The Timed Up and Go test: what it tells you about falls risk

If a physio or GP has ever asked you to stand up from a chair, walk a short distance, turn around and sit back down while they held a stopwatch, you have done the Timed Up and Go test, often called the TUG. It takes less than a minute, needs no special equipment, and gives a useful snapshot of how well you move. It is also one of the tools health professionals use when checking falls risk.

This guide explains what the TUG measures, what the times mean, its limits, and how to try it safely at home with someone beside you. It is general information only, not medical advice. A TUG time on its own is not a diagnosis, so talk to your GP or physiotherapist about your result and your falls risk.

The short answer

• The TUG times how long it takes to stand up from an armchair, walk 3 metres, turn, walk back and sit down.
• It was developed to measure basic functional mobility in older people, and the time relates well to balance, walking speed and daily function.
• The US Centers for Disease Control and Prevention’s STEADI program says an older adult who takes 12 seconds or more is at risk of falling.
• Research shows the TUG should not be used on its own to predict falls. It is one part of a full falls assessment.
• Strength and balance exercise can reduce the rate of falls, whatever your time.

What the TUG test is

The test was described in 1991 by researchers who timed a simpler “Get Up and Go” test with older patients at a geriatric day hospital. They found the time score was reliable, related closely to balance, walking speed and independence in daily activities, and seemed to predict whether someone could safely go outside alone (Podsiadlo and Richardson, 1991). They concluded it was quick, needed no special equipment, and was useful for following change over time.

That last point is where the TUG shines. Repeating it every few weeks is a simple way to see whether your mobility is improving with exercise or rehabilitation.

What does your time mean?

The CDC’s STEADI TUG instructions state that an older adult who takes 12 seconds or more to complete the test is at risk of falling. Other researchers have used different cut-offs, such as 13.5 seconds.

How the person moves matters as much as the time. STEADI suggests watching for:

• a slow, tentative pace
• loss of balance
• short strides or shuffling
• little or no arm swing
• steadying themselves on walls or furniture
• turning “en bloc”, moving the whole body in one piece
• not using their walking aid properly

These can point to problems that need further checking, even if the time looks fine.

The limits of the TUG

The TUG is useful, but it is not a crystal ball. A systematic review of community-dwelling older adults found it was better at ruling in higher risk than ruling it out, and concluded the TUG has limited ability to predict falls on its own and should not be used in isolation (Barry et al, 2014).

In practice, a good falls assessment also looks at your falls history, medicines, eyesight, feet and footwear, blood pressure, strength, balance, confidence and home environment. The TUG is one piece of that picture.

How to try the TUG safely at home

Safety first: only try this with another adult standing close beside you the whole time, ready to steady you. Do not try it if you have been told not to walk without help, if you feel dizzy or unwell, or if you have had a recent fall. It is not a race: walk at your normal, comfortable pace.

What you need

• a sturdy chair with armrests, placed against a wall so it cannot slide
• a clear, well-lit, non-slip path at least 3 metres long
• a tape measure and a piece of tape to mark the 3 metre line
• a stopwatch or phone timer
• your usual shoes and walking aid, if you use one

Steps

1. Sit back in the chair with your back against the backrest.
2. Your helper says “Go” and starts the timer.
3. Stand up from the chair. You can use the armrests.
4. Walk at your normal pace to the line on the floor.
5. Turn around.
6. Walk back to the chair at your normal pace.
7. Sit down. Your helper stops the timer when you are seated.

Write down the time, the date, and anything your helper noticed, such as unsteadiness or shuffling. Bring this to your next GP or physio appointment.

What to do with your result

• 12 seconds or more, or any unsteadiness: talk to your GP or a physiotherapist about a falls risk assessment.
• Under 12 seconds: that is reassuring, but it does not rule out falls risk, so keep active and mention any falls or near misses to your GP.
• Any result: strength and balance training helps. A Cochrane review found exercise reduces the rate of falls in older people living in the community by 23%, with balance and functional exercises particularly effective (Sherrington et al, 2019). Our guide to balance exercises for fall prevention is a good place to start.

When to see your doctor

See your GP if you:

• have had a fall or several near misses
• feel dizzy or light-headed when standing up
• notice your walking has changed, such as shuffling or tripping more
• find your TUG time is getting slower over time

Call triple zero (000) for sudden weakness on one side, sudden difficulty walking or speaking, or after a fall with a head injury and drowsiness or confusion.

Frequently asked questions

Can I use my walking frame for the test?

Yes. The test is done in your usual footwear with your usual walking aid, if you use one.

How often should I repeat the TUG?

Your physio may repeat it every few weeks during a program to track progress. At home, only repeat it with a helper present.

What if I cannot do the test without help?

That is useful information in itself. Do not attempt the test alone. Ask your GP or a physiotherapist for an assessment, which can be done safely in your own home with the right support.

Is a fast time always good?

Not necessarily. Rushing is unsafe and does not reflect everyday walking. The aim is your normal, comfortable pace.

Get a full falls assessment at home

At a home visit, our physiotherapists can assess your walking, balance and home environment together, then set a program to reduce your falls risk. Read about what to expect at your first home visit and our falls prevention guide, then make a referral or contact our team on 03 8824 0712.

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