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Stair climbing ability
1%
32/2220
Need for a walking aid
42%
941/2220
Implant failure
13/2220
Balance impairment
4%
91/2220
Independent performance of activities of daily living (ADL)
51%
1127/2220
Select Answer to see Preferred Response
The timed up and go (TUG) test may be used as a clinical indicator of function and the need for a walking aid in patients treated with hip hemiarthroplasty for femoral neck fracture at 2-year follow-up. Hip fractures are a cause of significant functional decline for elderly patients. Many outcome tests have been developed to prediction function after hip fracture to manage patient expectations and to assist in rehabilitation planning. The TUG test objectively measures functional mobility and dynamic balance. The test is performed by timing the amount of seconds it requires for a patient to stand up from a chair, walk 10ft (3.05m), return to the chair, and sit. Laflamme et al performed a prospective study evaluating the utility of the TUG test to predict functional outcomes in patients undergoing hip hemiarthroplasty for femoral neck fracture. The TUG scores were significantly higher at 4-days and 3-weeks post-operatively in patients requiring a walking aid compared with patients walking independently at two-years. Patients who performed the test in >58s at 4-days post-operatively had an eightfold greater risk of requiring an assistive device. Springer et al prospectively analyzed the unipedal stance test (UPST) with eyes open and closed in healthy subjects to establish normative values for the test across age and gender groups. Performance on the test was found to be age-specific and not related to gender. The UPST is a method of quantifying static balance ability. Kristensen et al studied the relative and absolute inter tester reliability of TUG in patients with hip fractures. The authors found that the TUG has a high interobserver reliability and an improvement by 6.2 seconds for a patient with a baseline of 20s indicates a change in functional mobility. Video A shows the timed up and go test. Incorrect Answers: Answer 1. Stair climbing ability - The Lower Extremity Measure (LEM) includes stairs in the assessment. Answers 3, 5. Implant failure, Independent performance of activities of daily living (ADL) - Not predicted by the TUG test. Answer 4. Balance Impairment - Best assessed with the unipedal stance test (UPST).
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