Mobility and falls
Timed Up and Go (TUG)
The Timed Up and Go records the seconds taken to rise from a chair, walk three metres, turn, walk back and sit down. It takes under two minutes, needs a chair and a stopwatch, and 13.5 seconds or more is a common falls-risk threshold in older adults, although the test should not be used alone to predict falls.
What it measures
A single number that combines transfer, gait, turning and sitting — the exact sequence in which most real-world falls happen. Its value is that it is fast, needs almost nothing, and is understood everywhere.
The dual-task version
Adding a cognitive task (counting backwards from 100 in threes) or a manual one (carrying a full glass of water) makes the test harder and reveals difficulty the plain version misses. We use the dual-task variant with patients who score in the normal range but still report near-falls at home.
Key facts
| Abbreviation | TUG |
|---|---|
| Score range | Time in seconds |
| Time to administer | Under 2 minutes |
| Training required | No |
| Cost | Free |
| Equipment | Standard-height chair with armrests · Stopwatch · 3-metre marked walkway |
| Domains | Mobility · Balance · Transfers · Gait |
| ICF domain | Activity |
| Age range | Adult and older adult; paediatric version available |
| Populations | Older adults · Stroke · Parkinson's disease · Hip and knee replacement · Vestibular disorders |
| Languages | Instructions available in many languages |
Psychometrics by population
The same instrument behaves differently in different conditions. A cut-off established in older adults does not transfer to Parkinson's disease, and a minimal detectable change from one study does not apply to another population.
| Population | Cut-off | MDC / MCID | Reliability | Validity |
|---|---|---|---|---|
| Older adults | 13.5 seconds or more (Rehabilitation Measures Database); limited predictive value when used alone (Barry 2014) | — | Excellent test–retest and inter-rater reliability | Correlates with the Berg Balance Scale and gait speed |
| Parkinson's diseaseFreezing during the turn affects the result and should be recorded separately from the time | Reported cut-offs differ: over 7.95 seconds and over 11.5 seconds (Rehabilitation Measures Database) | — | — | — |
| Stroke | — | MDC 2.9 seconds in chronic stroke (Rehabilitation Measures Database) | — | — |
Things to be careful about
- Chair height and the presence of armrests change the result and must be kept constant between assessments
- The dual-task version is more sensitive in higher-functioning patients
- The turn is where most difficulty appears — note it qualitatively as well as timing it
Frequently asked questions
What is a normal Timed Up and Go time?
In older adults, 13.5 seconds or more is the threshold most often used for increased falls risk, although a meta-analysis found that the test on its own predicts falls poorly in people living at home 2. In Parkinson’s disease different thresholds are reported — over 7.95 seconds in one study and over 11.5 seconds in another 3. The threshold depends on the population, so a single number carries different meaning in different conditions.
Why am I asked to count backwards while walking?
That is the dual-task version. Adding a cognitive task such as counting backwards from 100 in threes, or a manual one such as carrying a full glass of water, makes the test harder and reveals difficulty the plain version misses. We use it with patients who score in the normal range but still report near-falls at home.
Does the chair change the result?
Yes, and more than people expect. Chair height and the presence of armrests both change the time, so they must be kept constant between assessments. A faster time on a higher chair with armrests is not an improvement.
How much change in TUG time is real improvement?
A change of 2.9 seconds is reported as the minimal detectable change in chronic stroke 3 — meaning smaller differences may be measurement noise rather than genuine change. It is also worth noting where the difficulty appears: the turn is where most trouble shows, and we record that qualitatively alongside the time.
Sources
- Podsiadlo D, Richardson S. The Timed Up and Go: a test of basic functional mobility for frail elderly persons — Journal of the American Geriatrics Society (1991)
- Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis — BMC Geriatrics (2014)
- Rehabilitation Measures Database — Timed Up and Go record — Shirley Ryan AbilityLab (2013)
Topic
Related instruments
- Rehabilitation outcomeFunctional Independence Measure (FIM)The FIM is an 18-item scale scoring how much assistance a person needs across thirteen motor and five cognitive tasks.
- Daily livingBarthel IndexThe Barthel Index is a ten-item scale of independence in daily activities, scored from 0 to 100 in five-point increments.
- Balance and fallsBerg Balance ScaleThe Berg Balance Scale assesses static and dynamic balance through fourteen everyday tasks, each scored 0 to 4, giving a total out of 56.
