Proper assessment of the falling risk in the elderly by a physical mobility test with an obstacle

The Timed "Up & Go" (TUG) is a representative mobility test for assessing the falling risk of the elderly. Although several tests have been developed, including the TUG, these do not include a "tripping" element, and tripping is a major cause of falling. This study examined the influence of various obstacle heights on test performance in the TUG test and test-retest reliability. Twenty-two healthy elderly women participated in the TUG test and in the TUG test with an obstacle (TUGO). The obstacle is a box (width 120 cm and depth 20 cm), the height of which varies (0, 5 and 17 cm). In the 0-cm height condition, a thin sheet was laid down instead of the box. In the TUGO, subjects stood up from an armchair, walked 5 m, stepped over the box, turned, stepped over the box again, walked back to the chair and sat down. The reliability of the time required for the motion around the obstacle was high and the total time in the TUGO test increased (intra-class correlation coefficient = 0.74-0.99). These parameters were significantly larger for the height order 17, 5, and 0 cm and exhibited significant correlations with time required for the TUG (r = 0.61 - 0.92) and the height of subjects. An obstacle with 5 cm height prolonged the time during standing on one leg just before the obstacle and the time during turning motion after stepping over it. By adding the obstacle to the TUG, the physical mobility of the elderly is assessed more properly.