Using the Timed Up & Go Test in a Clinical Setting to Predict Falling in Parkinson's Disease

• Published in: Archives of physical medicine and rehabilitation Vol. 94; no. 7; pp. 1300 - 1305
• Main Authors: Nocera, Joe R., PhD, Stegemöller, Elizabeth L., PhD, Malaty, Irene A., MD, Okun, Michael S., MD, Marsiske, Michael, PhD, Hass, Chris J., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2013
• Subjects: Accidental falls; Accidental Falls - prevention & control; Aged; Arthritis - epidemiology; Body Height; Body Mass Index; Cross-Sectional Studies; Disability Evaluation; Executive Function; Female; Gait; Humans; Male; Middle Aged; Nervous system diseases; Parkinson Disease - epidemiology; Parkinson Disease - rehabilitation; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Quality of Life; Rehabilitation; Risk Assessment; Risk Factors; Severity of Illness Index; Nervous system diseases; Parkinson's disease; Gait; Timed Up & Go; body mass index; ROC; TUG; National Parkinson Foundation's Quality Improvement Initiative Registry; area under the curve; Hoehn and Yahr; AUC; NPF-QII; PDQ-39; Parkinson's Disease Questionnaire-39; PD; UPDRS; H&Y; Rehabilitation; receiver operating characteristic; Accidental falls; BMI; Unified Parkinson's Disease Rating Scale
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2013.02.020

Abstract Objective To investigate the ability of the Timed Up & Go test to identify patients with Parkinson's disease at risk for a fall. Design Cross-sectional cohort study. Setting Sixteen participating National Parkinson's Foundation Centers of Excellence. Participants A query yielded a total of 2985 records (1828 men and 1157 women). From these, 884 were excluded because of a lack of crucial information (age, diagnosis, presence of deep brain stimulation, disease duration, inability of performing the Timed Up & Go test without assistance) at the time of testing, leaving 2097 patients included in the analysis. Interventions Not applicable. Main Outcome Measures The primary outcome measure for this study was falls. The chief independent variable was the Timed Up & Go test. Results The initial model examined the prediction of falls from the Timed Up & Go test, adjusting for all study covariates. The estimated models in the imputed data sets represented a significant improvement above chance (χ2 range [ df =17], 531.29–542.39, P <.001), suggesting that 74% of participants were accurately classified as a faller or nonfaller. The secondary model in which the question of whether the effect of Timed Up & Go test was invariant across disease severity demonstrated 75% of participants were accurately classified as a faller or nonfaller. Additional analysis revealed a proposed cut score of 11.5 seconds for discrimination of those who did or did not fall. Conclusions The findings suggest that the Timed Up & Go test may be an accurate assessment tool to identify those at risk for falls.