The Timed Up-and-Go (TUG) test in children

Investigators : Ms Elizabeth Williams, Prof Mary Galea, A/Prof Dinah Reddihough

The Timed Up and Go test (TUG) has been described as a test of basic or functional mobility for an adult that has rarely been used in children. Functional mobility was defined for this study as a person's ability to manoeuvre his or her body, capably and independently, in order to accomplish everyday tasks. Reliability and validity of TUG scores were examined in children without physical disability aged 3-9y ( n = 173) and in young people with physical disabilities ( n = 41).  

Mean TUG score for children without physical disability was 5.9 ± 1.3 s . Reliability of the TUG was high, with intraclass correlation coefficients (ICC) of 0.89 within session, and 0.83 for test-retest reliability. The mean score of the youngest group aged 3-5 years was significantly higher (6.7 ± 1.2 s ) than that of the older group   (5.1 ± 0.8 s ). Scores in the younger group reduced significantly over a 5-month follow-up period, indicating that the TUG was responsive to change. Within session reliability of the TUG in young people with disabilities was very high (ICC = 0.99). There were significant differences in TUG scores between children classified at Levels I, II and III of the GMFCS (Fig. 1). TUG scores showed a strong negative correlation with scores on the standing and walking dimension of the GMFM ( n = 20, r = -0.820).

Figure 1. Box plots showing TUG scores in relation to GMFCS levels in children with cerebral palsy.

The TUG can be used reliably in children as young as 3 years, using the protocol we have described, and is a meaningful, quick and practical objective measure of functional mobility. With further investigation, the TUG is potentially useful as a screening test, as an outcome measure in intervention studies for young people with disabilities, as a measure of disability, and as a measure of change in functional mobility over time.

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