Modified TUG for Preschoolers
Descriptive Information
Title, Edition, Dates of Publication and Revision: A Modified Version of the Timed Up and Go Test for Children Who are Preschoolers, 2016, modified from Williams et al. TUG-IC, 2005.
Authors: Evi Verbecque, PT; Luc Vereeck, PT, PhD; An Boudewyns, MD, PhD; Paul Van de Heyning, MD, PhD; Ann Hallemans, PhD
Source: Pediatric Physical Therapy Volume 28(4) Evi Verbecque, PT Rehabilitation Sciences and Physiotherapy, University of Antwerp, Universiteitsplein 1, Antwerp 2610, Belgium. Email: evi.verbecque@uantwerpen,be
Costs (booklets, forms, kit): free, see below for equipment needed
Purpose: The purpose of this study was to investigate if the modified TUG is influenced by practice, if there is a difference in scores among age groups, and which factors are most predictive of TUG scores.
Type of Test: Screening for balance deficit indicative of further assessment and an evaluative measure.
Target Population and Ages: 172 preschoolers, age 3-5 without developmental disorders in Belgium were included in the study
Time Requirements – Approximately 5 min
Test Administration
Administration: The TUG for preschoolers is administered slightly different from the standard TUG with the placement of 2 chairs (seat height 27cm) placed 3.38m apart facing each other (the extra distance is to account for the reaching component to assure they walk the 3 meters). A Duplo brick is place on the second chair. The child begins seated in the first chair and is given the cue to start by counting 1,2, 3 “start”. The child begins walking as fast and safe as possible towards the second chair. The child is to grab the Duplo brick off the chair and walk back to the first chair and sit down. Timing starts when the cue is given to “start” and ends when the spine of the child touches the back of the chair.
Scoring: This study used the best of 3 trials, however in their discussion they mentioned performing trials until a plateau is reached to eliminate the practice effect.
Type of information, resulting from testing The mean score for 3-5 year olds was 7.11 seconds. This study determined age-specific reference values (mean score): 3 years old: 7.86 seconds, 4 years old: 7.3 seconds, 5 years old: 6.41 seconds.
Cut off values for those likely to have a balance deficit are: 9.92 seconds for 3 year olds, 9.84 seconds for 4 year olds, 8.61 seconds for 5 year olds.
Cut off for those at risk for balance deficit: are 8.89 seconds for 3 year olds, 8.57 seconds for 4 year olds, 7.51 seconds for 5 year olds.
Environment for Testing: Indoors on flat surface, hallway of school was used in this study
Equipment and Materials Needed: 2 chairs with backrests and no armrests (seat height of 27cm), red Duplo Brick, measuring tape, and stop watch
Examiner Qualifications: none
Summary Comments
Strengths: This modified version of TUG is timely, easy, and inexpensive test. The forward reach integrates an extra challenge to the balance system. The modifications made in this study to the previous TUG-IC decrease the influence of the push off against the wall when performing the task.
Weaknesses: Practice effect may occur therefore it may be imperative to complete trials until plateau is reached. Children with upper limb dysfunction may show poorer results due to the added task of grasping and picking up the block. The researchers studied the correlation of age and ethnicity to scores, however I believe it would be beneficial to also study the height/leg length correlation to scores. There is a lack of inter-rater and test-retest reliability, sensitivity, and specificity therefore further research is required.
Clinical Applications: The Modified TUG can be used to evaluate and reassess functional mobility and dynamic balance in preschoolers. It can also be used as a screening mechanism compared to norms in order to determine if further assessment is required such as motor assessment or vestibular function testing.
| Verbecque, E., Vereeck, L., Boudewyns, A., Van de Heyning, P., & Hallemans, A. (2016). A Modified Version of the Timed Up and Go Test for Children Who Are Preschoolers. Pediatric Physical Therapy, 28(4), 409-415. |
3 responses to “Modified TUG for Preschoolers”
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The Modified TUG for the pediatric population is an interesting and seemingly beneficial outcome measure when assessing balance in young children. However, I agree with your statement and the fact that a weakness within the test lies in the fact that the scores are not always representative of the actual impairment that the child is experiencing. There are numerous reasons that a child could demonstrate poor results, especially in regards to the UE. The child could demonstrate impairments in UE motor control, reduced grasp or hand/wrist strength, or overall poor coordination. The test and measure does not seem to provide an accurate and reliable way to differentiate the definite causes of the results.
I wish I had known about this for my last clinical! I had a kid I was working with that I definitely could have done this test on. It is cool to me to be able to see how people adapt these tests to be used with children, because kids are so different! I like how they incorporate an object for the child to get and bring back to their original seat. It gives them a goal, especially if its their favorite toy! And the best part is this is a quick test that a preschooler can easily stay focused on for a few minutes. Thanks Linsey!
The Modified TUG for Preschoolers seems like a really easy, beneficial way of measuring function in kids. Although the norms only depict balance deficits it seems like you can gather so much information from having them perform this test. Sit-to-stand, gait deficits, dynamic stability, turning ability, UE function, and ability to focus on the task are a few that come to mind. This seems like a great intervention to use in the clinic with kids and adults!