From clinic to smartphone evaluating the i-TUG for balance and fall risk in chronic stroke

Abstract

PurposeTo determine the test-retest reliability and construct validity of the Instrumental- Timed Up and Go Test (i-TUG), TUG, and Berg Balance Scale (BBS) using EncephaLog in individuals with stroke.MethodsThe study was conducted with 37 individuals diagnosed with chronic ischemic stroke. Participants were assessed using the i-TUG, TUG, BBS, and additional postural sway parameters collected via EncephaLog. Two test sessions were conducted to assess test-retest reliability. Pearson correlation coefficients were used to evaluate construct validity, and the Standard Error of Measurement and Minimal Detectable Change (MDC) were also calculated.ResultsHigh correlation was found between i-TUG and TUG (r = 0.92; r = 0.70), and moderate correlation between i-TUG and BBS (r= -0.54; r= -0.63). Postural sway parameters had negligible correlations with BBS and TUG. Test-retest reliability was excellent for i-TUG (ICC = 0.76), TUG (ICC = 0.83), BBS (ICC = 0.88), Time To Stand Up From The Chair (SUT) (ICC = 0.82), and Time To Sit Down On The Chair (SDT) (ICC = 0.79), but poor for Mediolateral Sway (MLsway) (ICC = 0.27) and Anteroposterior Sway (APsway) (ICC = 0.23). MDC values were as follows: i-TUG (12.36), TUG (9.21), BBS (7.48), MLsway (0.29), APsway (0.29), SUT (0.57), and SDT (0.51).ConclusionsEncephaLog-based i-TUG demonstrated high reliability and good validity, comparable to conventional clinical tests in chronic ischemic stroke. While sway parameters showed low correlation and reliability, i-TUG provides a promising, accessible, and objective tool for balance assessment.