Kinematic Biomarkers of Functional Disability in Older Adults: Analysis of the Timed Up and Go Test

Abstract

The Timed Up and Go (TUG) test is used to assess mobility in older adults, but its reliance on completion time limits its insight into detailed movement patterns that could serve as early indicators of functional decline. This study aimed to identify lower limb and trunk kinematic biomarkers during the TUG test that distinguish between older adults with and without functional disability, emphasizing the potential for wearable sensor applications. Sixty adults aged 60+ participated in this cross-sectional study. Three-dimensional lower limb and trunk range of motion (ROM), velocity, center of mass (CoM) displacement, and velocity were analyzed using an optoelectronic system across TUG subphases: sit-to-walk, walk-forward, turn, walk-back, and turn-to-sit. Principal component analysis identified eleven principal components (PCs), explaining 84.33% of the total variance. PCs included sagittal hip and knee motion and CoM velocity during turn-to-sit and walking (PC1); tri-dimensional trunk velocity during turning, walk-back, and sit-to-walk transitions (PC2, PC4, PC6); sagittal knee and hip velocity in sit-to-walk (PC3); and frontal and transverse plane knee ROM and velocity during turning (PC5). Significant differences between functional disability groups were found for PC1 and PC4. These findings provide benchmark data for developing and validating wearable biosensors aimed at monitoring kinematic biomarkers.