Predictors of Timed “Up-and-Go” Test in Elderly with

Knee Osteoarthritis

Priscila Marconcin, Margarida Espanha, Flávia Yázigi and Júlia Teles

Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, 1499-002, Lisboa, Portugal

Keywords: Knee Osteoarthritis, Physical Assessment, Timed “Up-and-Go” Test, Elderly.

Abstract: Knee Osteoarthritis (KOA) and aging are conditions that can compromise physical function and quality of

life of human being. Thus, performance-based tests and specific self-reported measures related with KOA

and general health-related quality of life (QoL) should be used in clinical intervention with elderlies. The

study aim was to investigate which factors best predict the performance of the Timed “up-and-go” test in the

elderly people with KOA. Eligibility criteria were age ≥ 60 years and uni or bilateral KOA. Subject

performed physical tests [Timed “up-and-go” (TUG), Six Minutes Waking Test (6MWT), Five Repetition

Sit-to-Stand Test (FRSTST)], Handgrip, 6 meters gait speed, Standing Balance], and filled self-reported

questionnaires [Knee Injury and Osteoarthritis Outcome Score (KOOS), health-related quality of life (EQ-

5D-5F) and International Physical Activity Questionnaire (IPAQ)]. Pearson and Spearman coefficients were

used for correlation analysis and multiple linear regression analysis to identify the significant predictors of

Timed “up-and-go”. Results: Final sample included 67 patients, 69±6 years of age. Timed “up-and-go” can

be explained by two models. The best model (explained 80.7% of variance) included FRSTST, 6MWT, Gait

Speed, KOOS ADL and EQ-5D-5F Self-Care variables. Conclusion: Functional strength, mobility, gait

speed, and perceived limitation in activities of daily living influenced the TUG performance.

1 INTRODUCTION

Knee Osteoarthritis (KOA) is a joint disease that

most often affects middle-age to elderly individuals,

leading the cause of lower extremity disability and

loss of functionality in this population (Johnson and

Hunter, 2014).

The burden of KOA can be measured in terms of

its signs and symptoms. Pain is the main symptom

that incapacitates the individual to perform daily

activities (Tanimura et al., 2011), which directly

affects physical function. Several studies have

shown the relationship between symptomatic KOA

with physical disabilities (Davis et al., 1991;

Machado et al., 2008; Wood et al., 2008).

Furthermore, a 3-years cohort study with hip and

KOA patients (van Dijk et al., 2010) refereed pain,

reduced range of motion (ROM) and decreased

muscle strength as good predictors of self-reported

limitation in daily activities.

Controversially, a study with 2545 subjects with

radiographic KOA shows no effects of physical

activity (Physical Activity Scale for the Elderly) on

knee pain (WOMAC) and a very small effect or no

effect on functional performance (20-meters walk

test) (Mansournia et al., 2012).

Results among studies may differ due to the use

of different physical function outcome measures in

people with KOA, which can be measured by self-

report methods or performance-based tests, and a

combination of both is recommended to provide

additional information (Stratford and Kennedy,

2006).

Therefore, the Osteoarthritis Research

International Society (OARSI), through an expert

advisory group, recommended a set of five physical

performance measures for hip and KOA: 30-s chair-

stand test, 40 m fast paced walk test, a stair-climb

test, 6MWT and Timed “up-and-go”, which was the

most feasible of the performance-based tests

(Dobson et al., 2013).

Elderly people with KOA have muscle

weakness, which is attributed both to skeletal muscle

wastage and sarcopenia (Wilhelm et al., 2014), and

also to neural inhibition caused by pain which

prevents the complete muscle activation,

compromising physical function. An European study

about sarcopenia suggested a set of measurements

Marconcin, P., Espanha, M., Yázigi, F. and Teles, J..

Predictors of Timed “Up-and-Go” Test in Elderly with Knee Osteoarthritis.

