Can You Walk the Talk? Exploring Distractions and the Timed Up and Go Test

Do your background research.

Confirm which cognitive task you will have participants complete during the Timed Up and Go Test. Make sure you use the same task for each participant. 

1. Choose a task that is appropriate for all of your participants’ age and ability levels.

2. Choose the task from the following options:

   1. Ask the participant to count backward from 20. 

   2. Ask the participant to say their ABCs.

3. If the participant completes the cognitive task before completing the TUG test, the participant should restart the cognitive task until the TUG test is completed.

4. It is a good idea to do a “test run” performing the cognitive task while completing the TUG test. You can do this yourself or ask a friend to help you.

Use your lab notebook or computer to prepare a data table like Table 1. 

1. Add enough rows for each participant.

2. For each participant, you will record their name, age, order of the trials, 3 columns for completing the TUG test without a distraction, and 3 columns for completing the TUG test with a distraction. 

3. Add a column to average the trials for the TUG test without a distraction and a column to average the trials for the TUG test with a distraction.

4. Make sure to add a column to note any observations you make during testing, such as observations on how smooth the turn is, how steady the walking is, how much the participants’ arms swing, or how smooth the participants stand or sit.

Determine a random order for each participant’s trials.

1. Choose a coin’s “heads” as the distracted trial and “tails” as the non-distracted trial.

2. Flip the coin to determine the order of your trials.

   1. For example, the first time you flip the coin, it lands on heads. The first trial the participant will conduct will be a distracted trial.

3. Flip the coin as many times as you need to determine order for all 6 trials (3 distracted and 3 non-distracted).

4. Record the order of trials on your data table, as shown in Table 1.

Find a testing space that allows ample room for the participants to complete the TUG test.

1. Acceptable flooring conditions include: carpet, wood, concrete, asphalt, rubber flooring (such as that commonly used in gyms)

2. Unacceptable flooring conditions include: flooring transitions (for example, switching from carpet to tile in the middle of the testing distance), uneven surfaces, loose materials (for example, gravel or mulch), slippery surfaces.

Place your chair on one end of the room (leave space between the wall and your chair so the chair isn’t touching the wall) and mark 3 meters from the chair on the floor using tape. You may also optionally place a cone on the line for the participant to walk around.

Explain to each participant the procedure of your test.

1. Explain the cognitive task that you will use as a distraction, confirmed in Step 2. Model the TUG test (with and without distraction) for them and ensure they understand the cognitive task and the TUG test.

2. Begin by having the participant sit with their back against the back of a standard armchair.

3. Instruct the participant not to use their arms on their own legs or on the arms of the armchair to stand or sit, unless necessary to ensure safety. 

4. Help participants identify the line (or cone) 3 meters away on the floor.

Give participants instructions according to the TUG test.:

1. “Start with your feet placed on the floor and your back up against the back of the chair.

2. When I say “Go” I will start the timer and I want you to start the cognitive task while you:

   1. Stand up from the chair, without using your arms.

   2. Walk to the line (or cone) on the floor at your normal pace.

   3. Turn around the line (or cone) on the ground.

   4. Walk back to the chair at your normal pace.

   5. Sit down again, without using your arms, with your back against the back of the chair.

3. I will stop timing when your back hits the back of the chair.”

Have the participant perform one practice trial to verify they are understanding and following your instructions.

Ask the participant if they are ready to begin testing. 

1. If the participant is ready, verify their back is against the back of the chair and continue with Step 11. 

2. If the participant needs a rest, allow them to rest up to one minute (60 seconds) before beginning the timed test. 

On the word “Go,” begin timing. While the participant is walking, have an adult nearby to help if the participant loses their balance and needs assistance. Stop timing after the participant sits back down with their back against the back of the chair.

1. While the participant rests for up to one minute (60 seconds) between trials, record the time for each trial in your data table.

2. Repeat for each trial.

   1. Have participants complete the TUG test without distractions (no talking) 3 times, according to the random order determined by the coin flip. 

   2. Have participants complete the TUG test with distractions (cognitive task) 3 times, according to the random order determined by the coin flip. 

3. For each participant, complete all of the trials within the same experimental session.

Analyze the results.

1. Average the results for each test condition (distraction vs. no distraction) for each participant.

2. Calculate the average time difference for each participant by subtracting the average non-distracted time from the average distracted time.

3. Compare results for each participant by making a bar graph of the averages (with distraction and without distraction) for each participant. 

4. Is there a difference between the non-distracted and distracted testing conditions? If so, on average, did people complete the TUG test faster while distracted or not distracted? 

5. Do younger participants complete the TUG test faster than the older participants? Does this change when the participants are distracted?