Objective: To develop and validate a clinical tool based on the biomechanical strategies exhibited by people with hemiparesis due to stroke during the performance of the Timed "Up and Go" test. Design/methods: The Timed "Up and Go" Assessment of Biomechanical Strategies (TUG-ABS) was developed for subjects with stroke, based on the analyses of 3 sources of information: published evidence; opinions of rehabilitation professionals; and observations of TUG performances, followed by a multi-step approach, which involved the investigation of the reliability, content, and criterion-related validity of the preliminary version. Content validity was established by an expert panel, whereas intra-and inter-rater reliability was established by two independent examiners. Criterion-related validity was established by comparing the TUG-ABS scores at the item level obtained by independent analyses of video observations and the gold standard motion analysis system. The final tool included the items, which showed acceptable values for these psychometric properties. Results: The preliminary version consisted of 24 items with 3 response categories. Twenty-one items showed acceptable content validity (0.72 ≤ κ ≤ 1.00; p ≤ 0.01), 19 acceptable intraand inter-rater reliability (0.36 ≤ κ ≤1.00; p ≤ 0.04), and 15 acceptable criterion-related validity (0.29 ≤ κ ≤ 1.00; p ≤ 0.04).
Conclusion:The final developed 15-item TUG-ABS version proved to be valid and reliable for individuals with hemiparesis due to stroke, but it should be clinically validated before being used for clinical applications and research purposes.Key words: stroke; assessment; mobility; instrument development; reliability; content validity. J Rehabil Med 2013; 45: 232-240 Correspondence address: Luci F. Teixeira-Salmela, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, 31270-901 Belo Horizonte, Minas Gerais, Brazil. E-mail: lfts@ufmg.br. Accepted Oct 9, 2012; Epub ahead of print Feb 6, 2013
INTRODUCTIONStroke remains one of the most common causes of long-term disability worldwide and is a major public health concern (1). Thus, the understanding of the disabilities following stroke is a high priority for healthcare systems. Among all of the common disabilities of stroke survivors, those related to functional mobility are the most prevalent and disabling (2), and are the primary targets for rehabilitation.A widely recommended test to assess functional mobility after stroke (3-7) is the Timed "Up and Go" (TUG) (6), proposed as a modified timed version of the "Get-up and Go" test (8). The TUG has shown high levels of validity to assess functional mobility (6), is highly reliable (3, 5) and responsive (3, 4) for individuals with stroke, and is able to differentiate between people with stroke from the healthy elderly population (5) and people with stroke with various degrees of disabilities (4). It can also be used as a predictive measure of disabilities (4). Finally, the TUG is easily administered, ...