Normative values for the Timed 'Up and Go' test in children and adolescents and validation for individuals with Down syndrome

Abstract

Aim: To determine normative values for the Timed Up and Go (TUG) test in typically developing children and adolescents and to validate its use in individuals with Down syndrome. Method: Participants in this cross-sectional study were South Brazilian schoolchildren aged 3 to 18 years. In phase 1, 459 typically developing individuals (227 males, 232 females; mean age 10y 8mo (SD 4y 4mo) were included; and in phase 2, 40 individuals with Down syndrome (16 males, 24 females; mean age 10y 6mo (SD 4y 4mo). Anthropometric measurements, real leg length, TUG test scores, and Gross Motor Function Measure (GMFM) scores were evaluated. The association between the TUG test and possible predictive variables was analyzed. Results: In phase 1, the mean time to perform the TUG test was 5.61 seconds (SD 1.06). Values were stratified in age groups that served as normative data for both sexes. A multiple linear regression analysis was conducted and the best variables to predict TUG scores were age and weight. The best model obtained presented an R2 of 0.25 and a standard error of the estimate of 0.92. Excellent intrasession reliability in the three tests performed (intraclass correlation coefficient [ICC] of 0.93, 0.94, and 0.95) and between the sessions (both with an ICC of 0.95) was demonstrated. In phase 2, the test also showed excellent reproducibility (ICC=0.82 between the two tests performed). The performance time was significantly longer (p<0.001) in individuals with Down syndrome compared with sex- age-, and weight-matched typically developing children with a mean difference of -3.53 (95% confidence interval -4.05 to -3.00). Dimension E of the GMFM (Walking, Running and Jumping) showed the highest correlation (r=-0.55, p<0.001) with the test. Interpretation: This study provides normative values for the TUG test and shows that TUG scores can be predicted as a function of age and weight in typically developing individuals. The test can also be used for assessment of functional mobility in individuals with Down syndrome. © 2013 Mac Keith Press.