Biomechanical analysis of the timed up-and-go (TUG) test in children with and without Down syndrome

Publication date: February 2019

Source: Gait & Posture, Volume 68

Author(s): Matthew Beerse, Michael Lelko, Jianhua Wu

Abstract

Background

The timed up-and-go (TUG) test consists of multiple functional activities of daily living performed in a sequence, with the goal to complete the test as quickly as possible. Considering children with Down syndrome (DS) have been shown to take longer to complete the TUG test, it is imperative to identify which tasks are problematic for this population in order to individualize physical interventions.

Research question

Is the biomechanical pattern of each functional task during the TUG test different between children with DS and typically developing (TD) children?

Methods

Thirteen children with DS and thirteen TD children aged 5–11 years old completed the TUG test. Kinematic data was captured using a Vicon motion capture system. We visually coded the TUG test into five phases: sit-to-stand, walk-out, turn-around, walk-in, and stand-to-sit. We focused on the center-of-mass (COM) movement in the sit-to-stand phase, spatiotemporal parameters in the walk-out phase, and intersegmental coordination in the turn-around phase.

Results and significance

Children with DS took longer to complete the entire test, as well as each of the five phases. During the sit-to-stand phase, children with DS produced smaller peak vertical COM velocity, medial-lateral COM excursion, and peak knee and hip extension velocity compared to TD peers. Children with DS walked at a slower velocity during the walk-out phase. Both groups demonstrated a similar intersegmental coordination pattern between the head, thorax, and pelvis during the turn-around phase although children with DS had slower average and peak angular velocity at the head, thorax, and pelvis. Our results suggest that children with DS were less able to anticipate transitioning between motor tasks and took longer to initiate motor tasks. Our TUG analysis provides the detailed insights to help evaluate individual motor tasks as well as the transition from one task to another for clinical populations.

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