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Reliability and concurrent validity of a modified timed up and go test for healthy preschoolers
Ann Hallemans1,2, Katrijn Klingels3,4, Tamaya Van Criekinge1,2
1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
Insights
The modified Timed Up and Go test for preschoolers is reliable and valid when using the best performance. This method offers more consistent results and reduces measurement error in young children.
Area of Science:
- Pediatric physical therapy
- Motor development assessment
- Gross motor skills evaluation
Background:
- The Timed Up and Go (TUG) test is widely used to assess mobility in various populations.
- Existing TUG protocols for children lack standardization, differing in instructions and outcome measures (average vs. best performance).
- Determining the optimal TUG protocol for preschoolers is crucial for reliable and valid assessments.
Purpose of the Study:
- To evaluate the interrater and test-retest reliability of a modified TUG test for preschoolers.
- To assess the concurrent validity of the modified TUG test against a standardized balance measure.
- To compare the suitability of using the best versus the average performance for the modified TUG test in preschoolers.
Main Methods:
- Thirty-two children aged 3-5 years completed three modified TUG trials on two separate occasions.
- Two researchers simultaneously recorded trial times during the initial session for interrater reliability.
- Intraclass correlation coefficients (ICCs) and minimal detectable change (MDC) were calculated for reliability; Pearson correlation was used for validity against the Movement Assessment Battery for Children, 2nd edition (MABC-2) balance subscale.
Main Results:
- High interrater (ICC > 0.97) and good test-retest (ICC > 0.75) reliability were observed for both average and best TUG performances.
- The best performance showed a lower MDC (1.86 s) compared to the average performance (2.30 s).
- Only the best TUG performance demonstrated a significant, albeit fair, correlation with the MABC-2 balance subscale (r = -0.347, p = 0.007).
Conclusions:
- The modified Timed Up and Go test using the best performance is a reliable measure for preschoolers.
- The best performance is recommended over average performance to minimize standard and measurement error.
- This approach enhances the reliability and validity of TUG test results in 3- to 5-year-old children.
Abstract:
The purpose of this study was to assess the interrater and test-retest reliability and the concurrent validity of the modified timed up and go test for preschoolers. As such, we aim to determine the most suited outcome of the modified timed up and go test: the best or the average performance. Thirty-two children (age 3-5) performed three timed up and go test trials as fast as possible on two separate occasions. During the first session, two researchers recorded the time to perform the task simultaneously. For reliability analyses, intra-class correlation coefficients (ICCs) and the minimal detectable change were determined. A Pearson correlation coefficient was calculated to determine concurrent validity between the timed up and go test and the balance subscale of the Movement Assessment Battery for Children, 2nd edition. Interrater (ICC > 0.97) and test-retest (ICC > 0.75) reliability were good both for the average and the best timed up and go test performance. A minimal detectable change of 1.86 s was found for the best performance, and 2.30 s for the average performance. Only the best timed up and go test performance correlated significantly with the balance subscale of the Movement Assessment Battery for Children, 2nd edition, though fair (r = -0.347, p = 0.007).Conclusion: The modified timed up and go test for preschoolers using the best performance is reliable and recommended to reduce standard and measurement error. What is Known: • A large variety of timed up and go test protocols is available for children • The protocols differ in the instructions on walking speed (self-selected/fastest), the use of an extra motivation (e.g., touch a star on the wall) and the applied outcome (average/best performance) What is New: • The best timed up and go test performance induces more consistent test results between raters and sessions and also less standard and measurement error in 3- to 5-year-old children • The best timed up and go test performance should be preferred over the average performance to achieve both reliable and valid test results in 3- to 5-year-old children.