In Proceedings of the 3rd International Congress on Sport Sciences Research and Technology Support (icSPORTS 2015), pages 97-103

ISBN: 978-989-758-159-5

which can be used as an indicative of sarcopenia: the

Short Physical Performance Battery (SPPB), that

evaluates balance (side-by-side stand, tandem and

semi-tandem position), gait speed (8 ft walk), lower

strength (time to rise from a chair and return to the

seated position five times) (Cruz-Jentoft et al.,

2010). This battery is highly predictive of

subsequent mobility-related disability,

institutionalization, and mortality (Guralnik et al.,

1994). Moreover, sarcopenia is strongly correlated

to risk of fall, and Timed “up-and-go” test seems to

be a sensitive and a specific measure for identifying

community-dwelling adults who are at risk of falls

(Shumway-Cook et al., 2000), and a good predictor

of sarcopenia in hospitalized patients (Martinez et

al., 2015).

The physical mobility is an essential component

of the geriatric assessment of the frail elderly

individual (Podsiadlo and Richardson, 1991), where

the Timed “up-and-go” test is widely used for daily

mobility skills assessment in this population

(Podsiadlo and Richardson, 1991).

Thus, the aim of this study was to investigate

which factors best predict the performance of elderly

individuals with symptomatic KOA in the Timed

“up-and-go” test.

2 METHODS

2.1 Sample

The recruitment and sample selection were done in

the Lisbon area and, to avoid convenience sampling,

different strategies for announcement by

communication channels were use: social networks,

newspapers, magazines, contacts with senior

universities, health centers, churches and community

centers.

Community-dwelling elderly with persistent

knee pain, age over than or equal to 60 years, with

KOA diagnosed according clinical and radiological

criteria of the American College of Rheumatology

(ACR) (Altman et al., 1986), independently mobile

and literate were selected to participate in the study.

The exclusion criteria were: (1) having undergone

surgery for knee replacement; or go to perform

surgery to place knee(s) prosthesis in the next eight

months; (2) have made applications (injections) of

corticosteroids or hyaluronic acid in the last 6

months. The eligible subjects, according to the

aforesaid eligibility criteria, were invited to an

interview for explanation of the study and gave their

written informed consent.

2.2 Measures and Instruments

The measures and instruments used were: (1) socio

demographic questionnaire (sex, age, educational

level, body index mass (BMI) and marital status);

(2) performance-based tests (physical mobility,

aerobic capacity, lower limb strength, hand grip

strength, gait speed and balance); (3) specific self-

reported measures related with KOA (pain, other

symptoms, daily living activities, sports and

recreations activities and quality of life), general

health-related quality of life (QoL) (mobility, self-

care, usual activities, pain/discomfort and

anxiety/depression) and (4) level of physical

activity.

Physical mobility was assessed by Timed “up-

and-go”, a test that incorporates multiple activities

including sit-to-stand, walking short distance,

changing direction during walking, and transitions

between them, allowing evaluation of strength,

agility and dynamic balance (Podsiadlo and

Richardson, 1991).

Aerobic capacity and mobility was measured by

the Six Minutes’ Walk Test (6MWT), that was a

valid measure for older adults (Rikli, 1998), and it

has been used in studies with KOA (Escalante et al.,

2011; Schlenk et al., 2011).

Lower limb strength was measured by the Five

Repetitions Sit to Stand Test (FRSTST) that is a

widely used measure of functional strength. ICC

values demonstrated from good to high test-retest

reliability for adults and subjects with osteoarthritis

(Bohannon, 1995; 2011; Schlenk et al., 2011).

For hand grip strength a dynamometer was used

to evaluate maximal isometric force of the hand and

forearm muscles. This test has been used in elderly

as an indicator of sarcopenia and/or disability (Alley

et al., 2014; Giampaoli et al., 1999).

Gait speed was assessed with a 6 meters test,

measuring the ability of linear walking since

acceleration and deceleration were excluded (Cesari

et al., 2009). This variable is also a primary outcome

of algorithm for sarcopenia in older individuals

(Cruz-Jentoft et al., 2010).

