Timed Up And Go Test and Falls Screening: What Is The TUG Test?

In this article, we outline the importance of the Timed Up and Go Test (TUG) as an objective falls risk screening assessment.

Falls are one of the most common and serious health risks for older adults and those with chronic conditions.

Each year, over 37 million falls are severe enough to warrant medical treatment, according to the World Health Organization.

One in four adults aged 65 and over in the US experience a fall each year. This is costing the healthcare system approximately $50 billion annually, according to the CDC.

Measurements of balance and functional mobility are extensively used in falls risk assessments to predict mobility impairments, frailty, and falls risk.

Key takeaways: The Timed Up and Go (TUG) test

The TUG test is designed to assess a person’s dynamic balance both during the transition from sitting to standing, whilst walking forwards and whilst turning.
The patient stands up from a chair, walks to a line three meters away, turns 180 degrees, walks back and sits down again.
An older adult who takes more than 12 seconds to complete the TUG is considered to be at risk of falling.
The TUG test metric alone is not enough to classify a patient’s risk of falls. NICE guidelines recommend multifactorial assessment (both subjective and objective) to guide intervention for patients at risk of falling in hospitals.
The combination of measuring grip strength, lower limb strength, gait speed, and balance provides a comprehensive approach to objective falls risk assessment. Able Assess is the first platform to combine these four key indicators of falls risk in one solution.

What is the TUG Test?

It is a safe, time-efficient, reliable, and cost-effective method for evaluating a patient’s balance and functional mobility.

The TUG test demonstrates high sensitivity and specificity as a predictor of mobility status and falls (Long et al., 2020).

Furthermore, it is quick to administer, requires no special equipment or training, and can easily be incorporated into routine medical examinations (Podsiadlo & Richardson, 1991).

It is used extensively in fall screening (Panel on Prevention of Falls in Older Persons, 2011), wherein high fall risk and low functional mobility are known indicators of mortality in older adults (Hartholt et al., 2019).

It is thus widely used for falls risk assessments, goal-setting and as a functional outcome measure by clinicians worldwide (Barry et al., 2014), as well as being used as part of frailty screening.

The TUG test originated from an assessment developed from a study called Balance in elderly patients: the get-up and go test (S Mathias, U S Nayak, and B Isaacs; 1986).

The assessment was modified to include a timed element in the study, called The timed “Up & Go”: a test of basic functional mobility for frail elderly persons (D Podsiadlo and S Richardson; 1991). The timed component increased the accuracy and reliability of the results.

Assessing functional mobility and balance

This is the basis of the TUG test used today. It is a simple, quick, and widely used clinical tool.

It is designed to assess a person’s functional mobility, balance, and walking ability. This can then support our understanding of their risk of falling.

Specifically, it is a test intended to assess a person’s dynamic balance. The patient stands up from a chair, walks to a line three meters away, turns 180 degrees, walks back and sits down again.

An older adult taking more than 12 seconds to complete the TUG is classified as at increased risk of falling, as per the CDC’s STEADI initiative.

Clinical uses of the TUG test include screening for falls risk in older adults and patients with conditions including Parkinson’s disease, stroke, hip osteoarthritis, fear of falling or vestibular disorders. The assessment can be used to monitor changes in mobility over time or in response to interventions.

How Does the TUG Test Work?

The following is a step-by-step guide to how the TUG test works using Able Assess, our falls risk screening platform.

Our digital solution measures the TUG test reliably and accurately. Able Assess also captures three other integral measurements to help assess the risk of falls.

