Abstracts
OBJECTIVE
To evaluate, by a literature review, the Timed "Up & Go" (TUG) test use and its main methodological aspects in children and adolescents.
DATA SOURCES
The searches were performed in the following databases: PubMed, CINAHL, Web of Science, SciELO and Cochrane Library, from April to July 2012. Studies published from 1990 to 2012 using the terms in Portuguese and English "Timed "Up & Go", "test", "balance", "child", and "adolescent" were selected. The results were divided into categories: general characteristics of the studies, population, test implementation METHODS, interpretation of results and associations with other measurements.
DATA SYNTHESIS
27 studies were analyzed in this review and most of them used the TUG test along with other outcome measures to assess functional mobility or balance. Three studies evaluated the TUG test in significant samples of children and adolescents with typical development, and the most studied specific diagnoses were cerebral palsy and traumatic brain injury. The absence of methodological standardization was noted, but one study proposed adaptations to the pediatric population. In children and adolescents with specific clinical diagnoses, the coefficient of within-session reliability was found to be high in most studies, as well as the intra and inter-examiner reliability, which characterizes the good reproducibility of the test.
CONCLUSIONS
The TUG test was shown to be a good tool to assess functional mobility in the pediatric population, presenting a good reproducibility and correlation with other assessment tools.
mobility limitation; postural balance; child; adolescent
OBJETIVO
Evaluar, mediante una revisión de la literatura, la utilización de la prueba Timed "Up & Go" y sus principales aspectos metodológicos en niños y adolescentes.
FUENTES DE DATOS
Se realizaron búsquedas en las siguientes bases de datos: PubMed, CINAHL, Web of Science, SciELO y Cochrane Library, entre abril y julio de 2012. Se seleccionaron los estudios publicados de 1990 a 2012, utilizándose los términos "timed up and go", "prueba" ("test"), "equilibrio" ("balance"), "niño" ("child") y "adolescente" ("adolescent"). Se dividieron los resultados en categorías: características generales de los estudios, poblaciones evaluadas, metodología de aplicación de la prueba, interpretación de los resultados y asociaciones de la prueba con otras medidas.
SÍNTESIS DE LOS DATOS
Se incluyeron 27 estudios y la mayoría utilizó el TUG juntamente con otras medidas de desfecho para evaluar movilidad o equilibrio funcional. Tres trabajos evaluaron el TUG en muestras expresivas de niños y adolescentes con desarrollo típico y los diagnósticos específicos más evaluados fueron parálisis cerebral y traumatismo craneoencefálico. No existe una estandarización respecto a la metodología utilizada, pero un estudio propuso adaptaciones para la población pediátrica. En niños y adolescentes con diagnósticos clínicos específicos, el coeficiente de confiabilidad intrasesión se mostró alto en la mayoría de los estudios, así como la confiabilidad intra e inter-examinador, caracterizando buena reproductibilidad de la prueba.
CONCLUSIONES
El TUG se mostró una buena herramienta para evaluar la movilidad funcional en Pediatría, correlacionándose con otros instrumentos de evaluación y presentando buena reproductibilidad.
limitación de la movilidad; equilibrio postural; niño; adolescente
OBJETIVO:
Avaliar, mediante uma revisão da literatura, a utilização do teste Timed "Up & Go" (TUG) e seus principais aspectos metodológicos em crianças e adolescentes.
FONTES DE DADOS
Foram realizadas buscas nas seguintes bases de dados: PubMed, CINAHL, Web of Science, SciELO e Cochrane Library, entre abril e julho de 2012. Selecionaram-se os estudos publicados de 1990 a 2012, utilizando-se os termos "timed up and go", "teste" ("test"), "equilíbrio" ("balance"), "criança" ("child") e "adolescente" ("adolescent"). Dividiram-se os resultados em categorias: características gerais dos estudos, populações avaliadas, metodologia de aplicação do teste, interpretação dos resultados e associações do teste com outras medidas.
SÍNTESE DOS DADOS
Incluíram-se 27 estudos e a maioria utilizou o TUG juntamente com outras medidas de desfecho para avaliar mobilidade ou equilíbrio funcional. Três trabalhos avaliaram o TUG em amostras expressivas de crianças e adolescentes com desenvolvimento típico e os diagnósticos específicos mais avaliados foram paralisia cerebral e traumatismo cranioencefálico. Não existe uma padronização quanto à metodologia utilizada, porém um estudo propôs adaptações para a população pediátrica. Em crianças e adolescentes com diagnósticos clínicos específicos, o coeficiente de confiabilidade intra-sessão mostrou-se alto na maioria dos estudos, assim como a confiabilidade intra e inter-examinador, caracterizando a boa reprodutibilidade do teste.
