Quantitative timed-up-and-go parameters in relation to cognitive parameters and health- related quality of life in mild-to-moderate Parkinson's disease

Janet M T Van Uem, Stefan Walgaard, Erik Ainsworth, Sandra E. Hasmann, Tanja Heger, Susanne Nussbaum, Markus A. Hobert, Encarnación M. Micó-amigo, Rob C. Van Lummel, Daniela Berg, Walter Maetzler

Research output: Contribution to JournalArticleAcademicpeer-review


Introduction The instrumented-Timed-Up-and-Go test (iTUG) provides detailed information about the following movement patterns: sit-to-walk (siwa), straight walking, turning and walk-to-sit (wasi). We were interested in the relative contributions of respective iTUG sub-phases to specific clinical deficits most relevant for daily life in Parkinson's disease (PD). More specifically, we investigated which condition-fast speed (FS) or convenient speed (CS)-differentiates best between mild- to moderate-stage PD patients and controls, which parameters of the iTUG sub-phases are significantly different between PD patients and controls, and how the iTUG parameters associate with cognitive parameters (with particular focus on cognitive flexibility and working memory) and Health-Related-Quality of Life (HRQoL). Methods Twenty-eight PD participants (65.1±7.1 years, H&Y stage 1-3, medication OFF state) and 20 controls (66.1±7.5 years) performed an iTUG (DynaPort1, McRoberts BV, The Netherlands) under CS and FS conditions. The PD Questionnaire 39 (PDQ-39) was employed to assess HRQoL. General cognitive and executive functions were assessed using the Montreal Cognitive Assessment and the Trail Making Test. Results The total iTUG duration and sub-phases durations under FS condition differentiated PD patients slightly better from controls, compared to the CS condition. The following subphases were responsible for the observed longer total duration PD patients needed to perform the iTUG: siwa, turn and wasi. None of the iTUG parameters correlated relevantly with general cognitive function. Turning duration and wasi maximum flexion velocity correlated strongest with executive function. Walking back duration correlated strongest with HRQoL. Discussion This study confirms that mild- to moderate-stage PD patients need more time to perform the iTUG than controls, and adds the following aspects to current literature: FS may be more powerful than CS to delineate subtle movement deficits in mild- to moderate-stage PD patients; correlation levels of intra-individual siwa and wasi parameters may be interesting surrogate markers for the level of automaticity of performed movements; and sub-phases and kinematic parameters of the iTUG may have the potential to reflect executive functioning and HRQoL aspects of PD patients.

Original languageEnglish
Article number0151997
JournalPLoS ONE
Issue number4
Publication statusPublished - 7 Apr 2016


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