iTUG, a sensitive and reliable measure of mobility

Arash Salarian, Fay B Horak, Cris Zampieri, Patricia Carlson-Kuhta, John G Nutt, Kamiar Aminian, Arash Salarian, Fay B Horak, Cris Zampieri, Patricia Carlson-Kuhta, John G Nutt, Kamiar Aminian

Abstract

Timed Up and Go (TUG) test is a widely used clinical paradigm to evaluate balance and mobility. Although TUG includes several complex subcomponents, namely: sit-to-stand, gait, 180 degree turn, and turn-to-sit; the only outcome is the total time to perform the task. We have proposed an instrumented TUG, called iTUG, using portable inertial sensors to improve TUG in several ways: automatic detection and separation of subcomponents, detailed analysis of each one of them and a higher sensitivity than TUG. Twelve subjects in early stages of Parkinson's disease (PD) and 12 age matched control subjects were enrolled. Stopwatch measurements did not show a significant difference between the two groups. The iTUG, however, showed a significant difference in cadence between early PD and control subjects (111.1 +/- 6.2 versus 120.4 +/- 7.6 step/min, p < 0.006) as well as in angular velocity of arm-swing (123 +/- 32.0 versus 174.0+/-50.4 degrees/s, p < 0.005), turning duration (2.18 +/- 0.43 versus 1.79 +/- 0.27 s, p < 0.023), and time to perform turn-to-sits (2.96 +/- 0.68 versus 2.40 +/- 0.33 s, p < 0.023). By repeating the tests for a second time, the test-retest reliability of iTUG was also evaluated. Among the subcomponents of iTUG, gait, turning, and turn-to-sit were the most reliable and sit-to-stand was the least reliable.

Figures

Fig 1
Fig 1
Sensors were attached on the upper and lower limbs using elastic bands. On the trunk, sensors were attached using a double sided adhesive tape.
Fig 2
Fig 2
Components of the iTUG and representative recorded raw signals from angular velocity of a shank and sternum
Fig 3
Fig 3
diagram showing how inertial sensors were used for the iTUG analysis algorithms.
Fig 4
Fig 4
a) Raw signal of the yaw gyroscope on the trunk during iTUG. The first peak corresponds to 180° turn and the second peak corresponds to the turn-to-sit transition b) Relative angle of the trunk in the horizontal plane and fitted mathematical model.

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