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Within-Day Test-Retest Reliability of the Timed Up & Go Test in Patients With Advanced Chronic Organ Failure
Authors:Rafael Mesquita  Daisy J.A. Janssen  Emiel F.M. Wouters  Jos M.G.A. Schols  Fabio Pitta  Martijn A. Spruit
Affiliation:1. Program Development Center, Center of Expertise for Chronic Organ Failure (CIRO+), Horn, The Netherlands;2. Centro de Pesquisa em Ciências da Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil;3. Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brazil;4. Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands;5. Department of General Practice and Department of Health Services Research, Faculty of Health Medicine and Life Sciences/CAPHRI, Maastricht University, Maastricht, The Netherlands
Abstract:

Objective

To investigate the within-day test-retest reliability of the Timed Up & Go (TUG) test in patients with advanced chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), and chronic renal failure (CRF).

Design

Cross-sectional.

Setting

Patients' home environment.

Participants

Subjects (N=235, 64% men; median age, 70y [interquartile range, 61–77y]; median body mass index, 25.6kg/m2 [interquartile range, 22.8–29.4kg/m2]) with advanced COPD (n=95), CHF (n=68), or CRF (n=72).

Interventions

Not applicable.

Main Outcome Measure

Time to complete the TUG test. Three trials were performed on the same day and by the same assessors. The intraclass correlation coefficient (ICC), kappa coefficient, standard error of measurement, and absolute and relative minimal detectable change (MDC) values were calculated.

Results

Good agreement was observed, in general, for both the total sample and subgroups (COPD, CHF, CRF), with ICC values ranging from .85 to .98, and kappa coefficients from .49 to 1.00. However, statistical improvement occurred in the total sample from the first to the second trial with large limits of agreement (mean difference, −.97s; 95% confidence interval, 3.00 to −4.94s; P<.01). The third trial added little or no information to the first 2 trials. For the total sample, a standard error of measurement value of approximately 1.6 seconds, an absolute value of MDC at the 95% confidence level (MDC95%) of approximately 4.5 seconds, and a relative value of MDC at the 95% confidence level (MDC95%%) of approximately 35% were found between the first 2 trials, with similar values found for the subgroups.

Conclusions

The TUG test is reliable in patients with advanced COPD, CHF, or CRF after 2 trials. Values of standard error of measurement and MDC may be used in daily clinical practice with these populations to define what is expected and what represents true change in repeated measures.
Keywords:Heart failure   Kidney failure   Outcome assessment (health care)   Pulmonary disease, chronic obstructive   Rehabilitation   Reproducibility of results
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