CONCLUSÕES
O TUG mostrou-se uma boa ferramenta para avaliar a mobilidade funcional em Pediatria, correlacionando-se com outros instrumentos de avaliação e apresentando boa reprodutibilidade.
limitação da mobilidade; equilíbrio postural; criança; adolescente
Introduction
The Timed "Up & Go" (TUG) test was developed by Podsiadlo and Richardson in 1991( 11. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8. ), based on the version named Get-up and Go test, proposed by Mathias et al in 1986(2). The "Get-up and Go" test originally aimed to clinically evaluate dynamic balance in elderly people during the performance of a task, involving critical situations for falls. Podsiadlo and Richardson proposed using time in seconds to score the test, naming it Timed "Up & Go", because there was a time limitation on the score of the original scale( 11. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8. ).
The TUG test measures, in seconds, the time required for an individual to stand up
from a standard chair with armrest (height of approximately 46cm), walk 3m, turn
around, walk back to the chair, and sit down again(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
). The test has been widely used in clinical practice as an outcome
measure to evaluate functional mobility, fall risk or dynamic balance in adults, and
its normative values have already been established in this population(
33. Pondal M, del Ser T. Normative data and determinants for the
timed "up and go" test in a population-based sample of elderly individuals
without gait disturbances. J Geriatr Phys Ther 2008;31:57-63.
,
44. Bohannon RW. Reference values for the timed up and go test: a
descriptive meta-analysis. J Geriatr Phys Ther 2006;29:64-8.
). Several studies used the test to assess fall risk in the
elderly(
55. Creel GL, Light KE, Thigpen MT. Concurrent and construct validity
of scores on the Timed Movement Battery. Phys Ther
2001;81:789-98.
6. Giné-Garriga M, Guerra M, Marí-Dell'Olmo M, Martin C, Unnithan
VB. Sensitivity of a modified version of the 'timed get up and go' test to
predict fall risk in the elderly: a pilot study. Arch Gerontol Geriatr
2009;49:e60-6.
7. Shumway-Cook A, Brauer S, Woollacott M. Predicting the
probability for falls in community-dwelling older adults using the Timed Up
& Go Test. Phys Ther 2000;80:896-903.
-
88. Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test
performance in community-dwelling elderly people: Six-Minute Walk Test, Berg
Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther
2002;82:128-37.
); other studies assessed balance and functional mobility in adults with
motor limitations, such as cerebral palsy (CP)(
99. Andersson C, Grooten W, Hellsten M, Kaping K, Mattsson E. Adults
with cerebral palsy: walking ability after progressive strength training. Dev
Med Child Neurol 2003;45:220-8.
), Parkinson disease(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
,
1010. Morris S, Morris ME, Iansek R. Reliability of measurements
obtained with the Timed "Up & Go" test in people with
Parkinson disease. Phys Ther 2001;81:810-8.
), stroke(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
,
1111. Flansbjer UB, Holmbäck AM, Downham D, Patten C, Lexell J.
Reliability of gait performance tests in men and women with hemiparesis after
stroke. J Rehabil Med 2005;37:75-82.
12. Ng SS, Hui-Chan CW. The timed up & go test: its reliability
and association with lower-limb impairments and locomotor capacities in people
with chronic stroke. Arch Phys Med Rehabil 2005;86:1641-7.
-
1313. Faria CD, Teixeira-Salmela LF, Nadeau S. Effects of the
direction of turning on the timed up & go test with stroke subjects. Top
Stroke Rehabil 2009;16:196-206.
), Down syndrome (DS)(
1414. Carmeli E, Kessel S, Coleman R, Ayalon M. Effects of a treadmill
walking program on muscle strength and balance in elderly people with Down
syndrome. J Gerontol A Biol Sci Med Sci 2002;57:M106-10.
), among others.
Because of its practicality, the TUG test began to be used in children and
adolescents with some type of motor limitation and/or balance deficit(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
16. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
-
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
). In order for ambulatory children or adolescents to have functional
independence, balance is required during movements performed in sitting and bipedal
postures. The activities that constitute the test assess the functional mobility and
the balance required to move from the sitting to the standing position, walk, turn
around, and sit down again.
