Inter-rater reliability of Timed Up and Go test in older adults measured by physiotherapist and caregivers

Abstract

Introduction Globally and in Nepal, 28–35% of older adults experience fall-related injuries annually. The ‘Timed Up and Go’ (TUG) test is a valid measure to assess risk of falls when administered by health professionals; but the reliability of the TUG administered by older adults’ primary caregiver is unknown. The aim of this study was to examine the inter-rater reliability of the TUG assessed by caregivers compared to a trained student physiotherapist in older adults. Methods One hundred older adults were recruited with their primary caregivers in a rural community of Nepal. The researchers trained primary caregivers prior to assessment following an a priori protocol. Both the caregiver and a trained student physiotherapist administered the TUG. The two tests were performed at an interval of five minutes, and the two testers were blinded to each other’s assessment. The inter-rater reliability was evaluated using the two-way random-effects model absolute agreement intra-class correlation coefficient (ICC2,1). The Bland–Altman plot was created to visualise systematic errors between the measurements. Results The ICC was found to be 0.87 (95% CI: 0.82–0.91) indicating excellent inter-rater reliability of the TUG between primary caregivers and the student physiotherapist. Conclusions Caregivers’ assessment of the TUG is reliable compared to a trained student physiotherapist. Therefore, caregivers could be used to assess risk of fall and to monitor changes after discharge, without having to be assessed by a physiotherapist in a rural community setting. This could help overcome both geographic and economic barriers.