[One Day Ten Thousand Steps] "Check Your Health with a 3m Round-Trip Walk"... The 'TUG Test' Involves Standing Up and Returning to the Starting Point

Chair, Turning Point, and Stopwatch Make Testing Easy
If It Takes Over 10 Seconds to Return, Physical Function Decline
Predicts Fractures, Dementia, Disabilities... Starting Point for Health Management

[Asia Economy Reporter Lee Gwan-ju] Walking is not only a good exercise in itself but also an excellent method to check one’s health condition. The representative walking test, the Timed Up and Go (TUG) test, can be easily performed anytime and anywhere as long as there is a chair and enough space, even outside of a hospital. Despite its short duration, it has high accuracy and can predict the likelihood of fractures, dementia, and disabilities in the future, making it highly efficient. Generally, it is widely conducted for seniors aged 65 and older, who are at a life transition stage, but it also has sufficient accuracy for younger age groups.

A scene from a video introducing the 'Timed Up and Go (TUG) test.' A chair is placed, and a white tape marking the turnaround point is attached 3 meters away.
[Photo by YouTube 'Physiotutors' capture]

Can Be Done at Home with Just a Chair

The TUG test is conducted in a very simple way. All you need is one chair, an object to place at the turnaround point, a space of at least 3 meters, and a stopwatch. First, place the chair and put an object 3 meters ahead at the turnaround point. The person being tested sits on the chair with their back against it, wearing comfortable shoes. When the assistant gives the signal, the person stands up, walks around the turnaround point at their usual walking speed, returns, and sits back down with their back against the chair. The assistant measures the time from the initial signal until the person sits back down. Assuming the person is healthy, it usually takes just over 10 seconds. Although more precise testing and consultation can be done at hospitals or health screening centers, since the method is not difficult, one can easily check their condition at home.

If there are no walking problems and physical functions are healthy, the average times are about 5 seconds for people in their 20s and 30s, 6 seconds for those in their 40s and 50s, 7 seconds for those in their 60s, and 8 seconds for those in their 70s. The general standard is that if the process can be completed within 10 seconds, walking ability and other functions are considered normal. However, if it takes longer, it is regarded as a partial decline in physical function. If it exceeds 20 seconds, it is evaluated that assistance is needed when walking. Although it may seem simple at first glance, medically, the TUG test has been proven to be an accurate test that comprehensively evaluates physical functions such as balance, leg strength, and walking speed. In South Korea, it is included in the health screening items for seniors aged 65, making it relatively easy to receive professional testing.

Predicting Risks from Falls to Fractures, Dementia, and Disabilities

The TUG test is usually conducted to prevent falls. As muscle strength and joints weaken with age, it is used as a predictive measure through early testing. Recently, continuous research has confirmed that the TUG test can predict various diseases. First, if there is a problem with walking function, the risk of developing dementia increases. In 2018, a research team from Seoul National University Hospital and Samsung Seoul Hospital analyzed 49,283 people who underwent the TUG test and investigated whether they were prescribed dementia medication after the test, confirming a correlation. The group with walking disabilities (TUG test time of 10 seconds or more) had a 1.34 times higher risk of developing dementia within six years compared to the normal group. Specifically, the risk was 1.65 times higher for vascular dementia and 1.26 times higher for Alzheimer’s dementia.

In 2019, research also showed that poor TUG test results are associated with an increased risk of fractures. Osteoporosis often has no symptoms and is recognized only after fractures occur, but the TUG test can be a good tool for screening. A research team from Samsung Seoul Hospital and Boramae Hospital analyzed the correlation between TUG test results and fracture treatment experience in 1.07 million people. They found that seniors with TUG times in the 10-second range and those over 20 seconds had fracture risks 8% and over 20% higher, respectively, than those under 10 seconds. Professor Shin Dong-wook of Samsung Seoul Hospital’s Department of Family Medicine said, "It is important to screen asymptomatic osteoporosis to identify those at high risk of fractures early," adding, "If the fracture risk is high, accurate diagnosis and active management through calcium and vitamin D supplementation and medication are necessary."

Last year, notable research related to the TUG test was also published. Professor Son Ki-young’s research team at Seoul Asan Hospital’s Department of Family Medicine confirmed that taking more than 10 seconds on the TUG test significantly increases the risk of disabilities related to the brain, vision, hearing, language, and mental health. Older adults with reduced walking ability had a 1.6 times higher incidence of disabilities compared to normal seniors. Specifically, when converted to 1,000 person-years (assuming 1,000 people observed for one year), the incidence of disabilities in the normal TUG group was 0.215, while the abnormal group showed 0.354. The types of disabilities included brain injury, visual impairment, hearing impairment, language impairment, and mental disorders.

Professor Son Gi-yeong, Department of Family Medicine, Asan Medical Center, Seoul. [Photo by Asan Medical Center, Seoul]

As such, the TUG test can predict various health conditions through a simple method. If the test result exceeds 10 seconds, more proactive health management is necessary. Professor Son emphasized, "For seniors transitioning from middle age to old age, it is important to accurately assess frailty through health screenings," adding, "If physical function is declining, it is essential to consistently perform strength exercises such as squats and lunges that help strengthen the quadriceps, and to maintain thorough health management by consuming sufficient protein."