Balance was assessed by Standing Balance Test

(Rose, 2003), and both most painful and least

painful leg were assessed. For analysis, only the

most painful one was used.

Pain and other symptoms, function in daily living

(ADL), sports and recreations activities and quality

of life, related with the pathology, were evaluated by

the Knee Injury and Osteoarthritis Outcome Score

(KOOS). This questionnaire includes five

dimensions, a score in each of the five dimensions is

icSPORTS 2015 - International Congress on Sport Sciences Research and Technology Support

calculated as the sum of the items included and then

converted to a 0-100 scale, with 0 representing

extreme knee problems and 100 representing no

knee problems. The KOOS is validated for patients

with knee injury or with knee OA and is a reliable

and responsive self-administered instrument for

short-term follow-up (Roos and Lohmander, 2003).

The Portuguese validation was done by Gonçalves et

al., (2009).

The EQ-5D-5L is a generic instrument for

measuring health-related quality of life in five

dimensions: mobility, self-care, usual activities,

pain/discomfort and anxiety/depression. Each of

these dimensions has five levels of severity (no,

light, moderate and severe problems, and unable).

This instrument has similar psychometric techniques

as the EQ-5D (Pickard et al., 2007) and is validated

to the Portuguese population (Ferreira et al., 2013).

Level of physical activity was measured by short

form of the International Physical Activity

Questionnaire (IPAQ). Its reliability was verified in

many countries and with different populations

(Craig et al., 2003; Rutten and Abu-Omar, 2004).

2.3 Statistical Analysis

Prior to performing multiple linear regression

analysis to identify the significant predictors of

TUG, correlation analyses and independent samples

t-test were conducted to gain a better understanding

of how predictors are associated with TUG.

Pearson correlation coefficient (r) was used to

evaluate the correlation between continuous

variables, and Spearman correlation coefficient (r

)

was used in the case of ordinal variables. Some

rough guidelines were employed for designating the

strength of correlation: if | r | ≥ 0.7, the correlation is

considered strong; if 0.3  | r | < 0.7, is classified as

moderate; and if | r | < 0.3, the correlation is weak.

These guidelines were also used to classify

Spearman correlation coefficients (Sheskin, 2007).

Independent samples t-test was used to test if

there were significant differences in the mean values

of TUG between males and females. The candidate

predictors that were considered for the linear

regression model were the following: (i) age, sex,

BMI a risk or related factors; (ii) pain, others

symptoms; (iii) health related physical fitness

measures (aerobic capacity, lower limb strength,

hand grip strength); (iv) skill related fitness

measures (gait speed and balance); (v) general and

specific self-reported health-related QoL measures,

and (vi) physical activity. Multiple regression

analysis, using the backward elimination stepwise

method, was done to identify the significant

predictors of TUG. Residual analysis was conducted

to ensure no violation of the assumptions of

normality, homoscedasticity, linearity; Variance

Inflation Factor (VIF) and Durbin-Watson statistics

was used to verify if multicollinearity is present and

if errors were independent, respectively. All

statistical analyses were performed with the software

SPSS v.22 and a significance level of 5% was

considered.

3 RESULTS

Study sample included 67 participants, 47 female

and 20 male, with mean (SD) age of 69.1 (5.8)

years, Body Mass Index (BMI) of 31.2 (5.2) Kg/m

with 38.8% having obesity grade 1 and 94.0%

having bilateral KOA. The participants were mostly

retired (91.0%) and married (59.7%).

