Quick answer: Give the standardised “Go” instruction, start timing when the patient begins to rise, stop when they sit back down. Normal TUG for healthy adults under 60 is under 10 seconds. A score of 12 seconds or more in community-dwelling older adults indicates elevated fall risk (Shumway-Cook et al., 2000). Use our free TUG calculator for instant scoring, age-normed comparison, and EMR documentation.
What Is the Timed Up and Go Test?
The Timed Up and Go (TUG) test is a standardised clinical mobility assessment that measures the time taken for a patient to rise from a chair, walk three metres, turn, walk back, and sit down again. Originally developed by Podsiadlo and Richardson in 1991 as a timed modification of the “Get Up and Go” test (Mathias et al., 1986), it has become one of the most widely used functional mobility measures in geriatric and neurological rehabilitation worldwide.
The TUG captures a complex sequence of motor tasks — sit-to-stand transfer, initiation of gait, turning, and sit-down — making it sensitive to a broad range of functional impairments. Unlike static balance measures such as the Berg Balance Scale, the TUG incorporates dynamic gait and directional change, giving clinicians a quick, ecologically valid snapshot of mobility and fall risk.
When to Use the TUG
- Community-dwelling older adults — fall risk screening and baseline functional assessment
- Post-stroke rehabilitation — gait and transfer assessment at any recovery stage
- Parkinson’s disease — mobility monitoring alongside disease progression
- Total hip or knee arthroplasty — pre- and post-surgical functional comparison
- Multiple sclerosis — lower extremity function and ambulation status
- Lower limb amputees — prosthetic functional capacity (K-level assessment support)
- Vestibular disorders — dynamic balance and gait initiation
- Any patient where basic functional mobility needs to be quantified quickly
Equipment Required
- Standard armchair — seat height approximately 46 cm (18 inches), armrest height approximately 65 cm (25.6 inches)
- Tape mark or cone on the floor exactly 3 metres from the front legs of the chair
- Stopwatch — not a phone timer (start/stop delay affects accuracy)
- Patient’s usual footwear and customary walking aid (if any)
Standardised Administration Protocol — Step by Step
Standardisation is the single most important factor in TUG reliability. The inter-rater reliability of the TUG is excellent (ICC = 0.92–0.99) when administered with consistent instructions — and significantly worse when instructions are paraphrased or timing methods vary.
Step 1 — Setup
Position the chair against a wall for safety. Measure exactly 3 metres from the front legs of the chair to a clearly visible tape line or cone. The patient sits fully back in the chair with their back against the backrest, arms resting on the armrests, and their walking aid (if used) within reach.
Step 2 — Practice trial
Allow one unpracticed walk-through before timing. Instruct: “I would like you to stand up, walk to the line, turn around, walk back, and sit down. I will say ‘go’ when I want you to start. Walk at your normal, comfortable pace.”
Step 3 — Timed trial
Say “Go” and start the stopwatch simultaneously. Stop timing the moment the patient’s buttocks make contact with the chair seat on return.
Step 4 — Observation during the test
While timing, observe and document:
- Gait initiation hesitancy or freezing
- Step length symmetry and cadence
- Trunk stability during walking
- Turning strategy — single pivot vs. multiple small steps
- Balance during the turn
- Chair contact strategy — controlled lowering vs. dropping
- Walking aid use and effectiveness
Step 5 — Number of trials
One practice trial, then record the mean of two timed trials. Some protocols use the best of three — document which protocol you use so reassessments are comparable.
Important: Never provide physical assistance during the timed trial. If the patient needs assistance, document this and score accordingly. Do not count a trial where you had to intervene.
TUG Scoring — What the Time Means
General Clinical Interpretation
| TUG Time | Interpretation | Functional implication |
|---|---|---|
| <10 seconds | Normal mobility | Freely mobile, independent ambulation in community |
| 10–12 seconds | Within normal limits — frail adults | Independent but may have some mobility concerns warranting monitoring |
| 12–20 seconds | Functional mobility — some limitations | Largely independent indoors; may need supervision for more demanding tasks |
| 20–30 seconds | Impaired mobility | Requires assistance outside home; elevated fall risk |
| >30 seconds | Dependent mobility | High fall risk; likely requires assistive device and supervision for most transfers |
The Primary Fall Risk Cut-off: 12 Seconds
The most clinically supported fall risk cut-off is 12 seconds, established by Bischoff et al. (2003) in community-dwelling women aged 65–85 years. A TUG of 12 seconds or more indicates elevated fall risk in this population, with the 10th–90th percentile range being 6.0–11.2 seconds for healthy women in this age group.
