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Physical Performance Assessment

 

Performance Measure

In Brief…

Important Values

Timed UP and GO (TUG test)

Patients are timed (in seconds) when performing the TUG - 3 conditions:

  1. TUG alone-from sitting in a chair, stand up, walk 3 meters, turn around, walk back, and sit down.
  2. TUG Cognitive- complete the task while counting backwards from a randomly selected number between 20 and100.
  3. TUG Manual-complete the task while carrying a full cup of water8.

The more time taken, the more dependent in activities of daily living)9.

The cutoff levels:

  • TUG: 13.5 seconds or longer with an overall

correct prediction rate of 90%;

  • TUG Manual is 14.5 seconds or longer with a 90% correct prediction rate;
  • TUG Cognitive is 15.0 seconds or longer with an overall correct prediction rate of 87%10.

 

TUG Scoring Interpretation: Older adults who take longer than 13.5 seconds to complete the TUG havea high risk for falls11.

Gait Speed

GAIT SPEED & Clinical Importance:

Slow gait speed predicts:

  • Future health status; Functional decline
  • Hospitalization; Potential for rehabilitation
  • Falls and fear of falling; Mortality
  • It has been reported to be the single best predictor of functional decline &

disability

Gait Speed Research Values:

  • A difference of 0.1m/s is considered a meaningful change in gait speed in hip fracture patients. (Palombaro,KM, 2006)
  • <1.8 ft./sec (0.55m/sec)= risk for recurrent falls: Sensitivity 72%, Specificity

74% (Van

Swearingon, JM, 1998)

Floor TransferTest

Assesses the person’s ability to transfer themselves from standing to lying supine on the floor without assistance.

Interpretation: The inability to get up from the floor could be an indication of failing health and predicts serious fall-related injuries: 30% of women who could not get off the floor would experience a serious fall- related

injury in the next year.10

 

8 Lundlin-Olsson, L., Nyberg, L., Gustafson, Y. (1998). Attention, frailty, and falls: the effect of a manual task on basic mobility. Journal of the American Geriatrics Society, 46, 758-761.

 

9 Podsiadlo, D., Richardson, S. (1991). The timed “up & go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142-148.

 

10 Shumway-Cook, A., Brauer, S., Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Physical Therapy, 80(9), 896-903.

11 Lusardi, M.M. (2004). Functional Performance in Community Living Older Adults. Journal of Geriatric Physical Therapy, 26(3), 14-22.

 

 

The importance of WALKING speed:

 

The graphic below depicts a summary of research into walking speed and function. Note that, on average, a walking speed that maintains a client's participation in community-based activities and staying in their home as opposed to being hospitalized requires a walking speed of 0.8m/s.

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