Thus, considering the practicality of the TUG test to assess functional mobility, its increasing use in Pediatrics, and the lack of theoretical studies critically reviewing the use of the test, this study evaluated, through a literature review, the use of the TUG test and its methodological aspects in children and adolescents.
Method
This study consisted of a bibliographical review. References for electronic research were selected in July 2012, in PubMed, CINAHL, Web of Science, SciELO and Cochrane Library databases. Searches used the following terms in Portuguese and English: "timed 'up and go'", "test", "balance", "child" and "adolescent". In order to obtain more specific results on the topic, searches were limited to title/abstract and to papers published from 1990 to 2012. All abstracts identified using these terms were reviewed, and those that addressed the proposed topic were fully examined. The reference list of the selected articles was also examined, in order to obtain other relevant articles. The study included only articles that evaluated or used the TUG test in children and adolescents with an observational or experimental design. Exclusion criteria consisted of abstracts from annals of events and articles using the TUG test in adults and elderly people. No review articles or case reports on the topic were found.
After studies were selected, according to the previously described criteria, they were critically read, in order to systematize test implementation and the main methodological aspects involved. To do so, the following categories were defined: general characteristics of the studies, populations, implementation METHODS, result interpretation, and associations with other measures.
Results and Discussion
Search strategies identified 56 references. According to the established inclusion and exclusion criteria, the reading of titles and abstracts allowed us to exclude 26 articles. Thus, 30 studies were reviewed in full and in more detail, of which three were excluded for not meeting the criteria and 27 were selected for this review.
General characteristics of the studies
Of the 27 studies included in the review, 17 (63%) were
cross-sectional(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
16. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
17. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
18. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
19. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
20. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
21. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
22. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
24. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
25. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
28. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
29. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
30. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
-
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
) and 10 (37%) were clinical trials(
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
33. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
34. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
35. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
36. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
37. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
38. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
39. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
). Only one article had the primary OBJECTIVE of evaluating the test
in children and adolescents(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
). Fifteen studies included the TUG test as one of the outcome
measures for their primary OBJECTIVE of assessing functional balance(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
), functional mobility(19,25-27,29,31) or
activity(
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
), according to the International Classification of Functioning,
Disability and Health (ICF)(
4242. Organização Mundial da Saúde. Direcção-geral da Saúde. CIF:
Classificação in ternacional de funcionalidade, incapacidade e saúde. São Paulo:
Edusp; 2003.
). Of the remaining articles, nine used the TUG test as a secondary
outcome measure for the evaluation of some type of intervention(
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
33. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
34. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
-
3535. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
,
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
38. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
39. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
) and two used it for the concurrent validation of other
tests(
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
).
Populations
As for the population assessed in the articles, children from different
nationalities were evaluated by the TUG test. Most studies evaluated American
children and adolescents(
1919. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
2525. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
28. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
-
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
,
3535. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
,
4040. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
); two of them evaluated Australians(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
); two of them, the Chinese(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
); five of them, Israelis(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
); three of them, Spaniards(
3434. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
,
3939. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
,
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
); one of them, the English(
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
); one of them, Brazilians(
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
); and two of them, Pakistanis(
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
). The main clinical diagnoses identified in the study samples are
shown in Table 1, with CP being the most
frequent.
Up to now, only one group of researchers(
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
) evaluated the TUG test specifically in children and adolescents
with typical development (TD), aiming to describe normal parameters. Another
study developed reference values for the Functional Mobility Assessment tool,
which includes the TUG test in one of its categories(
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
). However, several studies included a population with these
characteristics, in order to compare this population with that of children with
specific conditions(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
17. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
18. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
-
1919. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
22. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2727. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
).
Most studies with CP patients included children and adolescents from three to 19
years old(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
37. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
-
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
,
4040. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
). On the other hand, the only studies with children and adolescents
with DS evaluated four five-year old boys, seven girls from eight to 14
years(
2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
), and two subjects from six to 21 years(
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
). Typically-developed subjects evaluated by the TUG test were aged
from three to 15 years old(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
17. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
18. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
19. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
-
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2727. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
), and only three studies had significant samples(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
). CP children evaluated by the test showed the following Gross Motor
Function Classification System (GMFCS) levels(
4343. Palisano RJ, Kolobe TH, Haley SM, Lowes LP, Jones SL. Validity
of the Peabody develop mental gross motor scale as an evaluative measure of
infants receiving physical therapy. Phys Ther 1995;75:939-48.