This is how to set up the TUG test with the Able Assess app:

Only four pieces of equipment are required: the GripAble sensor, its accompanying waist bag, the turquoise tape provided, and a chair
The control of the test on the app can be carried out by an individual, or by an assessor on behalf of an individual.
Choose the Timed Up & Go (TUG) test option in the Able Assess app
Place the chair at the start of a clear walkway, moving to one side any other items within three meters in front of the chair, ensuring a straight and clear path
Roll out the three meter long tape, starting from the front of the chair
Squeeze the GripAble sensor until a blue light turns on
Place the GripAble in the pocket of the waist bag provided
The bag is fastened around the patient’s waist with the buckle at the front, so the GripAble sensor is positioned on the lower back

Now the TUG test is ready. To take the TUG test, the patient:

Sits back in the chair
Either the patient of the assessor presses ‘Ready’ in the Able Assess app screen
The patient stands up when they hear the beep sound, using a walking aid if needed
Walks along the turquoise tape for three meters at a comfortable pace
Turns around and walks back
Sits down with their bottom to the back of the chair
The assessor or patient then presses the ‘Test Complete’ button on the Able Assess app screen

The results are compared to normative data for the patient’s age and biological sex. For an older adult at low risk of falling, the time taken to complete the TUG test should be under 12 seconds.

More Fall Risk Screening Measurements Aside From the TUG Test

Other integral measurements that screen for the risk of falls include:

Grip strength

Grip strength is measured using a hand dynamometer. It is a vital biomarker for senior care.

Measuring full-body strength and physiological reserve, it is a very important assessment in falls risk screening.

It is a core measure of functional health. It reflects muscle strength, bone density and balance, but also a key indicator of biological resilience for many chronic conditions.

Assessment: Single maximum grip strength test (SMGT): Measuring grip strength involves administering a SMGT. This assesses peak grip strength by recording the maximum force exerted in a single grip.

Lower limb strength

Lower body strength is critical for mobility, balance, and independence in daily activities.

It is widely used in rehabilitation and preventative care settings to enable early identification of at-risk individuals. It allows the promotion of interventions that enhance functional independence and reduce falls risk.

Assessment: 30 second chair-to-stand (CTS) test: Counting the number of times a patient can reach a full standing position from a seated chair in half a minute. Below average scores indicate a risk of falls, as per the CDC’s STEADI initiative.

Gait speed

Gait speed indicates mobility and walking ability. It is a simple yet powerful predictor of falls risk, functional decline, and early mortality.

A walking speed below 0.6 m/s indicates high falls risk and increased mortality, necessitating targeted interventions.

Assessment: Four meter gait speed test: Timing how many seconds a patient takes to walk four meters. Below average scores indicating a risk of falls.

For more details, read out comprehensive guide: Able Assess as a Falls Risk Assessment Solution.

This video shows sample results from a patient at risk of falling. In this case, it is indicated by a below average score in the chair-to-stand test:

Able Assess: The Only Platform With Four Key Fall Risk Assessments

The Able Assess Falls Risk Screening platform is the first and only solution worldwide that is able to capture all four integral measurements accurately.

Note that the TUG test alone should not be used in isolation to identify patients at high risk of falls (E Barry et al., 2014). No one metric is enough on its own.

The NICE guidelines recommend multifactorial assessment and intervention for patients at risk of falling in hospitals. Read our key takeaways for clinical practice in the NICE guidelines: falls prevention 2025 updates.

However, the combination of these four objective measures, grip strength, lower limb strength, gait speed, and dynamic balance provides a comprehensive approach to falls risk assessment. It is also important to track these objective markers alongside subjective assessments, as per the NICE guidelines.

Summary: Able Assess as a Falls Risk Assessment Solution

Able Assess delivers accurate, reliable and sensitive data for better decision-making. It measures the TUG test, a measure of dynamic balance and functional mobility that is extensively used in falls risk assessments to predict mobility impairments, frailty, and falls risk.

In addition to the TUG test it measures the four meter gait speed test, 30 second chair-to-stand test (CTS), and the single maximum grip strength test (SMGT).

Able Care has designed the first falls risk screening tool that empowers every clinical and non-clinical staff member to deliver a standardized, objective, low-cost, data driven assessment in under five minutes.

It combines the best-in-class GripAble sensor with a user-friendly app, clinician-facing web portal and robust data model.

For further reading, explore our extensive collection of studies on using a hand dynamometer, grip strength and more including:

Our market-leading technology and data platforms drive early detection of functional health issues such as falls risks, track outcomes and support true value-based healthcare.

Please don’t hesitate to contact us at hello@able-care.co or contact us for more information.