Luque-Casado Antonio, Novo-Ponte Sabela, Sánchez-Molina José Andrés, Sevilla-Sánchez Marta, Santos-García Diego, Fernández-Del-Olmo Miguel
Area of Sport Sciences, Faculty of Sports Sciences and Physical Education. Center for Sport Studies, King Juan Carlos University, Madrid, Spain.
Department of Neurology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
J Parkinsons Dis. 2021;11(4):2047-2055. doi: 10.3233/JPD-212687.
Despite the frequent use of the Timed Up and Go (TUG) test in clinical trials, evaluation of longitudinal test-retest reliability is generally lacking and still inconclusive for patients with Parkinson's disease (PD).
We aimed to further investigate long-term reliability and sensitivity of the TUG test among this population. Furthermore, we explored alternative assessment strategies of the test aimed at elucidating whether the inclusion or combination of timed trials may have potential implications on outcome measure.
Relative and absolute reliability of the TUG performance were obtained in forty-three subjects with PD over three timed trials in two different testing sessions separated by a two-months period.
Our results reported excellent intra-session and moderate inter-session reliability coefficients. The use of different assessment strategies of the TUG was found to have an important impact on outcome measure, highlighting the averaging of several timed trials in each testing session as a recommended alternative to minimize measurement error and increase reliability in longitudinal assessments. Nevertheless, beyond acceptable reliability, poor trial-to-trial stability of the measure appears to exist, since the ranges of expected variability upon retesting were wide and the incidence of spurious statistical effects was not negligible, especially in longitudinal repeated testing.
Limitations may exist in the interpretation of the TUG outputs as part of longitudinal assessments aimed at evaluating treatment effectiveness in PD population. Researchers and practitioners should be aware of these concerns to prevent possible misrepresentations of functional ability in patients for a particular intervention.
尽管定时起立行走（TUG）测试在临床试验中经常使用，但对于帕金森病（PD）患者，纵向重测信度的评估普遍缺乏且尚无定论。
我们旨在进一步研究该测试在这一人群中的长期信度和敏感性。此外，我们探索了该测试的替代评估策略，以阐明定时试验的纳入或组合是否可能对结果测量有潜在影响。
在43名PD患者中，于两个不同的测试时段进行了三次定时试验，每次试验间隔两个月，从而获得了TUG测试表现的相对和绝对信度。
我们的结果显示，测试时段内信度极佳，测试时段间信度中等。研究发现，TUG测试采用不同的评估策略对结果测量有重要影响，这突出表明，在每个测试时段对多次定时试验结果求平均值，是一种推荐的替代方法，可将测量误差降至最低，并提高纵向评估的信度。然而，除了可接受的信度外，该测量似乎还存在较差的试验间稳定性，因为复测时预期变异性范围较宽，且虚假统计效应的发生率不可忽视，尤其是在纵向重复测试中。
作为旨在评估PD人群治疗效果的纵向评估的一部分，TUG测试结果的解释可能存在局限性。研究人员和从业者应意识到这些问题，以防止在特定干预措施中对患者功能能力的可能误判。
