Abstract
BackgroundThe timed up and go test (TUG) is a functional test which is increasingly used to evaluate patients with stroke. The outcome measured is usually global TUG performance-time. Assessment of spatiotemporal and kinematic parameters during the Oriented gait and Turn sub-tasks of the TUG would provide a better understanding of the mechanisms underlying patients’ performance and therefore may help to guide rehabilitation. The aim of this study was thus to determine the spatiotemporal and kinematic parameters which were most related to the walking and turning sub-tasks of TUG performance in stroke patients.Methods29 stroke patients carried out the TUG test which was recorded using an optoelectronic system in two conditions: spontaneous and standardized condition (standardized foot position and instructed to turn towards the paretic side). They also underwent a clinical assessment. Stepwise regression was used to determine the parameters most related to Oriented gait and Turn sub-tasks. Relationships between explanatory parameters of Oriented gait and Turn performance and clinical scales were evaluated using Spearman correlations.ResultsStep length and cadence explained 82% to 95% of the variance for the walking sub-tasks in both conditions. Percentage single support phase and contralateral swing phase (depending on the condition) respectively explained 27% and 56% of the variance during the turning sub-task in the spontaneous and standardized conditions.Discussion and ConclusionStep length, cadence, percentage of paretic single support phase and non-paretic swing phase, as well as dynamic stability were the main parameters related to TUG performance and they should be targeted in rehabilitation.
Highlights
Patients with stroke-related hemiparesis frequently have impaired balance and gait, limiting daily life activities
Cadence, percentage of paretic single support phase and non-paretic swing phase, as well as dynamic stability were the main parameters related to TimedUp and Go (TUG) performance and they should be targeted in rehabilitation
The stand-up and sit-down sub-tasks of the TUG may be affected by lower limb strength but were not assessed in this study. These results indicate that the walking sub-tasks of the TUG test which require a forward progression of the body are mainly affected by step length and cadence, while the turning sub-task of the TUG requires balance control which is related to the percentage of the gait cycle spent in stance phase
Summary
Patients with stroke-related hemiparesis frequently have impaired balance and gait, limiting daily life activities. Up and Go (TUG) test [2] is widely used to assess locomotor capacity in stroke patients [3] This test measures the time required to rise from a chair, walk 3 meters, turn, walk back and sit down again, evaluating tasks which are regularly encountered in daily life. The TUG is a good general indicator of locomotor function, the timed global performance does not provide any information regarding the mechanisms underlying the patient’s disabilities and specific problems relating to each sub-task are not highlighted [4]. Faria et al (2013) proposed the TUG-ABS (Assessement of Biomechanical Strategies) in order to aid decision making It consists of a 15-item scale of biomechanical strategies for each sub-task of the TUG [5]. The aim of this study was to determine the spatiotemporal and kinematic parameters which were most related to the walking and turning sub-tasks of TUG performance in stroke patients
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