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TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE WITH LOWER LIMB AMPUTATION. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; 
ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32036                                                                            

 

1 

 
OPEN  ACCESS 

ABSTRACT (ORAL PRESENTATION) 
 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ESTABLISHING THE RELIABILITY AND VALIDITY OF THE COMPONENT TIMED-

UP-AND-GO TEST TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE 

WITH LOWER LIMB AMPUTATION 

Sheila Clemens*1,2, Ignacio Gaunaurd 1,2 ,Jennifer Lucarevic2, Glenn Klute3, Neva Kirk-Sanchez2, Christopher 

Bennett4, Robert Gailey1,2 

1 Miami VA Healthcare System, Miami, FL, USA. 
2Department of Physical Therapy, University of Miami, Coral Gables, FL, USA. 
3Rehabilitation Research and Development, VA Puget Sound Health Care System, Seattle, WA,USA. 
4Music Engineering Technology Program, University of Miami, Coral Gables, FL, USA. 

* Email: clemens.sheila@gmail.com 

DOI: https://doi.org/10.33137/cpoj.v1i2.32036  

 

INTRODUCTION 

Studies suggest that brief bouts of activity consisting of 

sit-to-stand transitions, gait initiation, turning and 

negotiation of obstacles, are essential tasks of daily 

mobility, as well as prosthetic mobility1,2. Using outcome 

measures deemed reliable for use in the amputee 

population is ideal3,4. The purpose of this study was to 

investigate the reliability and validity of a component 

timed-up-and-go test (cTUG), using a mobile application 

(App), to evaluate basic prosthetic mobility tasks in 

people with lower limb amputation (LLA). The cTUG 

captures time required to perform the subtask 

components of sit to stand transitions, linear gait, and a 

180˚ turn that are requisites of the standard TUG test. It 

was hypothesized that the cTUG would demonstrate test-

retest reliability, differentiate between groups based on 

anatomical level of amputation, and exhibit convergent 

validity with other measures of prosthetic mobility and 

balance. 

METHODS 

Subjects performed 4 trials of the cTUG; turning twice 

toward and away from their prosthetic limb. The cTUG 

was performed on top of a sensored gait mat to capture 

additional gait parameters. A total time to perform the 

test was recorded, as well as 5 component times: 1) sit to 

stand, 2) walk entering the turn, 3) 180 degree turn, 4) 

walk exiting the turn, 5) turn to sit. A custom mobile 

application was used to capture the time intervals. All 

data was recorded using an iPad Air 2.   

RESULTS 

A convenience sample of 118 individuals with LLA. All 

participants had non-vascular cause of unilateral LLA at 

the transtibial (TTA) or transfemoral (TFA) level, and 

were between 18-80 years old, ambulating a minimum of 

8 m  independently.  Groups  were  compared  based  on  

 

their level of amputation. The mean age of the cohort was 

48.1 years, comprised of 54% males, with 53% having 

TFA. Test-retest analyses resulted in an ICC=.98 (F=.19; 

95% CI .97, .99) for the total performance time, and ICCs 

ranged from .71-.94 for each component time. Moderate 

correlations existed between the cTUG and PLUS-M (rs= 

-.56) suggesting convergent validity. Significant 

differences existed between the TTA and TFA groups 

(p<.05) for total time and each component time of the 

cTUG suggesting known-groups validity. Additionally, 

it was determined that people with TFA use different 

strategies to turn 180˚ compared to those with TTA. 

 

Table 1. Known-groups validity of the cTUG 

 

mailto:clemens.sheila@gmail.com
https://doi.org/10.33137/cpoj.v1i2.32036


 

 

Clemens S, Gaunaurd I, Lucarevic J, Klute G, Kirk-Sanchez N, Bennett C, Gailey R.ESTABLISHING THE RELIABILITY AND VALIDITY OF THE COMPONENT TIMED-UP-AND-GO TEST 
TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE WITH LOWER LIMB AMPUTATION. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; 
ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32036                                                                            

 

2 

 
OPEN  ACCESS 

ABSTRACT (ORAL PRESENTATION) 
 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

CONCLUSION 

The cTUG is a reliable and valid measure of basic 

prosthetic mobility in community-dwelling people with 

LLA. This study found differences between people with 

TFA as compared to TTA in the cTUG total time and all 

components times, confirming that basic prosthetic 

mobility skills vary between levels of amputation. 

SIGNIFICANCE 

An instrument for measurement of prosthetic mobility, 

the cTUG, has been developed for use on people with 

LLA. Preliminary psychometric analyses indicate 

excellent reliability and validity for use in the amputee 

population, providing a powerful clinical tool.  

REFERENCES 

1. Orendurff et al. How humans walk: Bout duration, steps per 

bout, and rest duration. J Rehabil Res Dev,2008; 45, 1077-89. 
DOI: 10.1682/JRRD.2007.11.0197  

2. Bussman J, Schrauwen HJ, Stam HJ. Daily physical activity 

and heart rate response in people with a unilateral traumatic 

transtibial amputation. Arch Phys Med Rehabil. 2008; 89, 430-

4. DOI:10.1016/j.apmr.2007.11.012 

3. Resnik L, Borgia M. Reliability of outcome measures for 

people with lower-limb amputations: distinguishing true 

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4. Deathe et al. Selection of outcome measures in lower 

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https://doi.org/10.1016/j.apmr.2007.11.012
https://doi.org/10.2522/ptj.20100287
https://doi.org/10.1080/09638280802639491