Shumway-Cook et al. (2000) established a cut-off of 13.5 seconds with a 90% correct prediction rate for identifying community-dwelling older adults at risk of falling. The TUG Cognitive variant (counting backwards while walking) showed a cut-off of 15.0 seconds at the same prediction rate.
TUG Age-Stratified Normative Data — Complete Tables
This is the most clinically important section — a raw TUG score means nothing without age-matched context. A 72-year-old scoring 14 seconds is performing below the normative mean for their age group, even though the absolute score suggests “functional mobility.”
Community-Dwelling Older Adults (Bohannon, 2006 — systematic review)
| Age Group | Mean TUG (seconds) | Range (10th–90th percentile) |
|---|---|---|
| 60–69 years | 8.1 | 6.0–11.4 |
| 70–79 years | 9.2 | 6.8–13.5 |
| 80–89 years | 11.3 | 7.1–18.0 |
| 90+ years | 15.7 | 10.2–26.8 |
Population-Specific Cut-offs (high clinical importance)
| Population | Fall-risk cut-off | Source |
|---|---|---|
| Community-dwelling older adults | ≥12 seconds | Bischoff et al., 2003 |
| Community-dwelling older adults (alternative) | ≥13.5 seconds | Shumway-Cook et al., 2000 |
| Parkinson’s disease | ≥11.5 seconds | Morris et al., 2001 |
| Post-stroke (subacute) | ≥19 seconds for limited community ambulation | Salbach et al., 2001 |
| Hip fracture post-surgery | ≥24 seconds predicts non-return to community | Kristensen et al., 2007 |
| Total knee arthroplasty | Pre-op mean ~17s; expected post-op (<12 weeks) ~13s | Almeida et al., 2019 |
Critical clinical note: Do not apply the community-dwelling older adult cut-off (12 seconds) to post-stroke or Parkinson’s patients. Population-specific thresholds exist because the relationship between TUG performance and fall risk differs significantly across clinical populations.
Minimal Detectable Change (MDC) — When Is a Change Clinically Real?
The MDC represents the smallest change that exceeds measurement error at a 90% or 95% confidence level. Changes smaller than the MDC cannot be confidently attributed to true functional improvement.
| Population | MDC90 | MDC95 | Clinical implication |
|---|---|---|---|
| Community-dwelling older adults | 2.9 seconds | 3.5 seconds | A patient improving from 14s to 11.5s = real change (exceeds MDC90) |
| Parkinson’s disease | 3.5 seconds | 4.2 seconds | Changes of 3 seconds or less are within measurement error |
| Post-stroke | 2.9 seconds | 3.5 seconds | Use same threshold as community older adults |
| Total knee arthroplasty | 2.0 seconds | 2.5 seconds | More sensitive to change — smaller changes detectable post-TKA |
Example documentation: Patient improved TUG from 16.4 seconds to 13.1 seconds (change = 3.3 seconds). This exceeds the MDC90 of 2.9 seconds for community-dwelling older adults, confirming genuine functional improvement beyond measurement error.
TUG Variants — Dual-Task and Modified Versions
The standard TUG measures physical mobility only. Adding a cognitive or manual secondary task creates dual-task variants that are more sensitive to fall risk in higher-functioning patients who score below 12 seconds on the standard test.
| Variant | Secondary task | Fall-risk cut-off | Best used for |
|---|---|---|---|
| TUG Standard | None | ≥12–13.5 seconds | All populations — first-line assessment |
| TUG Manual (TUG-M) | Carry a full glass of water without spilling | ≥14.5 seconds | Detecting attentional demands of mobility in older adults |
| TUG Cognitive (TUG-C) | Count backwards from a random number (e.g., 93) by threes | ≥15.0 seconds | Detecting cognitive-motor interference — Parkinson’s, MCI, early dementia |
A significant difference between TUG Standard and TUG Cognitive (>3.5 seconds) indicates cognitive-motor interference and is associated with increased fall risk even when the standard TUG is within normal limits.
TUG vs Berg Balance Scale — When to Use Which
| Assessment | Time | Best for | Limitation |
|---|---|---|---|
| TUG | 5 minutes | Quick functional mobility screen; includes gait and transfer | No item-level information; ceiling effect in high-functioning patients |
| Berg Balance Scale | 15–20 minutes | Comprehensive 14-task balance assessment; item-level diagnostic detail | No gait component; floor effect in severely impaired patients |
| Gait Speed (10MWT) | 5 minutes | Pure gait speed measurement; community ambulation prediction | No transfer or turning component |
For most clinical contexts, the TUG and Berg Balance Scale are used together — the TUG provides a quick functional mobility index, while the Berg provides a detailed item-level profile of which specific balance tasks are impaired.
