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

• Authors: Joe Nocera, Emory University; Elizabeth L. Stegemoeller, University of Florida; Irene A. Malaty, University of Florida; Michael S. Okun, University of Florida; Micharl Marsiske, University of Florida; Chris J. Hass, University of Florida
• Journal Title: Archives of Physical Medicine and Rehabilitation
• Volume: Volume 94, Number 7
• Publisher: Elsevier: 12 months | 2013-07-01, Pages 1300-1305
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.apmr.2013.02.020
• Subjects: Biology, Neuroscience; Health Sciences, Medicine and Surgery; Health Sciences, Pathology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Rehabilitation; Sport Sciences; Accidental falls; Gait; Nervous system diseases; GAIT; DEMENTIA

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.