Independent samples t-test revealed that there

were significant differences in the mean values of

TUG between males and females (males: M = 6.19,

SD = 1.29; females: M = 7.19, SD = 1.84;

t(65) = 2.193 , p = .032). Among the other socio-

demographic variables, Timed “up-and-go” was

positively correlated with age (r = .285, p = .020;

weak correlation), education level (r

= .331,

p = .006; moderate association), and BMI (r = .379,

p = .002; moderate correlation). Relatively to

performance-based tests, Timed “up-and-go” was

strongly negatively correlated with 6MWT test

(r = .709, p < .001) and gait speed (r = .734,

p < .001); FRSTST showed a moderate positive

correlation with Timed “up-and-go” (r = .635,

p < .001); Balance showed a moderate negative

correlation with Timed “up-and-go” (r

= .347,

p = .004). Concerning KOOS dimensions, all of

them showed moderate negative correlations with

Timed “up-and-go” (Pain: r = .504, p < .001;

Symptom: r = .451, p < .001; ADL: r = .663,

p < .001; Sport/Rec: r = .562, p < .001; QoL:

r = .521, p < .001). Among EQ-5D-5L dimensions,

Timed “up-and-go” had moderate positive

correlations with Mobility (r

= .481, p < .001), Self-

care (r

= .566, p < .001), Usual activities (r

= .651,

p < .001), and Pain/Discomfort (r

= .311, p = .010).

Timed “up-and-go” showed no significant

correlations with the level of physical activity

(IPAQ).

Multiple regression analysis, using the backward

elimination stepwise method, allowed identifying

two models to predict Timed “up-and-go”. The

Predictors of Timed “Up-and-Go” Test in Elderly with Knee Osteoarthritis

variables FRSTST, 6MWT, Gait Speed, and KOOS

ADL were included in both models. The Model 1

contained also the variable EQ-5D-5F Self Care and

the Model 2, EQ-5D-5F Usual Activities instead of

EQ-5D-5F Self Care. The results indicated that in

Model 1 the five predictors explained 80.7% of the

variance of Timed “up-and-go” (R

= .807,

adj. R

= .787, F(6,60) = 41.719, p < .001) and

78.7% of the variance (R

= .787, adj. R

= .766,

F(6,60) = 37.057, p < .001) in case of Model 2. The

regression coefficients and standard error estimates

for both models are presented in Table 1.

Table 1: Predictor´s variables of TIMED “UP-AND-GO”.

Predictors - Model 1 B (SE) t p

Intercept

11.400

(0.921)

12.376 <.001

FRSTST (s)

0.145

(0.037)

3.940 <.001

6MWT

0.006

(0.002)

3.443

.001

Gait Speed

1.027

(0.359)

2.862

.006

KOOS ADL

0.016

(0.006)

2.487

.016

EQ-5D-5F Self

Care(1)

0.930

(0.330)

2.816

.007

EQ-5D-5F Self

Care(2)

1.181

(0.314)

3.755

<.001

Predictors - Model 2 B (SE) t p

Intercept

10.767

(0.958)

11.241 <.001

FRSTST (s)

0.151

(0.038)

4.003 <.001

6MWT

0.005

(0.002)

2.826

.006

Gait Speed

1.119

(0.373)

3.001

.004

KOOS ADL

0.017

(0.007)

2.448

.017

EQ-5D-5F Usual

Act(1)

0.795

(0.323)

2.462

.007

EQ-5D-5F Usual Act

(2)

0.706

(0.290)

2.437

.018

Abbreviations: 6MWT= six Minutes Walking Test; FRSTST=

Five Repetitions Sit to Stand Test; EQ-5D-5L= EuroQol 5-

dimensions 5- level; KOOS ADL=Knee injury and Osteoarthritis

Outcomes, Score Function in daily living (ADL)

The reference level for the predictors EQ-5D-5L Usual Act and

EQ-5D-5L Self Care was “At least moderate problems”, and (1)

represents “No problem” and (2) represents “Slight problems”.

4 DISCUSSION

Osteoarthritis is a highly disabling disease, and pain

and physical function are the core domains

recommended to be measured in people diagnosed

with KOA. Outcome measures, both self-reported

questionnaires and performance-based tests, should

be used for these assessments (Sabirli et al., 2013).

