Using the Timed Up & Go test in a clinical setting to predict falling in Parkinson's disease.

Abstract

To investigate the ability of the Timed Up & Go test to identify patients with Parkinson's disease at risk for a fall. Cross-sectional cohort study. Sixteen participating National Parkinson's Foundation Centers of Excellence. A query yielded a total of 2985 records (1828 men and 1157 women). From these, 884 were excluded because of a lack of crucial information (age, diagnosis, presence of deep brain stimulation, disease duration, inability of performing the Timed Up & Go test without assistance) at the time of testing, leaving 2097 patients included in the analysis. Not applicable. The primary outcome measure for this study was falls. The chief independent variable was the Timed Up & Go test. The initial model examined the prediction of falls from the Timed Up & Go test, adjusting for all study covariates. The estimated models in the imputed data sets represented a significant improvement above chance (χ(2) range [df=17], 531.29-542.39, P<.001), suggesting that 74% of participants were accurately classified as a faller or nonfaller. The secondary model in which the question of whether the effect of Timed Up & Go test was invariant across disease severity demonstrated 75% of participants were accurately classified as a faller or nonfaller. Additional analysis revealed a proposed cut score of 11.5 seconds for discrimination of those who did or did not fall. The findings suggest that the Timed Up & Go test may be an accurate assessment tool to identify those at risk for falls.