Nordin Ellinor, Rosendahl Erik, Lundin-Olsson Lillemor
Department of Community Medicine and Rehabilitation, Physiotherapy and Geriatric Medicine, Umea University, SE-901 87 Umea, Sweden.
Phys Ther. 2006 May;86(5):646-55.
It is unknown how cognitive impairment affects the reliability of Timed "Up & Go" Test (TUG) scores. The aim of the present study was to investigate the expected variability of TUG scores in older subjects dependent in activities of daily living (ADL) and with different levels of cognitive state. The hypothesis was that cognitive impairment would increase the variability of TUG scores.
Seventy-eight subjects with multiple impairments, dependent in ADL, and living in residential care facilities were included in this study. The subjects were 84.8+/-5.7 (mean+/-SD) years of age, and their Mini-Mental State Examination score was 18.7+/-5.6.
The TUG assessments were performed on 3 different days. Intrarater and interrater analyses were carried out.
Cognitive impairment was not related to the size of the variability of TUG scores. There was a significant relationship between the variability and the time taken to perform the TUG. The intraclass correlations were greater than .90 and were similar within and between raters. In repeated measurements at the individual level, an observed value of 10 seconds was expected to vary from 7 to 15 seconds and an observed value of 40 seconds was expected to vary from 26 to 61 seconds for 95% of the observations.
The measurement error of a TUG assessment is substantial for a frail older person dependent in ADL, regardless of the level of cognitive function, when verbal cuing is permitted during testing. The variability increases with the time to perform the TUG. Despite high intraclass correlation coefficients, the ranges of expected variability can be wide and are similar within and between raters. Physical therapists should be aware of this variability before they interpret the TUG score for a particular individual.
认知障碍如何影响定时起立行走测试（TUG）分数的可靠性尚不清楚。本研究的目的是调查在日常生活活动（ADL）方面有依赖且认知状态不同的老年受试者中TUG分数的预期变异性。假设是认知障碍会增加TUG分数的变异性。
本研究纳入了78名有多种障碍、在ADL方面有依赖且居住在养老机构的受试者。受试者年龄为84.8±5.7（均值±标准差）岁，简易精神状态检查表分数为18.7±5.6。
在3个不同日期进行TUG评估。进行了评分者内和评分者间分析。
认知障碍与TUG分数变异性的大小无关。变异性与完成TUG所需时间之间存在显著关系。组内相关系数大于0.90，评分者内和评分者间相似。在个体水平的重复测量中，对于95%的观察值，10秒的观察值预计在7至15秒之间变化，40秒的观察值预计在26至61秒之间变化。
对于在ADL方面有依赖的体弱老年人，无论认知功能水平如何，当测试期间允许言语提示时，TUG评估的测量误差都很大。变异性随完成TUG的时间增加。尽管组内相关系数很高，但预期变异性的范围可能很宽，评分者内和评分者间相似。物理治疗师在为特定个体解读TUG分数之前应意识到这种变异性。