Performance measure and self-reported measure are

complementary, since they not measure the same

construct: self-report tests can show disability which

is the social side of the functional limitation

(Hoeymans et al., 1996), therefore, they cannot

substitute each other. Moreover, as this study

involved older adults that may underestimate or

overestimate their functional status, the use of these

two types of measures is advocate.

The Timed “up-and-go” test is one of the most

widely used tests of functional mobility, being

similar to many daily activities. In this study,

involving elderly individuals with KOA, we found

that Timed “up-and-go” was significantly associated

with pain and other OA symptoms, physical

function, and subjective general and specific health-

related quality of life factors. The strongest

predictors of this test were: FRSTST, 6MWT, Gait

Speed, KOOS ADL and EQ-5D-5F self-care and

usual activities dimensions.

It is understandable that FRSTST and gait speed

were predictors, as they are parts of the Timed “up-

and-go” test (Reid and Fielding, 2012). Although

6MWT is not incorporated in the Timed “up-and-

go” test, it reflects overall physical functional

performance and mobility, (Rikli, 1998), being

strongly associated with others functional tests like

Timed “up-and-go”.

Considering the self-reported measures, only the

EQ-5D-5F (self-care and usual activity dimension),

and KOOS ADL were included in the regression

models. Both questionnaires assess similar domains,

but in different ways, as EQ-5D-5F includes 5 levels

of severity, that only one should be reported, in each

of the dimensions, and in the KOOS ADL subscale a

final score is obtained from seventeen daily

activities performed in the previous week, assessing

therefore a wider range of activities.

It has previously been found in others studies

that health status (self-reported) is a predictor of

functional tests, namely the FRSTST (Lord et al.,

2002) and 6MWT (Lord and Menz, 2002).

In a related study, involving subjects with knee

and hip osteoarthritis, all dimensions/subscales of

KOOS and WOMAC had a moderate and inverse

relationship with Timed “up-and-go” (Juhakoski et

al., 2008; Sabirli et al., 2013), as occurred in this

study. However, it is important to highlight that all

KOOS’s subscales were correlated with each other,

therefore in the final multiple regression models

only ADL dimension was included.

In a study with 163 KOA patients, self-reported

icSPORTS 2015 - International Congress on Sport Sciences Research and Technology Support

100

measure of function (SF-36) was more influenced by

pain (WOMAC pain) than a performance-based

physical functioning test (Terwee et al., 2006), and

in a similar study, pain severity, obesity and

helplessness were the most important determinants

of physical function (Creamer et al., 2000).

Interestingly, in the present study Time “up-and-go”

performance was not influenced by self-reported

pain and other symptoms. One possible explanation

is because the test involves a quick activity [mean

(SD), 6.9s (0.2)] and therefore stimulus duration was

not sufficient to cause mechanical pain. It seems that

only when knee pain is severe, is significantly

associated with limited mobility (Lamb et al., 2000).

Pain and other OA symptoms probably has

influenced the Timed “up-and-go” that leads the

individual to exert less physical work and thereby

decreasing lower limb strength and power, indirectly

affecting Timed “up-and-go” performance.

It is challenging to select the best physical

function tests, especially in people with KOA that

might complain of mechanical pain if exposed to

overloading due to performance of several tests.

Thus, for this population, the Timed “up-and-go”

test may be most suitable than 6 meters test and

FRSTST.

5 CONCLUSIONS

In conclusion, the findings of this study indicate that

in older individuals with KOA, Timed “up-and-go”

performance is influenced by lower limb strength,

gait speed, mobility, and the perceived limitation in

performing activities of daily living.

Pain and other OA symptoms seem not to be as

relevant to the functionality, as strength and gait

speed, since they are associated with daily living

activities that seem to influence the functionality.

In a further study will be interesting to

investigate which physical fitness component the

Timed “up-and-go” test can predict.

