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Receiver operating characteristic curve analysis of the timed up and go test as a predictive tool for fall risk in persons with stroke: a retrospective study
Physical Therapy Rehabilitation Science 2018;7:54-60
Published online June 30, 2018
© 2018 Korean Academy of Physical Therapy Rehabilitation Science.

Seung-yeop Lima, Byung-jun Leeb, Wan-hee Leeb

aEducation Team, Apsuninc, Seoul, Republic of Korea, bDepartment of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
Correspondence to: Wan-hee Lee, Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 01795, Republic of Korea, Tel: 82-2-3399-1633 Fax: 82-2-3399-1639 E-mail:
Received March 27, 2018; Revised April 21, 2018; Accepted April 26, 2018.
cc This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: Persons with chronic stroke fall more often than healthy elderly individuals. The Timed Up and Go test (TUG) is used as a fall prediction tool, but only provides a result for the total measurement time. This study aimed to determine the optimal cut-off values for each of the 6 components of the TUG.
Design: Retrospective study.
Methods: Thirty persons with chronic stroke participated in the study. TUG evaluation was performed using a wearable miniaturized inertial sensor. Sensitivity, specificity, and predictive values were calculated using the Receiver Operating Characteristic (ROC) curve analysis for the measured values in each section. Optimal values for fall risk classification were determined. Logistic regression analysis was used to investigate the risk of future falls based on TUG.
Results: The cut-off values of the 6 sections of the TUG were determined, as follows: sit-to-stand >2.00 seconds (p<0.05), forward gait >4.68 seconds (p<0.05), mid-turn >3.82 seconds (p<0.05), return gait >4.81 seconds (p<0.05), end-turn >2.95 seconds (p<0.05), and stand-to-sit >2.13 seconds (p<0.05). The risk of falling increased by 2.278 times when the mid-turn value was >3.82 seconds (p<0.05).
Conclusions: The risk of falls increased by 2.28 times when the value of the mid-turn interval exceeded 3.82 seconds. Therefore, when interpreting TUG results, the predictive accuracy for falls will be higher when the measurement time for each section is analyzed, together with the total time for TUG.
Keywords : Accidental falls, Receiver operating characteristic curve, Walking


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