Further Validation of the Timed up and Go in Persons with Multiple Sclerosis
Objectives: To provide further validation of the TUG among a large sample of pwMS.
Methods: Participants were randomly selected from the patients seen at a community-based comprehensive MS care center as a part of a larger study. A total of 251 pwMS agreed to participate and completed the following assessments: timed up and go (TUG), patient determined disease status (PDDS), timed 25 foot walk (T25FW), functional status index (separated into subcategories for analysis of average assistance [FSI-A], mobility [FSI-Mobility] and difficulty [FSI-D]), multiple sclerosis walking scale 12 (separated into MSWS-12 total score and benchmarks), multiple sclerosis impact scale (MSIS-29) and Disabilities of the Arm, Shoulder, and Head (DASH). Age, gender and disease duration were obtained from each participant’s medical record. Data were analyzed using spearman’s rank-order correlations with a p-value of <0.01 considered significant.
Results: The TUG had a strong, positive and significant association with all of the following (p-value <0.001): a valid quantitative measure of lower extremity function (T25FW, rs= .902), perceived level of mobility (FSI-Mobility, rs=.667; MSWS-12, rs=.696), perceived limitations and difficulty in daily activities (FSI-D, rs= .519; MSIS-29, rs= .567; DASH, rs= .646), perceived need of assistance in daily activities (FSI-A, rs= .716), perceived overall disability (PDDS, rs=.716), and with recently defined MSWS-12 benchmarks (rs=.669).
Conclusions: This study provides further validation of the TUG and it’s use as a clinical measure of pwMS by enhancing existing research through validation on a larger more representative study sample. Increased difficulty on the TUG was strongly associated with increased disability on all measures assessed. In addition, this study supports using the TUG as a measure of mobility impairment and decreased functional independence in pwMS.