): I and II(
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
); I, II and III(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
,
4040. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
).
Evaluation of the methodology used
As for the equipment used in the TUG test, some studies describe chairs with
backrest and without armrest(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), with backrest and armrest(
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
), without backrest nor armrest(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
); in most studies, this was not described in the methodology
section(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
1919. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
24. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
25. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
28. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
-
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
,
3434. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
35. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
36. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
-
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
,
3939. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
). The height of the seat was described as adjustable in some
studies(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), was selected with the individual with feet flat on the floor and
hip and knees flexed to 90°(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
16. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
-
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), or was not reported(
1919. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
2525. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
-
2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
,
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3434. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
,
3535. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
,
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
38. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
39. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
). A study used a bench and did not describe adjustments for
height(
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
). The original article by the authors of the TUG test recommended
the use of a standard chair with armrest and an approximate height of
46cm(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
). The paper that described in more detail the methodology used to
perform the test in the pediatric population was the same that had the primary
OBJECTIVE of investigating the TUG test in children and recommended the use of a
chair with backrest but without arms and height respecting 90° of knee flexion,
measured with a goniometer(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
).
Most studies maintained the original route of the test, which was of
3m(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
16. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
17. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
18. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
19. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
20. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
21. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
22. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
24. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
25. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
-
2626. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
33. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
-
3434. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
,
3939. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
,
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
), with the chair positioned at this distance from different points:
a wall(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
), a line on the floor(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), a mark on the floor(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), a cone(
2727. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
), or a strip placed on the floor(
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
). One study considered a distance of 9m for the route(
2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
), another used 10ft (3.048m) as the unit of measurement(
2727. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
), an two used another test with a distance of 10m in addition to the
3-m one, describing them as TUG 10m and TUG 3m(
3434. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
,
3939. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
). Four studies did not report the route used, although providing
bibliographical references for the test(
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
,
3535. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
,
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
,
4040. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
). The article that adapted the test to the pediatric population
maintained the distance of 3m(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
).
Some changes were made to the TUG test to evaluate children and adolescents. The
study that adapted the test to children proposed to use the concrete task of
touching their hands on a target on the wall(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
). Other modifications to the original TUG test were: verbal
instructions repeated during the test(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
), demonstration of the test tasks(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), and an unrecorded practice trial(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
). Qualitative speed instructions were provided in some
studies(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
), such as "walk as fast as you can, but keep walking"(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
), or "perform the task as fast as you can"(
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
). Other studies provided non-qualitative instructions(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), e.g., "children instructed to walk at their preferred speed or
pace"(
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), or "this is not a race, you must walk only"(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
). Most papers did not report this type of instruction(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
,
1919. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
22. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
24. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
25. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
28. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
-
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
,
3434. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
35. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
36. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
-
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
,
3939. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
).
Time, measured by a chronometer, began to be recorded as children left and
stopped as they returned to the chair(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
) or were recorded from the "go" cue to when the child sat down in
the chair(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), or this information was not provided(
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
19. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
20. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
-
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
2525. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
-
2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
31. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
32. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
33. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
34. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
-
3535. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
,
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
38. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
39. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
). In the original study of the test in elderly people(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
), timing started at the command "go" and stopped as subjects' back
touched the chair again, in order to evaluate participants' cognition. In the
adaptation of the test to children(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
), in order to measure movement time only, the chronometer started as
children left the chair and stopped as they sat down again. Some studies also
reported what children were wearing during the test: comfortable tennis
shoes(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), orthotics(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), or no shoes(
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
); other studies also reported the possibility of using gait
assistive devices(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), such as crutches(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2525. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
) and walkers(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
).
As for the number of trials in the test, studies performed three
trials(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
16. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
-
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
), two trials(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), a single trial(
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), or this information was not provided
(18,19,25-28,31,33-35,37,39-41). The value considered as the test
result was: the best value (i.e., the lowest) out of three trials(
1515. Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of
functional balance assessment in children with cerebral palsy. Neurorehabil
Neural Repair 2008;22:745-53.
,
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
), the best value out of two trials(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
,
2929. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs
test: preliminary reliability and validity of a new measure of functional
mobility. Pediatr Phys Ther 2004;16:90-8.
), the mean of two trials(
2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities
in Pakistani children: a cultural perspective. Pediatric Physical Therapy
1999;11:73-82.
