Reliability and Validity of the Timed Up and Go Test With a Motor Task in People With Chronic Stroke

Objectives: To examine (1) the intra-rater, interrater, and test-retest reliabilities of the timed Up and Go test with a motor task (TUG_motor) in terms of the number of steps taken in the test and completion time in a population with chronic stroke; (2) the relation between stroke-specific impairments and the number of steps taken in the test and the completion time; (3) the minimum detectable change in TUG_motor times; and (4) the cutoff time that best discriminates the performance of people with stroke from that of older adults without stroke.

Design: Cross-sectional study.

Setting: University-based rehabilitation center.

Participants: A sample (N=65) of chronic stroke survivors (n=33) and healthy older adults (n=32).

Interventions: Not applicable.

Main outcome measures: TUG_motor times and number of steps taken; Fugl-Meyer Assessment for the Lower Extremities score; handheld dynamometer measurements of hip abductor, knee flexor and extensor, and ankle dorsiflexor and plantar flexor muscle strength; 5-times sit-to-stand test time, Berg Balance Scale score; conventional timed Up and Go test time, and Activities-specific Balance Confidence scale and Community Integration Measure questionnaire scores.

Results: The TUG_motor completion times and number of steps demonstrated excellent intra-rater, interrater, and test-retest reliabilities. The TUG_motor times correlated significantly with the Fugl-Meyer Assessment for the Lower Extremities and Berg Balance Scale scores, with hip abductor, knee flexor, ankle dorsiflexor and plantar flexor strength on the paretic side, with 5-times sit-to-stand test times, and with times on the conventional timed Up and Go test. The minimum detectable change in TUG_motor time was 3.53 seconds in stroke survivors. A TUG_motor cutoff time of 13.49 seconds was found to best discriminate the performance of stroke survivors from that of older adults without stroke.

Conclusions: The TUG_motor is a reliable, valid, and easy-to-administer clinical tool for assessing advanced functional mobility after a stroke.