title: Dynamic Stability and Risk of Tripping during the Timed Up and Go Test in Hemiparetic and Healthy Subjects.
abstract: BACKGROUND
  The Timed Up and Go (TUG) test is often used to estimate risk of falls. Foot clearance and displacement of the center of mass (COM), which are related to risk of tripping and dynamic stability have never been evaluated during the TUG. Accurate assessment of these parameters using instrumented measurements would provide a comprehensive assessment of risk of falls in hemiparetic patients. The aims of this study were to analyze correlations between TUG performance time and displacement of the COM and foot clearance in patients with stroke-related hemiparesis and healthy subjects during the walking and turning sub-tasks of the TUG and to compare these parameters between fallers and non-fallers.
  
  
  METHODS
  29 hemiparetic patients and 25 healthy subjects underwent three-dimensional gait analysis during the TUG test. COM and foot clearance were analyzed during the walking and turning sub-tasks of the TUG.
  
  
  RESULTS
  Lateral displacement of the COM was greater and faster during the walking sub-tasks and vertical displacement of the COM was greater during the turn in the patients compared to the healthy subjects (respectively p<0.01 and p<0.05). Paretic foot clearance was greater during walking and displacement of the COM was slower during the turn in the patients (p<0.01). COM displacement and velocity during the turn were correlated with TUG performance in the patients, however, vertical COM displacement was not. These correlations were significant in the healthy subjects. There were no differences between COM parameters or foot clearance in fallers and non-fallers.
  
  
  CONCLUSIONS
  Hemiparetic patients are less stable than healthy subjects, but compensate with a cautious gait to avoid tripping. Instrumented analysis of the TUG test appears relevant for the assessment of dynamic stability in hemiparetic patients, providing more information than straight-line gait.
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 1429, APHP Laboratoire d'analyse du mouvement, Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Bonnyaud
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 1429, APHP Laboratoire d'analyse du mouvement, Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Pradon
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 1429, APHP Service de médecine physique et réadaptation, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Djamel
authors.initials: D
authors.lastname: Bensmail
authors.affiliation: Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 1429, APHP Laboratoire d'analyse du mouvement, Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology*; D018570:Risk Assessment; D020521:Stroke / Q000150:complications / Q000503:physiopathology*