How Many Trials Are Needed to Achieve Performance Stability of the Timed Up & Go Test in Patients With Hip Fracture?

Abstract

Kristensen MT, Ekdahl C, Kehlet H, Bandholm T. How many trials are needed to achieve performance stability of the Timed Up & Go test in patients with hip fracture? Objective To examine the number of trials needed to achieve performance stability of the Timed Up & Go (TUG) test using a standardized walking aid in patients with hip fracture who are allowed full weight bearing (FWB). Design Prospective methodologic study. Setting An acute 14-bed orthopedic hip fracture unit. Participants Patients (N=122; 89 women, 33 men) with hip fracture with a median age (25%–75%, quartiles) of 80 (67–85) years performed the TUG on hospital discharge to their own home (n=115) or further inpatient rehabilitation (n=7). Interventions Not applicable. Main Outcome Measures After a demonstration by a physical therapist how to perform the TUG with a standardized walking aid (a 4-wheeled rollator), the patients performed 6 timed TUG trials with up to 1-minute seated rest intervals. The participants were given a few minutes to familiarize with the rollator before commencing the timed trials. Repeated-measures analysis of variance (ANOVA) with Bonferroni corrections were used to examine the number of trials needed to ensure statistically stable TUG scores. Results A total of 106 (87%) patients performed all 6 TUG trials, while 120 patients performed a minimum of 3 timed trials. Repeated-measures ANOVAs of both groups showed that TUG scores improved significantly ( P≤.007) up to and including the third TUG trial. Conclusions These results suggest that the original TUG manual, described as 1 practice trial followed by 1 timed trial, needs modification when used in patients with hip fracture who are allowed FWB. The best (fastest) of 3 timed TUG trials performed with a standardized walking aid is recommended.