Usefulness of the instrumented timed up and go test for walking assessment in older adults

Piotr Szaflik; Katarzyna Nowakowska-Lipiec; Hanna Zadoń; Robert Michnik

doi:10.37190/abb/224360

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Usefulness of the instrumented timed up and go test for walking assessment in older adults

Acta of Bioengineering and Biomechanics

Volume 28 (2026): Issue 2 (June 2026)

By: Piotr Szaflik , Katarzyna Nowakowska-Lipiec, Hanna Zadoń and Robert Michnik

Open Access

|Sep 2026

Abstract

Purpose

The Up and Go test is a widely used tool among physical therapists for assessing functional mobility. Advances in inertial measurement unit (IMU) sensors enable the analysis not only of total walk duration but also of the duration of individual walk phases, as well as the determination of spatiotemporal and kinematic parameters for each phase. Consequently, the IMU-supported version of the test up and go, referred to as the instrumented up and go, enables a substantially more comprehensive analysis of locomotor patterns. The aim of this study was to evaluate the extent to which spatiotemporal and kinematic parameters obtained during the instrumented timed up nad go test correspond to those observed during walking in older adults.

Methods

The study included 30 adults aged over 60 years, who performed the instrumented up and go test as well as a 10 m walk test at a self-selected walking speed. The study involved the analysis of selected spatiotemporal parameters, including cadence, velocity, stride length, and the percentage contribution of gait phases, as well as analysis of pelvic tilt and lower-limb kinematics, including ranges of motion.

Results

The results indicate that while the instrumented up and go test does not directly reflect natural walk patterns, selected parameters may still provide complementary information relevant to functional mobility assessment in older adults.

Conclusion

The instrumented up and go test should not be considered a substitute for standard walk analysis.

