Estimation of average and maximum daily-life mobility performance using the Timed Up-and-Go (TUG): Exploring the added value of an instrumented TUG

Introduction: The association between specific motor capacity variables obtained in a laboratory and parameters of daily-life mobility performance obtained via wearables is still unclear. The Timed Up-and-Go (TUG) test is a widely used motor capacity tests available either as traditional hand-stopped TUG or as instrumented TUG (iTUG) providing specific information about its subphases. This study aimed to: 1) estimate the association between the TUG and specific parameters reflecting average and maximum daily-life mobility performance (MP), 2) estimate the benefits of the iTUG in terms of explaining MP in daily life compared to the TUG. Methods: The present study was a cross-sectional analysis using baseline data of 294 older persons (mean age: 76.7 ± 5.3 years). Univariate linear regression analysis was performed to delineate the coefficient of determination between TUG time and participants' MP. MP variables containing mean cadence (MCA) to represent average performance and the 95th percentile of mean cadence of walks with more than three steps (p95>3stepsMCA) to represent maximum performance. To determine whether the iTUG variables give more information about MP, a stepwise multivariate regression analysis between iTUG variables and the p95>3stepsMCA variable to represent maximum performance was conducted. Results: The univariate regression models revealed associations of the TUG with MCA (adjusted R² = .078, p<0.001) and p95>3stepsMCA (adjusted R² = .199, p<0.001). The multivariate stepwise regression models revealed a total explanation of maximum daily life MP (p95>3stepsMCA) of the TUG (adjusted R² = .199, p<0.001) vs. iTUG (adjusted R² = .278, p<0.010). Discussion/ Conclusion: This study shows that the TUG better reflects maximum daily life MP than average daily life MP. Moreover, we demonstrate the added value of the iTUG for a more accurate estimation of daily MP compared to the traditional TUG. The iTUG is recommended to estimate maximum daily life MP in fall-prone older adults. The study is a step toward a specific assessment paradigm using capacity variables from the iTUG to estimate maximum daily life MP.