,
2222. Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and
gait characteristics in post-traumatic brain injury, cerebral palsy and
typically developed children. Dev Neurorehabil 2009;12:100-5.
23. Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical
activities among children with a history of severe traumatic brain injury. Brain
Inj 2010;24:1561-7.
-
2424. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S.
Relationship between balance abilities and gait characteristics in children with
post-traumatic brain injury. Brain Inj 2008;22:153-9.
,
3030. Habib Z, Westcott S. Assessment of anthropometric factors on
balance tests in children. Pediatr Phys Ther 1998;10:101-9.
,
3232. Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia
in children with cerebral palsy via repetitive passive knee movements. J Rehabil
Med 2012;44:235-40.
,
3636. Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a
'home-based' task-oriented exercise programme on motor and balance performance
in children with spastic cerebral palsy and severe traumatic brain injury. Clin
Rehabil 2009;23:714-24.
), the only trial conducted(
3838. Salem Y, Godwin EM. Effects of task-oriented training on
mobility function in children with cerebral palsy. NeuroRehabilitation
2009;24:307-13.
), or this information was not provided(
1616. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional
balance tests for children with traumatic brain injury: within-session
reliability. Pediatr Phys Ther 2008;20:254-8.
,
1818. Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A
comparison of activity, participation and quality of life in children with and
without spastic diplegia cerebral palsy. Disabil Rehabil
2012;34:1306-10.
,
1919. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and
functional mobility in children with acute lymphoblastic leukemia. Med Pediatr
Oncol 2003;40:230-2.
,
2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course
(SWOC): reliability and validity of a new functional measurement tool for
children. Pediatr Phys Ther 2006;18:23-30.
,
2525. Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An
examination of outcome measures to assess functional mobility in childhood
survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
26. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS
et al. Relationships among range of motion, functional mobility, and quality of
life in children and adolescents after limb-sparing surgery for lower-extremity
sarcoma. Pediatr Phys Ther 2006;18:238-44.
27. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the
functional mobility assessment tool for children and adolescents with lower
extremity amputations. Pediatr Phys Ther 2011;23:171-7.
-
2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett
D. Reliability of 16 balance tests in individuals with Down syndrome. Percept
Mot Skills 2010;111:530-42.
,
3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et
al Development of reference values for the Functional Mobility Assessment.
Pediatr Phys Ther 2012;24:224-30.
,
3333. De Campos AC, da Costa CS, Rocha NA. Measuring changes in
functional mobility in children with mild cerebral palsy. Dev Neurorehabil
2011;14:140-4.
34. Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C,
Bustamante-Ara N, Gallardo C et al Does resistance training improve the
functional capacity and well being of very young anorexic patients? A randomized
controlled trial. J Adolesc Health 2010;46:352-8.
-
3535. Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S.
Intensive mobility training postcerebral hemispherectomy: early surgery shows
best functional improvements. Eur J Phys Rehabil Med
2011;47:569-77.
,
3737. McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in
muscle volume after plantarflexor strength training in children with spastic
cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
,
3939. San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S,
García-Castro J et al. Early-phase adaptations to intrahospital training in
strength and functional mobility of children with leukemia. J Strength Cond Res
2007;21:173-7.
40. Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined
passive stretching and active movement rehabilitation of lower-limb impairments
in children with cerebral palsy using a portable robot. Neurorehabil Neural
Repair 2011;25:378-85.
-
4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares
LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic
training in children with cystic fibrosis: a randomized controlled trial. Med
Sci Sports Exerc 2012;44:2-11.
). The original article in adults(
11. Podsiadlo D, Richardson S. The timed "Up &
Go": a test of basic functional mobility for frail elderly persons. J Am
Geriatr Soc 1991;39:142-8.
) mentioned performing a trial for familiarization and another one
with time recording; in turn, the article that adapted the test to
Pediatrics(
1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP.
Investigation of the timed 'up & go' test in children. Dev Med Child Neurol
2005;47:518-24.
) recommended to perform three trials, recording the lowest score
achieved by children with TD, and two trials, recording the lowest score
achieved by children with CP and spina bifida (SB).
