![]() ![]() Shumway-Cook et al ( 2000) reported in a study with 30 participants that TUG's ability to predict falls is not enhanced by adding a secondary task. While Cardon-Verbecq et al ( 2017) also did not find an improved predictive ability in a study with 157 participants, and Sailer ( 2016) did not find the cognitive TUG to be an effective measure of fall risk in 14 participants. ![]() Virtuoso et al ( 2014) performed a study with 82 physically active old people over 12 months and achieved an AUC of 65.3 and 58.1 with the cognitive TUG test for predicting the occurrence of falls. TUG tests with such covariates (a secondary task) like a cognitive task and TUG with a manual task like physical exercises have been evaluated by different authors. Nocera et al ( 2013) recommended including covariates like disease severity, quality of life and cognitive abilities to increase the number of correctly classified TUG test samples. Also, Beauchet et al ( 2011) mentioned in their review that TUG is discussible, and that the predictive ability is limited. Viccaro et al ( 2011) reported that the TUG test did not add predictive ability rather than using gait speed for fall classification in 457 over 1 year (both AUCs < 0.7). Kojima et al ( 2015) monitored 259 participants over 6 months and concluded that the ability of TUG to predict future falls is limited with an achieved AUC of 0.58. Nevertheless, several studies looking at the total TUG time (that is, time from standing up until sitting down again), however, have shown limited ability to predict falls (Barry et al 2014). (Killough 2006) mentioned the ROC curve for the previous fall analysis which demonstrated an area under the curve (AUC) of 0.64 to differ between fallers and non-fallers and (Andersson et al 2006) showed in 105 participants that TUG can be used to evaluate which patients tend to fall in order to carry out preventive measures (positive predictive value = 59%). Numerous authors have investigated TUG ability of assessing the fall risk. The TUG test has been recommended to assess gait and balance (Herman et al 2011). It includes a variety of functional mobility tasks (TUG subtasks), such as standing up, walking, turning, and sitting down. It measures the time in seconds taken by an individual to stand up from a standard chair, walk for 3 meters, turn, walk back to the chair, and sit down. The Timed Up-and-Go (TUG) test is a commonly used tool for evaluating elderly individuals' risk of falling (Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society 2011, Kang et al 2017). According to previous studies, the strongest risk factors for falling are previous falls, the strength of a person, gait characteristics, balance impairments and the usage of specific medications (Tinetti and Kumar 2010, Tinetti et al 1988). Several studies have shown that 40% of falls in nursing homes are related to posture changes from sitting to standing (Rapp et al 2012, Goswami 2017). Around one third of persons over 65 years fall at least once a year (Tinetti and Kumar 2010). Automatic recording and analysis of TUG measurements could, therefore, reduce time of measurements and improve precision as compared to other methods currently being used in the assessments of fall risk.įrailty and falls are the main causes of morbidity and disability in elderly people. ![]() ![]() Significance: We found that specific features calculated from the TUG distance over time curve were significantly different between fallers and non-fallers in our study population. Subtasks of the TUG test like the sit-up time showed near significance ( p < 0.07, AUC = 0.67). We found that the coefficient of determination for Gaussian bell-shaped curves ( p < 0.05, AUC = 0.71) and linear regression lines ( p < 0.02, AUC = 0.74) significantly separated fallers from non-fallers. We fitted two different regression and probability models into a region of interest of the distance over time curve as derived from the TUG device. Twenty-three participants did fall at least once within the fall screening period. Main results: TUG test data were available for 39 participants (36 f, age 84.2 ± 8.2, BMI 26.0 ± 5.1). Fall recordings were compared to six TUG test measurements that were recorded in fallers and non-fallers. For frailty evaluation, state-of-the-art questionnaires were used. The fall protocols over a period of one year were used to classify participants as fallers and non-fallers. Approach: We conducted a clinical study with 46 older participants for evaluating the fall risk assessment capabilities of an ultra-sound based TUG test device. The Timed Up-and-Go (TUG) test is commonly used to assess gait and balance and to evaluate an individual's risk of falling. Objective: A third of people over 65 years experiences at least one fall a year. ![]()
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