Discriminative ability and clinical utility of the Timed Up and Go (TUG) in identifying falls risk in people with multiple sclerosis: a prospective cohort study

Clin Rehabil. 2019 Feb;33(2):317-326. doi: 10.1177/0269215518793481. Epub 2018 Aug 14.

Abstract

Objective:: To investigate discriminative ability and clinical utility of the Timed Up and Go under single- and dual-task conditions between fallers and non-fallers in multiple sclerosis (MS).

Design:: Prospective cohort study.

Setting:: Neurology service in a tertiary hospital.

Subjects:: Participants were 101 people with MS and Expanded Disability Status Scale score of 3-6.5. One participant withdrew after the baseline assessment, and hence the data were analysed for 100 participants.

Interventions:: No specific intervention.

Main measures:: Timed Up and Go and Timed Up and Go-Cognitive. Three-month prospective diaries recorded falls.

Results:: Mean age was 52.6 (SD 10.7) and 66 were female. Majority of the participants had progressive MS (72) and 73 used a walking aid; 56 participants recorded 791 falls. The area under the receiver operating characteristic curve values for Timed Up and Go and Timed Up and Go-Cognitive in distinguishing fallers (person with ⩾1 fall) from non-fallers are 0.60 and 0.57, respectively, and in distinguishing multiple fallers (⩾2 falls) the values are 0.46 and 0.43. A Timed Up and Go score of ⩾9 seconds has a sensitivity of 0.82 and a specificity of 0.34 to identify fallers and a sensitivity of 0.79 and a specificity of 0.27 to identify multiple fallers. A Timed Up and Go-Cognitive score of ⩾11 seconds has a sensitivity of 0.77 and a specificity of 0.30 to identify fallers and a sensitivity of 0.71 and a specificity of 0.26 to identify multiple fallers.

Conclusion:: The Timed Up and Go and Timed Up and Go-Cognitive do not demonstrate sufficient clinical utility or discriminative ability for assessing falls risk in MS.

Keywords: Multiple sclerosis; Timed Up and Go; accidental falls; risk.

MeSH terms

  • Accidental Falls*
  • Adult
  • Aged
  • Cognition / physiology*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / physiopathology*
  • Multiple Sclerosis / psychology*
  • Postural Balance
  • Predictive Value of Tests
  • ROC Curve