The Timed-up-and-go (TUG) Test: Illustrative Case Presentation to Demonstrate Its Relation to Pain, Functional Disability, and Health-Related Quality of Life in Patients with Lumbar Degenerative Disc Disease

Abstract

Background: To demonstrate our clinical experience with the implementation of an objective measure of disability, the timed-up-and-go (TUG) test, into clinical practice in patients with lumbar degenerative disc disease (DDD). Methods: Nine representative patients with lumbar DDD (four with lumbar spinal stenosis [LSS], three with lumbar disc herniation [LDH], and two with DDD requiring lumbar fusion) have been selected from an ongoing prospective study to demonstrate our clinical experience with the TUG test. The following parameters were assessed preoperatively and at 3 days and 6 weeks postoperatively: back and leg pain using the visual analogue scale (VAS), functional impairment using the Oswestry Disability Index (ODI) and Roland–Morris Disability Index (RMDI), as well as health-related quality of life (HRQoL) using the EuroQol 5D (EQ-5D) and Short-Form 12 (SF-12). Results: In six patients considered responders to surgery, the mean TUG test improved from 11.9 seconds (range 9.0–18.8) preoperatively to 5.5 seconds (range 4.7–7.0) at 6 weeks follow-up. Correspondingly, mean VAS back and leg pain improved from 6.0 and 8.0 to 1.8 and 1.3, while all functional and HRQoL measures likewise indicated good recovery (RMDI 13.2 to 3.2; ODI 50 to 14.8%; EQ-5D 0.349 to 0.767; SF-12 PCS 29.7 to 43.0, and MCS 41.3 to 49.9). The value of the TUG test is discussed in relation to functional disability as well as for specific clinical situations like obesity, high-grade motor deficit, and surgical complications in three selected patients. Conclusions: The TUG test proved to be a reliable tool adding an objective dimension to the comprehensive assessment of patients with lumbar DDD. It reflects the functional disability of the patient well before and after surgery.