The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 81; no. 2; pp. 171 - 176
• Main Authors: Zampieri, Cris, Salarian, Arash, Carlson-Kuhta, Patricia, Aminian, Kamiar, Nutt, John G, Horak, Fay B
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.02.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Aged; Algorithms; Antiparkinson Agents - therapeutic use; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Gait; Humans; inertial sensors; Male; Medical sciences; Middle Aged; Mobility; Movement Disorders - diagnosis; Movement Disorders - epidemiology; Neurology; Parkinson Disease - diagnosis; Parkinson Disease - drug therapy; Parkinson Disease - epidemiology; Parkinson's disease; postural transitions; Posture; Psychomotor Performance; Range of motion; Sensors; Surveys and Questionnaires; Time Factors; timed up and go; Velocity; Nervous system diseases; Prognosis; Treatment; Central nervous system disease; Instrument; Parkinson disease; Degenerative disease; Cerebral disorder; Extrapyramidal syndrome
• ISSN: 0022-3050; 1468-330X; 1468-330X
• DOI: 10.1136/jnnp.2009.173740

The Timed Up and Go (TUG) test has been used to assess balance and mobility in Parkinson's Disease (PD). However, it is not known if this test is sensitive to subtle abnormalities present in early stages of the disease, when balance and gait problems are not clinically evident but may be detected with instrumented analysis of movement. We hypothesise that postural transitions and arm swing during gait will be the most sensitive characteristics of the TUG for early PD. In the present study, we instrumented the TUG test (iTUG) using portable inertial sensors, and extended the walking distance from 3 m (traditional TUG) to 7 m. Twelve subjects with early-to-moderate, untreated PD and 12 healthy individuals participated. Our findings show that although the stopwatch measure of TUG duration did not detect any abnormalities in early-to-mid-stage PD, the peak arm swing velocity on the more affected side, average turning velocity, cadence and peak trunk rotation velocity were significantly slower. These iTUG parameters were also correlated with the Unified Parkinson's Disease Rating Motor Scale. Thus, the iTUG test is sensitive to untreated PD and could potentially detect progression of PD and response to symptomatic and disease-modifying treatments.