SOAP Note Documentation Template
Example entry:
Timed Up and Go (TUG) administered per Podsiadlo & Richardson (1991) standardised protocol. Walking aid: standard quad cane (patient’s usual aid). Two timed trials completed following one practice trial. Trial 1: 17.2 seconds. Trial 2: 16.8 seconds. Mean: 17.0 seconds.
Interpretation: Score of 17.0 seconds exceeds the fall-risk cut-off of 12 seconds for community-dwelling adults (Bischoff et al., 2003) and falls below the age-specific normative mean of 9.2 seconds for adults aged 70–79 years (Bohannon, 2006). Indicates impaired functional mobility with elevated fall risk. Observed: prolonged gait initiation, reduced right step length, and multi-step turning strategy suggesting right lower extremity weakness.
MDC90 for this population: 2.9 seconds. A minimum improvement of 2.9 seconds is required at reassessment to confirm genuine functional change beyond measurement error.
Plan: Targeted interventions for sit-to-stand transfer strength (bilateral lower extremity), gait initiation, and turning stability. Reassess TUG in 4 weeks.
Free TUG Calculator
Our free Timed Up and Go calculator includes a built-in stopwatch, automatic age-normed comparison, fall risk classification, MDC threshold display, and EMR-ready SOAP documentation. No login required, works on any device including mobile at bedside.
→ Open the free TUG Calculator
Frequently Asked Questions
What is a normal TUG test score for a 70-year-old?
For community-dwelling adults aged 70–79, the mean TUG score is 9.2 seconds, with the 10th–90th percentile range of 6.8–13.5 seconds (Bohannon, 2006). A 70-year-old scoring above 12 seconds is above the fall-risk cut-off and below the normative mean for their age group, warranting targeted balance and mobility intervention.
How do you start and stop timing on the TUG test?
Start timing on the word “Go” — not when the patient begins to move, but on your verbal cue. Stop timing the moment the patient’s buttocks make contact with the chair seat after returning. This standardised start/stop method is critical for reliable inter-rater comparisons.
Can the patient use their walking aid during the TUG?
Yes — the patient uses their customary walking aid. Document which aid was used for every administration so that reassessments are comparable. A TUG performed with a cane cannot be directly compared to a later test performed without one.
What is the MDC for the Timed Up and Go test?
The MDC90 is 2.9 seconds for community-dwelling older adults and 3.5 seconds for patients with Parkinson’s disease. Changes smaller than these thresholds are within measurement error and cannot be confidently attributed to genuine functional improvement.
Is one trial or two trials the standard for TUG?
The most widely used protocol is one practice trial followed by the mean of two timed trials. Some protocols record the best of three timed trials. The key is consistency between assessments — use the same protocol every time with the same patient.
Can TUG be used with dementia patients?
Yes, with modification. The TUG can be administered to patients with mild-to-moderate dementia using simplified, repeated instructions and a demonstration. The TUG Cognitive variant (counting backwards) is particularly useful for detecting cognitive-motor interference in early dementia and MCI populations.
Related Calculators
Use these alongside the TUG for a comprehensive balance and mobility assessment:
- Berg Balance Scale — 14-task static and dynamic balance assessment
- Gait Speed Calculator (10 Meter Walk Test) — community ambulation prediction
- Tinetti Balance Assessment — balance and gait subscores for older adults
References
- Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148. PMID: 1991946.
- Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903. PMID: 10960937.
- Bischoff HA, Stähelin HB, Monsch AU, et al. Identifying a cut-off point for normal mobility: comparison of the timed ‘up and go’ test in community-dwelling and institutionalised elderly women. Age Ageing. 2003;32(3):315-320. PMID: 12720619.
- Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29(2):64-68. PMID: 16914068.
- Morris S, Morris ME, Iansek R. Reliability of measurements obtained with the Timed “Up & Go” test in people with Parkinson disease. Phys Ther. 2001;81(2):810-818. PMID: 11175678.
- Salbach NM, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards CL. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Phys Ther. 2001;81(8):1428-1438. PMID: 11509073.
Written by Nikhil Mahajan, PT, MPT | Last reviewed: June 2026 | Free TUG Calculator →