References

Ivanenko, Y.P., Poppele, R.E., Lacquaniti, F., Five basic muscle activation patterns account for muscle activity during human locomotion, J. Physiol., 2004, 556: 267–282. 10.1113/jphysiol.2003.057174.
Open DOI Search in Google Scholar Back to article
Fagerström, C., Borglin, G., Mobility, functional ability and health-related quality of life among people of 60 years or older, Aging Clin. Exp. Res., 2010, 22: 387–394. 10.1007/BF03324941.
Open DOI Search in Google Scholar Back to article
La Grow, S., Yeung, P., Towers, A., Alpass, F., Stephens, C., The impact of mobility on quality of life among older persons, J. Aging Health, 2013, 25: 723–736. 10.1177/0898264313490198/ASSET/D7278C99-AAF0-485C-8BB9-68ECEE7D32BE/ASSETS/IMAGES/LARGE/10.1177_0898264313490198-FIG2.JPG.
Open DOI Search in Google Scholar Back to article
Studenski, S., Perera, S., Patel, K., Rosano, C., Faulkner, K., Inzitari, M., et al., Gait Speed and Survival in Older Adults, JAMA, 2011, 305: 50–58. 10.1001/JAMA.2010.1923.
Open DOI Search in Google Scholar Back to article
Parihar, R., Mahoney, J.R., Verghese, J., Relationship of gait and cognition in the elderly, Curr. Transl. Geriatr. Exp. Gerontol. Rep., 2013, 2: 167–173. 10.1007/s13670-013-0052-7.
Open DOI Search in Google Scholar Back to article
Trombetti, A., Reid, K.F., Hars, M., Herrmann , F.R., Pasha, E., Phillips , E.M., et al., Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life, Osteoporos. Int., 2016, 27: 463–471. 10.1007/s00198-015-3236-5.
Open DOI Search in Google Scholar Back to article
Gadelha, A.B., Neri, S.G.R., Oliveira, R.J. de, Bottaro, M., David, A.C. de Vainshelboim, B., et al., Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women, Exp. Aging Res., 2018, 44: 258–269. 10.1080/0361073X.2018.1449591.
Open DOI Search in Google Scholar Back to article
Doi, T., Nakakubo, S., Tsutsumimoto, K., Kim, M.J., Kurita, S., Ishii, H., et al., Spatio-temporal gait variables predicted incident disability, J. Neuroeng. Rehabil., 2020, 17: 1–7. 10.1186/S12984-020-0643-4/FIGURES/1.
Open DOI Search in Google Scholar Back to article
Del Din, S., Godfrey, A., Mazzà, C., Lord, S., Rochester, L., Free‐living monitoring of Parkinson’s disease: Lessons from the field, Mov. Disord., 2016, 31: 1293–1313. 10.1002/mds.26718.
Open DOI Search in Google Scholar Back to article
Mundt, M., Thomsen, W., David, S., Dupré, T., Bamer, F., Potthast, W., et al., Assessment of the measurement accuracy of inertial sensors during different tasks of daily living, J. Biomech., 2019, 84: 81–86. 10.1016/j.jbiomech.2018.12.023.
Open DOI Search in Google Scholar Back to article
Park, S., Yoon, S., Validity Evaluation of an Inertial Measurement Unit (IMU) in Gait Analysis Using Statistical Parametric Mapping (SPM)., Sensors (Basel)., 2021, 21: 3667. 10.3390/s21113667.
Open DOI Search in Google Scholar Back to article
Podsiadlo, D., Richardson, S., The timed “Up & Go”: A test of basic functional mobility for frail elderly persons, J. Am. Geriatr. Soc., 1991, 39: 142–148. 10.1111/j.1532-5415.1991.tb01616.x.
Open DOI Search in Google Scholar Back to article
Kowal, M., Winiarski, S., Morgiel, E., Madej, M., Proc , K., Madziarski, M., et al., Functional mobility studies in younger adults: Instrumented Timed Up and Go (iTUG) test using inertial devices, J. Clin. Med. 2025, 14: 1944. 10.3390/jcm14061944.
Open DOI Search in Google Scholar Back to article
Salarian, A., Horak, F.B., Zampieri, C., Carlson-Kuhta, P., Nutt, J.G., Aminian, K., iTUG, a sensitive and reliable measure of mobility, IEEE Trans. Neural Syst. Rehabil. Eng., 2010, 18: 303–310. 10.1109/TNSRE.2010.2047606.
Open DOI Search in Google Scholar Back to article
Szaflik, P., Kaczmarczyk, A., Zadoń, H., Szefler-Derela, J., Wasiuk-Zowada, D., Nowakowska-Lipiec, K., et al., Instrumented timed up and go test as a tool to early detection of gait and functional mobility impairments in multiple sclerosis, J. Clin. Med., 2026, 15: 679. 10.3390/jcm15020679.
Open DOI Search in Google Scholar Back to article
Nicolini-Panisson, R.D., Donadio, M.V.F., Timed “Up & Go” test in children and adolescents, Rev. Paul. Pediatr., 2013, 31: 377–83. 10.1590/S0103-05822013000300016.
Open DOI Search in Google Scholar Back to article
Zarzeczny, R., Nawrat-Szołtysik, A., Polak, A., Maliszewski, J., Kiełtyka, A., Matyja, B., et al., Aging effect on the instrumented Timed-Up-and-Go test variables in nursing home women aged 80–93 years, Biogerontology, 2017, 18: 651. 10.1007/s10522-017-9717-5.
Open DOI Search in Google Scholar Back to article
Mulas, I., Putzu, V., Asoni, G., Viale, D., Mameli, I., Pau, M., Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors, Aging Clin. Exp. Res., 2020, 33: 1853. 10.1007/s40520-020-01715-9.
Open DOI Search in Google Scholar Back to article
Porta, M., Pilloni, G., Corona, F., Fastame, M.C., Hitchott, P.K., Penna, M.P., et al., Relationships between objectively assessed functional mobility and handgrip strength in healthy older adults, Eur. Geriatr. Med. 2018 92, 2018, 9: 201–209. 10.1007/s41999-018-0025-7.
