Table 3 Summary table of the Timed Up and Go test as a falls assessment tool
Review | Review characteristics | Risk of bias | Summary of key findings | Interpretation |
|---|---|---|---|---|
Ambrose [19] | Narrative No details on characteristics | High | No data to extract | Unclear |
Lee [29] | Systematic review without meta-analysis (n = 4) Mixed settings | High | Community dwelling older people (n = 2): - TUG > 12.3 s demonstrated 83.3% sensitivity, 96.6% specificity, 95.9% positive predictive value, 85.8% negative predictive value. - TUG> 20 s 90% sensitivity, 22% specificity, 45% positive predictive value, 75% negative predictive value Acute Inpatient rehabilitation (n = 1): - AUC 0.58 (95% CI 0.53–0.63) Outpatient stroke clinics (n = 1): - 63% sensitivity, 58% specificity, 58% positive predictive value, AUC = 0.70 (95% CI 0.60–0.81) | Favourable for community-dwelling older adults |
Nakamura [20] | Narrative (n = not reported) No details on characteristics | High | TUG was reported as one of the most commonly used tests, but do not report predictive ability. | Not favourable |
Park [12] | Meta-analysis (n = 5, 427 participants) Community-dwelling | High | Pooled sensitivity was 0.76 (95% CI 0.68–0.83), and article heterogeneity was 0.0% (χ2 = 2.20, P = .85). Pooled specificity was 0.49 (95% CI 0.43–0.54) and heterogeneity among the articles was high, 94.8% (χ2 = 95.87, P < .001). The sROC AUC was 0.80 (SE = 0.04) | Favourable |
Schoene [13] | Meta-analysis (n = 53) Mixed settings | High | Ddiagnostic accuracy poor to moderate across studies and settings. Pooled estimate of mean difference between fallers and non-fallers in the healthy, higher-functioning samples was 0.63 seconds (95% CI 0.14–1.12, P = .01), and the heterogeneity was moderate (v2 = 12.6,(df) = 6,P = .05;I2 = 52%) Pooled estimate of mean difference between fallers and non-fallers in studies that included a mix of higher- and lower-functioning people living independently was 2.05 seconds (95% CI 1.47–2.62,P < .001), and the heterogeneity was substantial (v2 = 50.7,df = 20,P < .001;I2 = 61%) Pooled estimate of the mean difference between fallers and non-fallers in institutional settings was 3.59 seconds (95% CI 2.18–4.99,P < .001), and there was no sign of heterogeneity (v2 = 7.7,df = 8,P = .47;I2 = 0%) | Not favourable/ favourable for less healthy, lower-functioning groups |
Scott [35] | Systematic review without meta-analysis (n = 2) Mixed settings | High | Community (n = 2): IRR = 0.90 IRR = 0.56 Long term care (n = 1): IRR = 0.56 | Inconsistent |
Beauchet [24] | Systematic review without meta-analysis (n = 11) Mixed settings | Unclear | Retrospective studies (n = 7): TUG associated with past falls history in all 7 studies Prospective studies (n = 4): 3 with no significant association to falls and no significant prediction of falls (2 inpatient, 1 community)) 1 with positive association and prediction of falls in community dwelling | Inconsistent |
Dolatabadi [26] | Systematic review without meta-analysis (n = 4) Older adults with diagnosis of dementia | Unclear | Successful predictor of future falls (n = 2) No predictive value (n = 2) | Inconsistent |
Lusardi [9] | Meta-analysis (n = 12) Community-dwelling | Unclear | TUG > 7.4 s positive likelihood ratio 1.6, negative likelihood ratio 0.7, posttest probability with a positive test 41%, posttest probability with a negative test 23% TUG > 12 s positive likelihood ratio 2.1, negative likelihood ratio 0.8, posttest probability with a positive test 47%, posttest probability with a negative test 25% | Favourable |
Barry [10] | Meta-analysis (n = 10) Community-dwelling | Low | Logistic regression analysis indicated that the TUG score is not a significant predictor of falls (OR = 1.01, 95% CI 1.00–1.02, p = 0.05). | Not favourable |
Chantanachai [38] | Meta-analysis (n = 16) Older people with cognitive impairment living in the community | Low | Mean difference in meta-analysis fallers vs non fallers TUG 2.20 (−1.42, 5.82), p = 0.23 (n = 4) | Not favourable |
Eagles [27] | Systematic review without meta-analysis (n = 1) Emergency department | Low | One study was reported as assessing TUG and falls but no results for falls prediction given. 38% of participants unable to complete TUG. | Unclear |
Muir [42] | Meta-analysis (n = 1*) Community-dwelling | Low | No data to extract but indicates non-significant findings for falls risk | Not favourable |