Methodological differences in test implementation are common in adult and pediatric populations, which makes it difficult to establish an universal measure. A study in adults evaluated whether changes in test methodology or in the instructions provided could interfere with results and concluded that, in elderly people, both verbal instructions and methodology affect test results. In young adults, instructions affect TUG results, but markers (line on the floor or cone) do not. In addition, it was observed that the variability in the results was smaller when instructions on speed were provided( 4444. Bergmann JH, Alexiou C, Smith IC. Procedural differences directly affect timed up and go times. J Am Geriatr Soc 2009;57:2168-9. ). There are no studies evaluating the influence of these changes on the pediatric population. Thus, it can be suggested that, in order to evaluate the TUG test in children and adolescents, the proposed adaptations to Pediatrics should be used( 1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol 2005;47:518-24. ), combined with instructions on speed, such as "walk as fast as you can".
Result interpretation
Table 1 shows the studies that evaluated children and adolescents and reported mean, standard deviation and/or intraclass correlation coefficients (ICC) for within-session, between-session (test-retest), intra-examiner and inter-examiner reliability. In articles that reported pre- and post-intervention measures, the pre-intervention score was considered. The time it took for children with TD to perform the TUG test had a mean variation of 3.21( 2727. Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the functional mobility assessment tool for children and adolescents with lower extremity amputations. Pediatr Phys Ther 2011;23:171-7. ) to 6.7 seconds( 1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol 2005;47:518-24. ). Children showed improvement in balance as age increased, with a decrease in mean score( 1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol 2005;47:518-24. , 2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities in Pakistani children: a cultural perspective. Pediatric Physical Therapy 1999;11:73-82. , 3030. Habib Z, Westcott S. Assessment of anthropometric factors on balance tests in children. Pediatr Phys Ther 1998;10:101-9. ). In one study, there was no significant difference in the scores of male and female children and adolescents( 1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol 2005;47:518-24. ); in another one, there was significant difference in the scores, with boys showing better performance in the TUG test( 2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities in Pakistani children: a cultural perspective. Pediatric Physical Therapy 1999;11:73-82. , 3030. Habib Z, Westcott S. Assessment of anthropometric factors on balance tests in children. Pediatr Phys Ther 1998;10:101-9. ). Of these studies, only one used a multiple linear regression model and evaluated the effect of anthropometric variables on TUG values of individuals from five to 13 years old, with test scores being influenced by age in the general sample (R2=0.18)( 3030. Habib Z, Westcott S. Assessment of anthropometric factors on balance tests in children. Pediatr Phys Ther 1998;10:101-9. ). The remaining studies reported means and standard deviations( 1717. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol 2005;47:518-24. , 2020. Habib Z, Westcott S, Valvano J. Assessment of balance abilities in Pakistani children: a cultural perspective. Pediatric Physical Therapy 1999;11:73-82. ) or median and ranges( 3131. Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et al Development of reference values for the Functional Mobility Assessment. Pediatr Phys Ther 2012;24:224-30. ) of TUG values for children and adolescents.
On the other hand, in children and adolescents with specific clinical diagnosis, the time required to perform the TUG test had a mean variation from 3.6( 4141. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic training in children with cystic fibrosis: a randomized controlled trial. Med Sci Sports Exerc 2012;44:2-11. ) to 50.3(15) seconds. Of the two studies that evaluated children and adolescents with DS, one was not included in Table 1 because it used a route of 9m( 2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down syndrome. Percept Mot Skills 2010;111:530-42. ). In addition, its results did not report TUG mean; only ICC was below 0.5 in the female group (n=7; eight to 14 years old) and in the male group (n=4; five years old)( 2828. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down syndrome. Percept Mot Skills 2010;111:530-42. ). The other study with subjects with DS that appears in Table 1 reported the mean score and the whole sample of individuals were developmentally-disabled( 2121. Held SL, Kott KM, Young BL. Standardized walking obstacle course (SWOC): reliability and validity of a new functional measurement tool for children. Pediatr Phys Ther 2006;18:23-30. ).
Associations of the test with other measures
Several studies correlated the TUG test with other assessment tools, including motor function, functional mobility, range of motion (ROM), muscle strength, and quality of life. Generally speaking, these correlations are specific for certain clinical diagnoses and vary according to the tool studied. The main results for the associations between the TUG test and other measures are shown in Table 2.