Open DOI Search in Google Scholar Back to article
Roberts, M., Mongeon, D., Prince, F., Biomechanical parameters for gait analysis: a systematic review of healthy human gait, Phys. Ther. Rehabil., 2017, 4: 6. 10.7243/2055-2386-4-6.
Open DOI Search in Google Scholar Back to article
Studenski, S., Gait Speed and Survival in Older Adults, JAMA, 2011, 305: 50. 10.1001/jama.2010.1923.
Open DOI Search in Google Scholar Back to article
Fan, Y., Zhang, B., Huang, G., Zhang, G., Ding, Z., Li, Z., et al., Sarcopenia: Body composition and gait analysis, Front. Aging Neurosci., 2022, 14: 909551. 10.3389/fnagi.2022.909551.
Open DOI Search in Google Scholar Back to article
Moon, Y., Sung, J., An, R., Hernandez, M.E., Sosnoff, J.J., Gait variability in people with neurological disorders: A systematic review and meta-analysis, Hum. Mov. Sci., 2016, 47: 197–208. 10.1016/j.humov.2016.03.010.
Open DOI Search in Google Scholar Back to article
Kyrdalen, I.L., Thingstad, P., Sandvik, L., Ormstad, H., Associations between gait speed and well‐known fall risk factors among community‐dwelling older adults, Physiother. Res. Int., 2019, 24: 1743. 10.1002/pri.1743.
Open DOI Search in Google Scholar Back to article
Brown, J.C., Harhay, M.O., Harhay, M.N., Walking cadence and mortality among community-dwelling older adults, J. Gen. Intern. Med., 2014, 29: 1263–1269. 10.1007/s11606-014-2926-6.
Open DOI Search in Google Scholar Back to article
Walz, I.D., Waibel, S., Kuhner, A., Gollhofer, A., Maurer, C., Age-related changes in mobility assessments correlate with repetitive goal-directed arm-movement performance, BMC Geriatr., 2023, 23: 487. 10.1186/s12877-023-04150-3.
Open DOI Search in Google Scholar Back to article
Tudor-Locke, C., Mora-Gonzalez, J., Ducharme, S.W., Aguiar, E.J., Schuna, J.M., Barreira, T. V., et al., Walking cadence (steps/min) and intensity in 61–85-year-old adults: the CADENCE-Adults study, Int. J. Behav. Nutr. Phys. Act., 2021, 18: 129. 10.1186/s12966-021-01199-4.
Open DOI Search in Google Scholar Back to article
Beauchet, O., Fantino, B., Allali, G., Muir, S.W., Montero-Odasso, M., Annweiler, C., Timed up and go test and risk of falls in older adults: A systematic review, J. Nutr. Heal. Aging, 2011, 15: 933–938. 10.1007/s12603-011-0062-0.
Open DOI Search in Google Scholar Back to article
Howard, C., Wallace, C., Stokic, D.S., Stride length–cadence relationship is disrupted in below-knee prosthesis users, Gait Posture, 2013, 38: 883–887. 10.1016/J.GAITPOST.2013.04.008.
Open DOI Search in Google Scholar Back to article
Hollman, J.H., McDade , E.M., Petersen, R.C., Normative spatiotemporal gait parameters in older adults., Gait Posture, 2011, 34: 111–8. 10.1016/j.gaitpost.2011.03.024.
Open DOI Search in Google Scholar Back to article
Agathos, C.P., Velisar, A., Shanidze, N.M., A comparison of walking behavior during the instrumented TUG and Habitual Gait, Sensors, 2023, 23: 7261. 10.3390/s23167261.
Open DOI Search in Google Scholar Back to article
Letournel, A., Marques, M., Vigário, R., Quintão, C., Quaresma, C., Biomechanical characterisation of gait in older adults: A cross-sectional study using inertial sensor-based motion capture., Bioeng. (Basel, Switzerland), 2025, 12: 12080889. 10.3390/bioengineering12080889.
Open DOI Search in Google Scholar Back to article
Vachranukunkiet, T., Esquenazi, A., Pathophysiology of gait disturbance in neurologic disorders and clinical presentations, Phys. Med. Rehabil. Clin. N. Am., 2013, 24: 233–246. 10.1016/j.pmr.2012.11.010.
Open DOI Search in Google Scholar Back to article
Hurd, W.J., Snyder‐Mackler, L., Knee instability after acute ACL rupture affects movement patterns during the mid‐stance phase of gait, J. Orthop. Res., 2007, 25: 1369–1377. 10.1002/jor.20440.
Open DOI Search in Google Scholar Back to article
Kataoka, Y., Saito, Y., Takeda, R., Ishida , T., Tadano, S., Suzuki, T., et al., Evaluation of lower-limb kinematics during timed up and go (TUG) test in subjects with Locomotive Syndrome (LS) using wearable gait sensors (H-Gait System), Sensors, 2023, 23: 687. 10.3390/s23020687.
Open DOI Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.37190/abb/224360 | Journal eISSN: 2450-6303 | Journal ISSN: 1509-409X

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Language: English

Page range: 51 - 62

Submitted on: Apr 1, 2026

Accepted on: Jun 9, 2026

Published on: Sep 23, 2026

Published by: Wroclaw University of Science and Technology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Aging,

Inertial sensors,

iTUG,

Older adults,

Timed Up and Go test,

Walk assessment

Related subjects:

Engineering,

Bioengineering and biomedical engineering,

Cellular and tissue engineering,

Biomechanics,

Medicine,

Biomedical engineering,

Materials sciences,

Biomaterials and natural materials

© 2026 Piotr Szaflik, Katarzyna Nowakowska-Lipiec, Hanna Zadoń, Robert Michnik, published by Wroclaw University of Science and Technology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 28 (2026): Issue 2 (June 2026)