Timed Up and Go (TUG) Test — Mobility & Fall Risk Assessment
The Timed Up and Go (TUG) test is a simple, reliable, and widely used screening tool for assessing mobility, balance, and fall risk in older adults. It measures the time a person takes to stand from a standard armchair, walk 3 meters, turn, walk back, and sit down.
About
The TUG test was developed by Podsiadlo and Richardson in 1991 as a modification of the "Get-Up and Go" test. The TUG adds a timed component to the original qualitative assessment, providing an objective, quantitative measure of functional mobility. The test requires only a standard armchair, a stopwatch, and 3 meters of clear floor space. It has excellent test-retest reliability (ICC 0.97-0.99) and inter-rater reliability (ICC 0.99). The TUG is endorsed by the American Geriatrics Society, the British Geriatrics Society, and the CDC's STEADI initiative for fall risk screening.
Formula
Patient sits in a standard armchair (seat height 46 cm, armrest height 65 cm), stands up, walks 3 meters at a comfortable and safe pace, turns around marked line or cone, walks back to chair, and sits down. Time is recorded in seconds from the command "Go" until the patient sits back down.
The TUG time is recorded as follows: Normal mobility: <10 seconds. Good mobility with no fall risk: 10-13 seconds. Moderate fall risk: 14-19 seconds. High fall risk: 20-29 seconds. Very high fall risk with significant mobility impairment: ≥30 seconds. Assistive devices may be used and should be documented. The test can be repeated 3 times and the average recorded. A cognitive dual-task TUG (counting backwards while walking) may reveal additional fall risk.
Score Interpretation
The TUG test is one of the most widely recommended screening tools for fall risk in older adults. A cutoff of ≥13.5 seconds has sensitivity of 80-87% and specificity of 56-89% for predicting falls. The TUG is recommended by the AGS/BGS Clinical Practice Guideline for Fall Prevention and the CDC STEADI initiative. It correlates well with the Berg Balance Scale (r = -0.81), gait speed, and the Barthel Index.
Normal — Low Fall Risk — 0–9.9
Normal mobility for most healthy adults. Patient likely independent with community mobility.
Management: Maintain current activity level. Reassess TUG annually or with change in function.
Good Mobility — Minimal Risk — 10–13.9
Good functional mobility. Patient may be slower but generally safe.
Management: Encourage regular physical activity, including balance and strengthening exercises.
Moderate Fall Risk — 14–19.9
Measures/medications required. Refer to physiotherapy for balance and gait training.
Management: Comprehensive fall risk assessment. Physical therapy for balance training. Home safety evaluation.
High Fall Risk — 20–29.9
Significant mobility impairment. Assistive device indicated.
Management: Immediate fall prevention interventions. Physical therapy, assistive device prescription, and home safety modifications.
Very High Fall Risk — 30+
Severe mobility impairment. Patient likely requires supervision for all ambulation.
Management: Urgent comprehensive geriatric assessment. Intensive rehabilitation program. Consider mobility aids and home care services.
Reference Ranges
| Population | Normal Range |
|---|---|
| Healthy older adults (65-79) | <8.1 seconds (mean 7.1s) |
| Healthy older adults (80-99) | <10.2 seconds (mean 8.9s) |
| Parkinson's disease | Mean 10.5-19.6s (mild-moderate PD) |
Tabeeb+ Medical Review Team
Expert physiotherapy review panel.
View medical review board & editorial policy →Example Calculation
An 82-year-old woman with history of fall completes TUG in 18 seconds. She does not use an assistive device. Result: 18 seconds — Moderate fall risk. Recommendation: Refer to physiotherapy for balance and gait training, home safety evaluation, and vitamin D supplementation.
Common Mistakes
Using cutoffs without considering patient-specific factors (e.g., age, comorbidities, baseline functional level).
Interpret TUG results in context of the individual patient. A TUG of 15 seconds may be acceptable for an 85-year-old with osteoarthritis but abnormal for a 65-year-old. Always correlate with clinical judgment.
Frequently Asked Questions
How many practice trials should I allow?
Can the TUG be used in patients with specific conditions?
What is the cognitive TUG and when should I use it?
References
- Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148.
- Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29(2):64-68.
- AGS/BGS Clinical Practice Guideline: Prevention of Falls in Older Persons (2023).
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