What Is the Timed Up and Go (TUG) Test?

Simple test used to estimate the risk of falls

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Healthcare workers with senior woman using walker

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The Timed Up and Go test, also known as the TUG test, is a simple evaluative test used to measure your functional mobility. It is most often used in physical therapy to give your therapist an idea of how safely you can move around. The TUG test can also be used by your doctor to estimate your risk of falling and your ability to maintain balance while walking.

Purpose of Test

The TUG test is frequently used in elderly people as it is easy to administer and can be completed by most older adults. It can be included as part of a more comprehensive Get Up and Go (GUG) test which involves additional tasks like standing with your eyes closed or sitting in a chair without using the armrests.

There are many benefits to the TUG test. Among them:

  • Minimal equipment is needed.
  • It can be performed almost anywhere.
  • It only takes a few minutes.
  • It can be self-performed at home.
  • Minimal training is needed to administer the test.
  • It can be used routinely to measure your response to physical therapy.

The TUG test is recommended as a routine screening test for falls by the American Geriatric Society.

Preparation

The TUG test requires only a few pieces of equipment, most of which people will already have at home:

  • A chair with a solid seat and flat back
  • A manual or cellphone stopwatch
  • A measuring tape or ruler
  • A piece of tape or chalk
  • Regular walking shoes
  • Any assistive device you routinely use to walk, such as a walker or a quad can

To set up the test, the therapist will place a chair in an open space and measure three meters (9.8 feet) from the front edge of the seat. A small piece of tape or chalk is used to mark the distance on the floor.

It is important that the chair be stable not and move or slip away when you stand. You can usually prevent this by setting up the test on a carpeted space.

How to Perform the Test

To start the TUG, you will sit in the chair with your arms resting comfortably on your lap or at your sides (not on the armrests). You should be seated properly with your hips positioned all the way to the back of the seat.

The test begins when the therapist says "Go" and starts the stopwatch. You would then be timed as you rise from the chair, walk three meters, turn around, return to the chair, and sit down.

The recorded time on the stopwatch is your TUG score. Many physical therapists will perform a practice run followed by two timed tests. The average recorded time of the two tests is your final score.

While an assistive device is permitted, no other form of physical assistance should be used. If your balance is impaired, someone should be at your side to prevent you from falling, but they should not hold you up.

There is no time limit to the TUG test. Elderly people who are otherwise healthy can usually complete the task in 10 seconds or less. Very frail older adults may take two minutes or more.

You can perform the TUG test at home if your doctor or physical therapist gives permission. But you should never do it on your own if you have significant mobility or balance issues.

Interpreting the Results

A 2014 review of studies in BMC Geriatrics concluded that a TUG score of 13.5 seconds or longer was predictive of a falls risk. By contrast, a TUG score of under 13.5 seconds suggests better functional performance.

With that being said, the cut-off of 13.5 seconds should not be the sole determinant of a falls risk. According to the review, while a TUG score of 13.5 seconds or more could rule in the risk of a fall, a score of under 13.5 seconds could not rule out the risk.

Other factors can inadvertently skew the results, including how you were feeling on the day of the test or whether you have fluctuations in your blood pressure, blood sugar, or energy levels. Even medication side effects can contribute to a periodic loss of balance, energy, or strength.

To this end, the TUG test only provides your doctor or therapist a general idea of your mobility status. If your score is near or over the cut-off threshold, other tests may be used to better characterize your mobility, including:

  • Pick Up Weight test in which you reach down and pick up an object from the floor
  • Half Turn test in which you take a few steps and then turn around to face the opposite direction
  • Alternate Step test in which you alternately place and remove your left and right foot on an 18-centimeter (7-inch) step for eight repetitions
  • Stairs Ascent and Descent test in which you walk up and down eight steps holding a guard rail

On its own, the TUG test may have the most value when used on an ongoing basis to assess any improvement or deterioration in your mobility.

A Word From Verywell

The TUG test is a useful screening tool but one that needs to be interpreted in context with your age, weight, current health, and risks of fractures.

The TUG test should never be used on its own to decide whether you need an assistive device or not. That decision should be based on a review of your medical history and a comprehensive exam by an orthopedic specialist.

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