Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Timed up and down stairs test (TUDS) Update

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Article Summary:

Marchese, V. G., Connolly, B. H., Able, C., Booten, A. R., Bowen, P., Porter, B. M.,Rai, S. N., Hancock, M. L., Pui, C., Howard, S., Neel, M. D., & Kaste, S. C. (2008).Relationships Among Severity of Osteonecrosis, Pain, Range of Motion, and Functional Mobility in Children, Adolescents, and Young Adults With Acute Lymphoblastic Leukemia. Physical Therapy, 88(3), 341-350.

The purpose of this article was to explore the relationships among specific measures of body function/structure, as measured by the stage of osteonecrosis in the hips and knees, pain, ROM, and activity (TUDS). This study included 33 participants, 16 females and 17 males, ranging from 5-27 years old newly diagnosed with Acute Lymphatic Leukemia (ALL) and experiencing pain from osteonecrosis. Instruments used for this study were ARCO classification (for osteonecrosis), Ficat and Ariet knee staging method, Wong-Baker Faces scale, active and passive ROM, TUDS Test for functional mobility. No physical therapy intervention was performed before or after participation in order to examine the correlations of severity of osteonecrosis with ROM, pain, and stair climbing and not the effects of physical therapy intervention. ROM was measured via goniometer and the TUDS test performed in a stairwell near the PT gym. Each of the 12 steps measured 16.5 cm high, 31cm deep, and 104.4 cm wide. The test started with the subjects in standing with feet together, a spotter closely monitored each participant during this task. The data collection process lasted 6 months. Results revealed that distributions of ROM did not differ significantly across the different ARCO subgroups. No association of significant differences between Ficat and Ariet scores and any of the other variables were found. There was an inverse correlation between TUDS test time and knee pain score; also, no significant differences between the TUDS Test times of participants with hip and knee osteonecrosis and those with osteonecrosis in the knees only. The data supported some of the hypotheses including that there would be a relationship between knee pain and TUDS test as demonstrated by the inverse correlation between the pain score and the TUDS test times recorded. The authors suggest that this indicates that unless an individual is experiencing pain in the knees, functional mobility may not be affected.