In the acute care setting, the value of the Timed Up and Go lies in the inability to complete the test, and the reasons for this inability, rather than the time recorded.
This study aimed to determine whether the admission Timed Up and Go Test (TUG) predicted the length of stay of patients in an acute geriatric ward. Consecutive patients were quasi-randomly allocated to either a model development sample or a model validation sample. Multivariate Cox proportional hazards regression was used to model length of stay. Variables considered for inclusion in the development model were risk factors for length of stay reported in the literature and univariate predictors from our dataset (p < 0.05). Variables selected for use in the development sample were then tested in the validation sample. Of 2463 patients of mean age 82.1 years, 932 (37.8%) were able to complete the TUG. Despite a significant, though weak, relationship between the length of stay and the TUG time (Spearman coefficient 0.18, p < 0.001), no time clearly identified patients with longer length of stay. Patients unable to complete the TUG had a median length of stay of 11 days (IQR 7 to 18), 40% longer than those able to complete the TUG (median 8 days, IQR 8 to 12, p < 0.001). Other significant (p < 0.05) predictors of length of stay in both samples were number of active medical diagnoses, referral from the emergency department, in-patient fall, and diagnosis of ulcer or infection. The admission TUG time should not be used to screen for patients likely to have longer lengths of stay. The value of the TUG lies in determining the patient's ability to complete it, rather than the time taken.
Background: Obstacle avoidance and negotiation may pose significant difficulties for older people. Of particular interest is the fluency with which they can negotiate obstacles which contrast poorly with their surroundings.
Methods: Two groups of healthy subjects, one young group of mean age 22 years and an older group of mean age 73 years, were tested while walking at a preferred and a fast walking speed under conditions of high and low contrast obstacle. Data were collected using a video‐camera to derive values for step length, duration and velocity while subjects ambulated over a 20m track and stepped on to and over a low wooden block.
Results: In essence, there was no difference between these young and old subjects in their gait strategies nor in the fluency with which they approached the obstacle. Older subjects did, however, walk slower than younger subjects at the “fast” pace. The subjects did not appear to be influenced by the contrast of the obstacle with its surroundings.
Conclusions: Healthy older subjects do not show any inherent loss of fluency or hesitation in negotiating a simple obstacle, irrespective of the contrast of the obstacle with its surroundings.
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