ACKNOWLEDGEMENTS

The author wish to acknowledge the Ciência Sem

Fronteiras / CAPES – Brazil.

REFERENCES

Alley, D. E., Shardell, M. D., Peters, K. W., McLean, R.

R., Dam, T. T., Kenny, A. M., Cawthon, P. M.,

(2014). Grip strength cutpoints for the identification of

clinically relevant weakness. Journals of Gerontology.

Series A: Biological Sciences and Medical Sciences,

69(5), 559-566.

Altman, R., Asch, E., Bloch, D., Bole, G., Borenstein, D.,

Brandt, K., Christy, W., Cooke, T. D., Greenwald, R.,

Hochberg, M., et al., (1986). Development of criteria

for the classification and reporting of osteoarthritis:

Classification of osteoarthritis of the knee. Arthritis &

Rheumatism, 29(8), 1039-1049.

Bijlsma, J. W. J., Berenbaum, F., & Lafeber, F. P. J. G.,

(2011). Osteoarthritis: an update with relevance for

clinical practice. The Lancet, 377(9783), 2115-2126.

Bohannon, R. W., (1995). Sit-to-stand test for measuring

performance of lower extremity muscles. Perceptual

and Motor Skills, 80(1), 163-166.

Bohannon, R. W., (2011). Test-retest reliability of the

five-repetition sit-to-stand test: a systematic review of

the literature involving adults. Journal of Strength and

Conditioning Research, 25(11), 3205-3207.

Cesari, M., Kritchevsky, S. B., Newman, A. B.,

Simonsick, E. M., Harris, T. B., Penninx, B. W. Pahor,

M., (2009). Added Value of Physical Performance

Measures in Predicting Adverse Health-Related

Events: Results from the Health, Aging, and Body

Composition Study. Journal of the American

Geriatrics Society, 57(2), 251-259.

Craig, C. L., Marshall, A. L., Sjostrom, M., Bauman, A.

E., Booth, M. L., Ainsworth, B. E., Oja, P., (2003).

International physical activity questionnaire: 12-

country reliability and validity. Medicine & Science in

Sports & Exercise, 35(8), 1381-1395.

Creamer, P., LethbridgeCejku, M., & Hochberg, M. C.,

(2000). Factors associated with functional impairment

in symptomatic knee osteoarthritis. The Journal of

Rheumatology, 39(5), 490-496.

Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y.,

Cederholm, T., Landi, F., Zamboni, M., (2010).

Sarcopenia: European consensus on definition and

diagnosis: Report of the European Working Group on

Sarcopenia in Older People. Age Ageing, 39(4), 412-

423.

Davis, M. A., Ettinger, W. H., Neuhaus, J. M., & Mallon,

K. P., (1991). Knee osteoarthritis and physical

functioning: evidence from the NHANES I

Epidemiologic Follow-up Study. The Journal of

Rheumatology, 18(4), 591-598.

Dobson, F., Hinman, R. S., Roos, E. M., Abbott, J. H.,

Stratford, P., Davis, A. M., Bennell, K. L., (2013).

OARSI recommended performance-based tests to

assess physical function in people diagnosed with hip

or knee osteoarthritis. Osteoarthritis and Cartilage,

21(8), 1042-1052.

Escalante, Y., García-Hermoso, A., & Saavedra, J. M.,

(2011). Effects of exercise on functional aerobic

capacity in lower limb osteoarthritis: A systematic

review. Journal of Science and Medicine in Sport,

14(3), 190-198.

Ferreira, P. L., Ferreira, L. N., & Pereira, L. N., (2013).

Predictors of Timed “Up-and-Go” Test in Elderly with Knee Osteoarthritis

101

Contribution for the Validation of the Portuguese

Version of EQ-5D. Acta Médica Portuguesa, 26, 6.

Giampaoli, S., Ferrucci, L., Cecchi, F., Lo Noce, C., Poce,

A., Dima, F., Menotti, A., (1999). Hand-grip strength

predicts incident disability in non-disabled older men.