On the other hand, only one study with sarcoma survivors used multiple and simple regression analyses to explain the result of the TUG test by other variables( 2626. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS et al. Relationships among range of motion, functional mobility, and quality of life in children and adolescents after limb-sparing surgery for lower-extremity sarcoma. Pediatr Phys Ther 2006;18:238-44. ). The variance in the test may be explained 5% by hip extension active ROM, 5% by knee extension passive ROM, and 16% by knee flexion active ROM. In addition, the mental and physical components summarized in the quality of life questionnaire - The Short Form 36 Health Survey, version two (SF36v2) - were significant predictors of TUG time in this population, explaining 26 (p=0.01) and 14% (p=0.01) of test variance, respectively( 2626. Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS et al. Relationships among range of motion, functional mobility, and quality of life in children and adolescents after limb-sparing surgery for lower-extremity sarcoma. Pediatr Phys Ther 2006;18:238-44. ).
Final comments
The results of this review demonstrate that there are neither reference equations yet for the TUG test in children and adolescents with TD nor information about the influence of possible predictive variables for the test in the age group from 13 to 18 years old. In children and adolescents with specific clinical diagnoses, the within-session reliability coefficient was found to be high in most studies, as well as intra- and inter-examiner reliability, characterizing the good reproducibility of the test.
Thus, the TUG test was shown to be a good tool to assess functional mobility in the pediatric population and correlated with other tests of balance, functional mobility, gross motor function, quality of life, muscle strength, ROM, functional capacity, and physical activity level. This review may help therapists in the evaluation of functional mobility in children and adolescents by the TUG test. Future studies aiming to determine normative values for healthy children and adolescents are required to improve the evaluation of individuals with specific clinical diagnoses.
References
-
1Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8.
-
2Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil 1986;67:387-9.
-
3Pondal M, del Ser T. Normative data and determinants for the timed "up and go" test in a population-based sample of elderly individuals without gait disturbances. J Geriatr Phys Ther 2008;31:57-63.
-
4Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther 2006;29:64-8.
-
5Creel GL, Light KE, Thigpen MT. Concurrent and construct validity of scores on the Timed Movement Battery. Phys Ther 2001;81:789-98.
-
6Giné-Garriga M, Guerra M, Marí-Dell'Olmo M, Martin C, Unnithan VB. Sensitivity of a modified version of the 'timed get up and go' test to predict fall risk in the elderly: a pilot study. Arch Gerontol Geriatr 2009;49:e60-6.
-
7Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896-903.
-
8Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002;82:128-37.
-
9Andersson C, Grooten W, Hellsten M, Kaping K, Mattsson E. Adults with cerebral palsy: walking ability after progressive strength training. Dev Med Child Neurol 2003;45:220-8.
-
10Morris S, Morris ME, Iansek R. Reliability of measurements obtained with the Timed "Up & Go" test in people with Parkinson disease. Phys Ther 2001;81:810-8.
-
11Flansbjer UB, Holmbäck AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med 2005;37:75-82.
-
12Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil 2005;86:1641-7.
-
13Faria CD, Teixeira-Salmela LF, Nadeau S. Effects of the direction of turning on the timed up & go test with stroke subjects. Top Stroke Rehabil 2009;16:196-206.
-
14Carmeli E, Kessel S, Coleman R, Ayalon M. Effects of a treadmill walking program on muscle strength and balance in elderly people with Down syndrome. J Gerontol A Biol Sci Med Sci 2002;57:M106-10.
-
15Gan SM, Tung LC, Tang YH, Wang CH. Psychometric properties of functional balance assessment in children with cerebral palsy. Neurorehabil Neural Repair 2008;22:745-53.
-
16Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Functional balance tests for children with traumatic brain injury: within-session reliability. Pediatr Phys Ther 2008;20:254-8.
-
17Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol 2005;47:518-24.
-
18Calley A, Williams S, Reid S, Blair E, Valentine J, Girdler S. A comparison of activity, participation and quality of life in children with and without spastic diplegia cerebral palsy. Disabil Rehabil 2012;34:1306-10.
-
19Gocha Marchese V, Chiarello LA, Lange BJ. Strength and functional mobility in children with acute lymphoblastic leukemia. Med Pediatr Oncol 2003;40:230-2.
-
20Habib Z, Westcott S, Valvano J. Assessment of balance abilities in Pakistani children: a cultural perspective. Pediatric Physical Therapy 1999;11:73-82.
-
21Held SL, Kott KM, Young BL. Standardized walking obstacle course (SWOC): reliability and validity of a new functional measurement tool for children. Pediatr Phys Ther 2006;18:23-30.
-
22Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and gait characteristics in post-traumatic brain injury, cerebral palsy and typically developed children. Dev Neurorehabil 2009;12:100-5.
-
23Katz-Leurer M, Rotem H, Keren O, Meyer S. Recreational physical activities among children with a history of severe traumatic brain injury. Brain Inj 2010;24:1561-7.
