AppTUG Clinic

AppTUG Clinic

AppTUG Clinic

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INTRODUCTION

Timed Up and Go (TUG) is a standard neurological assessment procedure.  For the most part TUG is used for motor assessment but there is evidence that the test can provide cognitive indicators as well. Traditionally, TUG test is performed by a clinician who observes the patient while performing the test, measuring the time the test lasts by using a stopwatch, sometime adding a subjective impression for the performance of the patient. The patient stands up from a chair, walks 3 meters, turns back, returns to the chair and sits down again.

Using the smartphone built-in sensors (no external accessory is needed) we turn the test into instrumental-TUG (AppTUG) that offers the following:

  • General setting that will be used for all the AppTUG sessions, based on the physician preference.
  • The test can run in the clinic or remotely in the patient’s preferred location and time.
  • Simple instructions that control the flow of examination.
  • Capturing every aspect of the patient movement during the test.
  • View the results on the device.
  • Send the data by mail for more detailed analysis and comparison to previous results.

The patient starts by sitting on a chair with the smartphone attached to the patient’s sternum by means of a simple strap. The physician presses the Start button commencing a countdown, the patient completes the TUG protocol, by the end of which AppTUG automatically ends the recording. If more than one trial is needed, AppTUG will repeat the test.

TEST FLOW SCHEMATICS

SET-UP

(derived from Podsiadlo and Richardson, 1991):

  • We start by choosing the test location, inside the clinician room, in the waiting room or in the patient’s home if the test is run independently. The location should have a smooth floor without any obstacles or distractions (avoid running the test in a noisy environment, where many people cross the test path or near it etc.)
  • Set your app preference in settings (for options and explanations please refer to user manual)
  • Measure and mark a 3 meter (9.8 feet) walkway
  • Place a standard height chair (seat height 46cm, arm height 67cm) at the beginning of the walkway

TEST ROUTINE

(derived from Podsiadlo and Richardson, 1991):

  • Set the app parameters according to your preference ( (for options and explanations please refer to user manual) and insert patients name or ID.
  • If needed, demonstrate the procedure
  • Regular footwear and customary walking aids should be used.
  • The patient sits on the chair and places his/her back against the chair and rest his/her arms on the chair’s arms.
  • The upper extremities should not be on the assistive device (if used for walking), but it should be nearby.
  • When the patient is ready, press Begin.
  • A countdown will be heard followed by a “Go!” command and vibration to initiate the test.
  • The patient should walk to the marked line that is 3 meters (9.8 feet) away, turn around at the line, walk back to the chair, and sit down.
  • If multiple repeats is chosen, a new countdown will begin and the patient will execute the test again.
  • At the end of the procedure, view the results of each trial and export the data to the database (via e.mail)

FEATURES

  • By using any simple band, the AppTUG app can be used to capture the movement of any specific body location (the four limbs are supported, along with various locations on the torso).
  • Multiple trials can be recorded.
  • AppTUG app supports manual and automatic flow control.

For more details and settings please refer to the user manual

RESULTS

 

Timed-up-and-go profile. Acceleration and direction (dashed line) vs. time
Multiple steps overlay for step-to-step correlation
Sway chart of a healthy individual
Sway chart of a Huntington disease patient