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Purpose: The Timed Up and Go (TUG) is an easy to use and cost-efficient measure of an individual’s functional mobility. Multiple studies have been conducted using the TUG in populations of children and older adults, but limited data is available for younger adults. Therefore, the purpose of this study is to obtain normative data for young adults in order to expand the use of the TUG for physical therapists working with this age group, in particular, transition age young adults with disabilities. The research questions are as follows: 1.) What is the mean time, in seconds, required for healthy young adults (18-22 years of age) to complete the TUG? 2.) Is the TUG a reliable tool (both intra-rater and inter-rater) to be used with the young adult population (18-22 years of age)? Methods: Forty participants without disabilities, ranging from 18 years of age through 22 years of age were included for this study. The TUG which measures the time taken by an individual to stand from a chair, (approximately 18 inches tall, arm height 25.6 inches) walk three meters, turn around, walk back to the chair, and sit down was used as the outcome measure. Two testers rated 1 practice trial and 3 timed trials to obtain data for mean speeds in seconds and reliability data. Participants wore comfortable clothing and regular footwear and were instructed to walk at a normal pace. Results: The final scores included 14 male participants and 26 female participants with ages ranging from 18-22 years. With an overall mean speed of 7.63 seconds (SD=+/-1.072, range=4.51) intraclass correlation coefficients demonstrated high reliability for both raters with intra-rater reliabilities of (ICC=.92) for the primary investigator and (ICC=.92) for the co-investigator. Inter-rater reliability also displayed high values (ICC=.99). No significant differences were found for differences in age, BMI or gender. Conclusion: The TUG was found to have high intra-rater and inter-rater reliability for young adults. With expanded normative reference data from this study, physical therapists will improve understanding of this functional tool when evaluating transition age patients clinically. This data serves as normative reference values for young adults 18-22 years of age, supporting physical therapists so that they can better assess people of similar age.

This systematic review held the goal of determining the most effective type of ambulation physical therapy treatment for Parkinson’s disease patients. A total of 2,518 study articles were reviewed and narrowed down based on specific eligibility criteria, which, when completed, left a total of 12 articles. The necessary data was then extracted from these 12 articles. This data included the control and PD groups’ pre- and post-mean TUG scores, pre- and post-mean standard deviation values, and p-values. These values were utilized in order to calculate the effect size, or Cohen’s d value, for each individual study. The calculated Cohen’s d value was the primary measurement used to determine the effectiveness of each study. The higher the Cohen’s d value correlates with a larger effect. With this knowledge, the values for each study were compared to one another, leading to the production of an answer to the desired research question.

Parkinson’s disease is a progressive multifaceted neurodegenerative motor disorder resulting from a decrease in dopamine neurotransmission in the nigrostriatial pathway, located in the substantia nigra of the midbrain, specifically the basal ganglia. Due to the loss of dopamine, people with Parkinson’s disease typically experience symptoms such as slowness of movement, muscular rigidity and stiffness, postural and gait abnormalities as well as tremor. Parkinson’s disease not only affects a person’s movement, there are also neuropsychiatric implications such as depression, anxiety, hallucinations, psychosis, and sleep abnormalities. Other indicators of the disease include reduced range of facial expression, soft or hypophonic speech, drooling, slowing of gait, shorter stride, micrographia, freezing, difficulty initiating movement and loss of spontaneous movements such as shifting weight in a chair. This study will focus on bradykinesia, a cardinal symptom of the disease that describes slowed movements. The most common way to treat Parkinson’s disease is through the pharmacological method of prescribing levodopa. While this method has been beneficial for Parkinson’s patients, there are other nonpharmacological methods of treatment, such as exercise. There are currently no studies conducted that evaluate the most effective exercises utilized in the treatment of bradykinesia for people with Parkinson’s disease. This study aims to determine the most effective exercises used in multi-modal exercise programs using the Timed Up and Go (TUG) Test.

Background: Changes in gait due to simultaneous performance of an attention-demanding dual task, such as walking while talking on the phone, may be caused by competing demands for attentional resources. As dual-tasking during gait is common, assessment of this paradigm is becoming highly important for mobility research. The objective of this study is to examine changes in gait and verbal response while performing a timed up and go test (TUG) with a concurrent cognitive task of counting backwards and a motor task of carrying a meal tray in order to understand the role of cognitive factors in gait-related balance control. Significance: Exploring the influence of attention processes on gait may represent an efficient way to- 1) improve the assessment of the falling risk among older adults, 2) help in promoting healthy senile life by focusing on cognitive development, and 3) improve post fall rehabilitation interventions by inclusion of cognitive tasks in addition to improving musculoskeletal impairments.Methods: Community dwelling healthy older adult volunteers participated in a timed get up and go (TUG) test while their movements were recorded by a 3D motion analysis system and force plates. Statistical Analysis: Multiple one-way repeated measures ANOVAs were performed for each of the kinematic and kinetic variables to examine differences across task conditions. Post hoc tests with Bonferroni corrections were conducted for significant main outcome variables. T tests were performed to assess cognitive skills.Results: The study successfully examined 15 healthy older adults between ages 65 and 88, scores of > 25 on MMSE test on their performance of dual task conditions in an attempt to get an insight into their gait and dynamic balance control system. We found that the most complex task situation of carrying the food tray and counting backward had the most adverse effect on gait performance in healthy older adults that resulted in 24% more time required to complete the TUG task, about 12% slowing of gait, 40% increase in double support time and a 10% decrease in the generation of medio-lateral ground reaction force, with conservation of cognitive task performance. However, balance control parameters like center of mass excursion and velocity in the frontal plane remained unaffected. Conclusions: Gait is an attention-demanding task, and a concurrent cognitive or motor task disrupts walking performance in community-dwelling older adults.

Recent geopolitical fortunes have brought Islamic parties into sharp salience for the scientific, political, and diplomatic communities. Islamic parties have experienced varying and ill-explained levels of development and success across time and geographic region. Using historical and quantitative analyses, this dissertation examines the case of Pakistan to more accurately describe Islamic parties and account for variations in their formation and electoral success. While the broad distinction between Muslim Democratic from Islamist party types is a clear one, this study finds that the latter must be further divided into the Hierarchical and Network subtypes. Each of these forms of political party features distinctive characteristics of formation, organization, policy, elites, strategies, strengths, and weaknesses. Despite these differences, the parties share a formation process that reflects (1) organization of elites, (2) state legitimization, and (3) mass recruitment. Islamist parties hold significant advantages over Muslim Democratic parties in the recruitment phase because they offer lower entry stakes for entrepreneurs, are more broadly embedded in the electorate, exercise religious authority and affiliated message-delivery tools, and provide a combination of advancement, spiritual values and material goods. Despite these advantages, Muslim Democratic parties have proven to perform better than either subtype of Islamist party at broad levels of aggregation, largely because their more moderate postures are associated with better levels of incorporation into state machinery and in-group policing. However, Islamist groups fare better than Muslim Democrats at the local level because of the strategic voting patterns of an electorate strongly influenced by religious-sect affiliation. These factors are explicated and analyzed to arrive at a set of definitions and dynamics that differentiate these party types and their relative successes at achieving political power under various conditions. Implications of this study are both theoretical and applied. Only on the basis of a study of political processes in the masses themselves, can we understand the role of parties and leaders, whom we least of all are inclined to ignore. They constitute not an independent, but nevertheless a very important, element in the process. Without a guiding organization, the energy of the masses would dissipate like steam not enclosed in a piston-box. But nevertheless what moves things is not the piston or the box, but the steam. - Leon Trotsky1 1Trotsky, History of Russian Revolution, 1930