Effects of the Direction of Turning on the Timed Up & Go Test with Stroke Subjects

Purpose: To compare the Timed Up & Go (TUG) test between subjects with and without hemiparesis, considering the direction toward which they turned, and to determine the potential clinical variables that could explain possible observed differences between the groups and/or the turning directions. Method: Twenty-two hemiparetic and 22 matched control subjects performed the TUG twice, with each one turning in both directions. Measures of the strength and tonus of the quadriceps, gait speed, balance, and fear of failing were also collected. Results: Stroke subjects were slower in the TUG than the control group, independent of the direction toward which they turned (F=45.87; p<.001). For both groups, similar performances were observed when turning toward the paretic and nonparetic/matched sides (F=0.50; p=.48). The absolute differences between the two TUG trials were greater for the stroke subjects (p=.001) and were significantly correlated with gait speed, balance, and fear of failing (-0.69<r<-0.52; p<.013), with fear of failing being the only variable retained in the regression model (R-2=0.44; p=.001). For the control subjects, no significant correlations were found. Conclusions: The larger differences between the two TUG trials for the stroke subjects illustrated the impact of the turning direction on test performance. These differences were not related to hemiparesis, but to the fear of falling.