in multiple sclerosis.Acta Neurol Scand. 2013; 127: 384-390
- Validity, invariance and responsiveness of a self-report measure of functional limitations and disability in multiple sclerosis.Disabil Rehabil. 2010; 32: 1260-1271
- Mobility, balance and falls in persons with multiple sclerosis.PLoS One. 2011; 6: e28021
- Activities-specific Balance Confidence in people with multiple sclerosis.Mult Scler Int. 2012; 2012: 1-8
- Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS).Neurology. 1983; 33: 1444-1452
- Risk factors for and management of cognitive dysfunction in multiple sclerosis.Nat Rev Neurol. 2011; 7: 332-342
- Validation of Patient Determined Disease Steps (PDDS) scale scores in persons with multiple sclerosis.BMC Neurol. 2013; 13: 37
- Improving standards in brain-behavior correlation analyses.Front Hum Neurosci. 2012; 6: 119
- Statistical power analysis for the behavioral sciences.Vol 2nd. L. ERLBAUM Associates, Hillsdale1988
- The Six Spot Step Test: a new measurement for walking ability in multiple sclerosis.Mult Scler. 2006; 12: 495-500
- Further validation of Multiple Sclerosis Walking Scale-12 scores based on spatiotemporal gait parameters.Arch Phys Med Rehabil. 2013; 94: 575-578
- Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures.Health Qual Life Outcomes. 2014; 12: 2
Published online: March 01, 2016
© 2016 by the American Congress of Rehabilitation Medicine