Age Ageing, 28(3), 283-288.

Goncalves, R. S., Cabri, J., Pinheiro, J. P., & Ferreira, P.

L., (2009). Cross-cultural adaptation and validation of

the Portuguese version of the Knee injury and

Osteoarthritis Outcome Score (KOOS). Osteoarthritis

and Cartilage, 17(9), 1156-1162.

Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R.

J., Berkman, L. F., Blazer, D. G., Wallace, R. B.,

(1994). A short physical performance battery assessing

lower extremity function: association with self-

reported disability and prediction of mortality and

nursing home admission. The Journals of

Gerontology, 49(2), M85-94.

Hoeymans, N., Feskens, E. J. M., van den Bos, G. A. M.,

& Kromhout, D., (1996). Measuring functional status:

Cross-sectional and longitudinal associations between

performance and self-report (Zutphen Elderly Study

1990–1993). Journal of Clinical Epidemiology,

49(10), 1103-1110.

Johnson, V. L., & Hunter, D. J., (2014). The epidemiology

of osteoarthritis. Best Practice & Research Clinical

Rheumatology, 28(1), 5-15.

Juhakoski, R., Tenhonen, S., Anttonen, T., Kauppinen, T.,

& Arokoski, J. P., (2008). Factors affecting self-

reported pain and physical function in patients with

hip osteoarthritis. Archives of Physical Medicine and

Rehabilitation, 89(6), 1066-1073.

Lamb, S., Guralnik, J., Buchner, D., Ferrucci, L.,

Hochberg, M., Simonsick, E., & Fried, L., (2000).

Factors that modify the association between knee pain

and mobility limitation in older women: the Women's

Health and Aging Study. Annals of the Rheumatic

Diseases, 59(5), 331-337.

Lee, P., Macfarlane, D., Lam, T., & Stewart, S., (2011).

Validity of the international physical activity

questionnaire short form (IPAQ-SF): A systematic

review. International Journal of Behavioural Nutrition

and Physical Activity, 8(1), 115.

Lord, S. R., & Menz, H. B., (2002). Physiologic, and

health predictors of 6-minute walk performance in

older people. Archives of Physical Medicine and

Rehabilitation, 83(7), 907-911.

Lord, S. R., Murray, S. M., Chapman, K., Munro, B., &

Tiedemann, A., (2002). Sit-to-Stand Performance

Depends on Sensation, Speed, Balance, and

Psychological Status in Addition to Strength in Older

People. The Journals of Gerontology Series A:

Biological Sciences and Medical Sciences, 57(8),

M539-M543.

Machado, G. P., Gignac, M. A., & Badley, E. M., (2008).

Participation restrictions among older adults with

osteoarthritis: a mediated model of physical

symptoms, activity limitations, and depression.

Arthritis & Rheumatology, 59(1), 129-135.

Mansournia, M. A., Danaei, G., Forouzanfar, M. H.,

Mahmoodi, M., Jamali, M., Mansournia, N., &

Mohammad, K., (2012). Effect of physical activity on

functional performance and knee pain in patients with

osteoarthritis: analysis with marginal structural

models. Epidemiology, 23(4), 631-640.

Martinez, B. P., Gomes, I. B., Oliveira, C. S., Ramos, I.

R., Rocha, M. D., Forgiarini Junior, L. A., Camelier,

F.W., & Camelier, A. A., (2015). Accuracy of the

Timed Up and Go test for predicting sarcopenia in

elderly hospitalized patients. Clinics, 70(5), 369-372.

Pickard, A. S., Kohlmann, T., Janssen, M. F., Bonsel, G.,

Rosenbloom, S., & Cella, D., (2007). Evaluating

Equivalency Between Response Systems: Application

of the Rasch Model to a 3-Level and 5-Level EQ-5D.

Medical Care, 45(9), 812-819.

