The timed up and go obstacle test in people with multiple sclerosis: a reliability and validity study

Area of Science:

• Neurology
• Rehabilitation Science
• Clinical Assessment Tools

Background:

• Multiple sclerosis (MS) significantly impacts mobility and balance, increasing fall risk.
• Accurate assessment of functional mobility, particularly obstacle negotiation, is crucial for managing MS.
• Existing tests may not fully capture the complexities of obstacle negotiation in PwMS.

Purpose of the Study:

• To evaluate the test-retest reliability, concurrent validity, and known-groups validity of the Timed Up and Go Obstacle Test (TUGO).
• To determine cut-off times for the TUGO in people with multiple sclerosis (PwMS).
• To establish TUGO as a clinical assessment tool for PwMS.

Main Methods:

• Investigated test-retest reliability using Intraclass Correlation Coefficients (ICC) and Minimal Detectable Change (MDC).
• Assessed concurrent validity by correlating TUGO times with established measures (EDSS, TUG, T25FW, DGI, FES-I).
• Examined known-groups validity by comparing TUGO times between PwMS and controls, and between fallers and non-fallers with MS.

Main Results:

• TUGO demonstrated excellent test-retest reliability (ICC > 0.96) across different obstacle heights.
• MDC95 values were established for each obstacle height, indicating sensitivity to change.
• TUGO times showed moderate to strong correlations with other functional measures (r ranging from -0.891 to 0.907, p < 0.001).
• PwMS consistently had higher TUGO times than controls (p < 0.001).
• Fallers with MS exhibited significantly higher TUGO times compared to non-fallers (p < 0.017).

Conclusions:

• The TUGO is a reliable and valid clinical tool for assessing obstacle negotiation in PwMS.
• It is a low-cost and easy-to-administer assessment.
• TUGO effectively differentiates functional mobility levels in PwMS, aiding in fall risk identification.