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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
European Journal of Physical and Rehabilitation Medicine 2017 Mar 13
Copyright © 2017 EDIZIONI MINERVA MEDICA
Further construct validity of the timed up and go test as a measure of ambulation in persons with multiple sclerosis
Alon KALRON 1 ✉, Mark DOLEV 2, Uri GIVON 2, 3
1 Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; 2 Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel; 3 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
BACKGROUND: The importance of mobility impairments in people with multiple sclerosis (PwMS) denotes a need for valid, reliable, sensitive and feasible clinical measuring tools. The Timed Up and Go (TUG) test is a unique mobility measure as it captures other functions apart from walking, ie, rising out of a chair or turning around an object.
AIM: To expand the construct validity of the TUG test in PwMS and determine the ability of the TUG score to discriminate between four levels of disability between fallers, recurrent fallers and non-fallers.
SETTINGS: Multiple Sclerosis Center, Sheba Medical Center, Israel.
POPULATION: 285 PwMS (176 women) with a mean disease duration of 8.1 (SD=8.1) years. METHODS: We retrospectively evaluated and analyzed computerized data of the TUG test, Four Square Step Test (FSST), posturography measures, 2-Minute Walk Test (2mWT), Timed 25-Foot Walk Test, Fall status, Falls Efficacy Scale International, Modified Fatigue Impact Scale, instrumented cognitive assessment and the Multiple Sclerosis Walking Scale self-reported questionnaire.
RESULTS: The TUG score of the total sample was 9.3 (SD=5.1). In terms of the disability subgroups, significant differences were observed between the four groups with the exception of "very mild" to "mild" groups. In terms of fall status, the MS recurrent fallers demonstrated a significantly slower TUG compared to the MS non-fallers. Strong-modest significant correlation scores were found between the TUG and ambulation tests. The strongest scores were found for the FSST and 2MWT; Pearson's rho=0.740, -0.731, respectively.
CONCLUSIONS: The current study broadens the evidence supporting the usage of the TUG test to assess walking and balance performance in PwMS regardless of the patient's cognitive status. Furthermore, the test can aid in identifying PwMS who are at a high risk of falling.
CLINICAL REHABILITATION IMPACT: The TUG test is an excellent tool used to assess mobility capabilities in PwMS, monitor disease progression and identify potential MS fallers.
KEY WORDS: Multiple sclerosis - Timed Up and Go test - Gait – Balance - Falls