Podsiadlo, D., & Richardson, S., (1991). The timed "Up &

Go": a test of basic functional mobility for frail elderly

persons. Journal of the American Geriatrics Society,

39(2), 142-148.

Reid, K. F., & Fielding, R. A., (2012). Skeletal muscle

power: a critical determinant of physical functioning

in older adults. Exercise and Sport Sciences Reviews,

40(1), 4-12.

Rikli, R. E., & Jones, C. J., (1998). The reliability and

validity of a 6-minute walk test as a measure of

physical endurance in older adults. Journal of Aging

and Physical Activity, 6, 363–375.

Roos, E. M., & Lohmander, L. S., (2003). The Knee injury

and Osteoarthritis Outcome Score (KOOS): from joint

injury to osteoarthritis. Health and Quality of Life

Outcomes, 1, 64-64.

Rose, D. J., (2003). A Comprehensive Balance and

Mobility Training Program. Champaign: Human

Kinectics.

Rutten, A., & Abu-Omar, K., (2004). Prevalence of

physical activity in the European Union. Soz

Praventivmed, 49(4), 281-289.

Sabirli, F., Paker, N., & Bugdayci, D., (2013). The

relationship between Knee Injury and Osteoarthritis

Outcome Score (KOOS) and Timed Up and Go test in

patients with symptomatic knee osteoarthritis.

Rheumatology International, 33(10), 2691-2694.

Schlenk, E. A., Lias, J. L., Sereika, S. M., Dunbar-Jacob,

J., & Kwoh, C. K., (2011). Improving Physical

Activity and Function in Overweight and Obese Older

Adults with Osteoarthritis of the Knee: A Feasibility

Study. Rehabilitation Nursing, 36(1), 32-42.

Sheskin, D. J., (2007). Handbook of Parametric and

Nonparametric Statistical Procedures Boca Raton,

Florida: Chapman and Hall/CRC.

Shumway-Cook, A., Brauer, S., & Woollacott, M., (2000).

Predicting the probability for falls in community-

dwelling older adults using the Timed up & go Test.

Physical Therapy, 80(9), 896-903.

Stratford, P. W., & Kennedy, D. M., (2006). Performance

measures were necessary to obtain a complete picture

of osteoarthritic patients. The Journal of Clinical

Epidemiology, 59(2), 160-167.

Tanimura C1, Morimoto M., Hiramatsu K., Hagino H.,

(2011). Difficulties in the daily life of patients with

icSPORTS 2015 - International Congress on Sport Sciences Research and Technology Support

102

osteoarthritis of the knee: scale development and

descriptive study. Journal of Clinical Nursing, 20(5-

6), 743-53.

Terwee, C. B., van der Slikke, R. M., van Lummel, R. C.,

Benink, R. J., Meijers, W. G., & de Vet, H. C., (2006).

Self-reported physical functioning was more

influenced by pain than performance-based physical

functioning in knee-osteoarthritis patients. The

Journal of Clinical Epidemiology, 59(7), 724-731.

van Dijk, G. M., Veenhof, C., Spreeuwenberg, P., Coene,

N., Burger, B. J., van Schaardenburg, D.,& Dekker, J.,

(2010). Prognosis of limitations in activities in

osteoarthritis of the hip or knee: a 3-year cohort study.

Archives of Physical Medicine and Rehabilitation,

91(1), 58-66.

Wilhelm, E. N., Rech, A., Minozzo, F., Radaelli, R.,

Botton, C. E., & Pinto, R. S., (2014). Relationship

between quadriceps femoris echo intensity, muscle

power, and functional capacity of older men. Age

(Dordr), 36(3), 9625.

Wood, L., Peat, G., Thomas, E., Hay, E. M., & Sim, J.,

(2008). Associations between physical examination

and self-reported physical function in older

community-dwelling adults with knee pain. Physical

Therapy, 88(1), 33-42.

Predictors of Timed “Up-and-Go” Test in Elderly with Knee Osteoarthritis

103