-
24Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Relationship between balance abilities and gait characteristics in children with post-traumatic brain injury. Brain Inj 2008;22:153-9.
-
25Marchese VG, Ogle S, Womer RB, Dormans J, Ginsberg JP. An examination of outcome measures to assess functional mobility in childhood survivors of osteosarcoma. Pediatr Blood Cancer 2004;42:41-5.
-
26Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS et al. Relationships among range of motion, functional mobility, and quality of life in children and adolescents after limb-sparing surgery for lower-extremity sarcoma. Pediatr Phys Ther 2006;18:238-44.
-
27Pierce S, Fergus A, Brady B, Wolff-Burke M. Examination of the functional mobility assessment tool for children and adolescents with lower extremity amputations. Pediatr Phys Ther 2011;23:171-7.
-
28Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down syndrome. Percept Mot Skills 2010;111:530-42.
-
29Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs test: preliminary reliability and validity of a new measure of functional mobility. Pediatr Phys Ther 2004;16:90-8.
-
30Habib Z, Westcott S. Assessment of anthropometric factors on balance tests in children. Pediatr Phys Ther 1998;10:101-9.
-
31Marchese VG, Oriel KN, Fry JA, Kovacs JL, Weaver RL, Reily MM et al Development of reference values for the Functional Mobility Assessment. Pediatr Phys Ther 2012;24:224-30.
-
32Cheng HY, Ju YY, Chen CL, Wong MK. Managing spastic hypertonia in children with cerebral palsy via repetitive passive knee movements. J Rehabil Med 2012;44:235-40.
-
33De Campos AC, da Costa CS, Rocha NA. Measuring changes in functional mobility in children with mild cerebral palsy. Dev Neurorehabil 2011;14:140-4.
-
34Del Valle MF, Pérez M, Santana-Sosa E, Fiuza-Luces C, Bustamante-Ara N, Gallardo C et al Does resistance training improve the functional capacity and well being of very young anorexic patients? A randomized controlled trial. J Adolesc Health 2010;46:352-8.
-
35Fritz SL, Rivers ED, Merlo AM, Reed AD, Mathern GD, De Bode S. Intensive mobility training postcerebral hemispherectomy: early surgery shows best functional improvements. Eur J Phys Rehabil Med 2011;47:569-77.
-
36Katz-Leurer M, Rotem H, Keren O, Meyer S. The effects of a 'home-based' task-oriented exercise programme on motor and balance performance in children with spastic cerebral palsy and severe traumatic brain injury. Clin Rehabil 2009;23:714-24.
-
37McNee AE, Gough M, Morrissey MC, Shortland AP. Increases in muscle volume after plantarflexor strength training in children with spastic cerebral palsy. Dev Med Child Neurol 2009;51:429-35.
-
38Salem Y, Godwin EM. Effects of task-oriented training on mobility function in children with cerebral palsy. NeuroRehabilitation 2009;24:307-13.
-
39San Juan AF, Fleck SJ, Chamorro-Viña C, Maté-Muñoz JL, Moral S, García-Castro J et al. Early-phase adaptations to intrahospital training in strength and functional mobility of children with leukemia. J Strength Cond Res 2007;21:173-7.
-
40Wu YN, Hwang M, Ren Y, Gaebler-Spira D, Zhang LQ. Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot. Neurorehabil Neural Repair 2011;25:378-85.
-
41Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, López-Mojares LM, Villa-Asensi JR, Barrio Gonzalez MI et al. Intrahospital weight and aerobic training in children with cystic fibrosis: a randomized controlled trial. Med Sci Sports Exerc 2012;44:2-11.
-
42Organização Mundial da Saúde. Direcção-geral da Saúde. CIF: Classificação in ternacional de funcionalidade, incapacidade e saúde. São Paulo: Edusp; 2003.
-
43Palisano RJ, Kolobe TH, Haley SM, Lowes LP, Jones SL. Validity of the Peabody develop mental gross motor scale as an evaluative measure of infants receiving physical therapy. Phys Ther 1995;75:939-48.
-
44Bergmann JH, Alexiou C, Smith IC. Procedural differences directly affect timed up and go times. J Am Geriatr Soc 2009;57:2168-9.
-
Instituição: Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil
Publication Dates
-
Publication in this collection
Sept 2013
History
-
Received
06 Aug 2012 -
Accepted
15 Jan 2013