Using Motion Capture Technology in the Instrumented Timed Up and Go Test to Detect the Risk of Falling in Aged Adults
October 25th, 2024
The instrumented Timed Up and Go (iTUG) test is gaining increasing attention in body sway and gait analysis with the development of new technologies. We present a protocol to analyze the subcomponents of the iTUG with motion capture.
In the current study, we aimed to analyze the ITUG test sub components using motion capture technology and to determine the correlation between ITUG test subtasks. we wanted to show that ITUG test has highlighted points to show more details than traditional TUG test. The significance of this method is that it's subdivides, the traditional TUG test with the motion capture system providing new variables regarding time and body sway our results demonstrated that some sub-components time variables, rather than body sway variables differed between groups with different leveled risk of falling.
As recent studies have evidence that the TUG test several components are associated with cognitive function, this method can also pave the way for screening for cognitive impairment. To begin set up a standardized ITUG test area, ensuring that it is equipped with 12 cameras distributed around the room. Incorporate traditional TUG setups such as a chair and a sign to remind the participant to turn back.
Make sure that the motion capture area is confined within the camera coverage and that all tug test setup materials are non-white reflective. Next, initiate the motion capture software by clicking the software icon for general camera configuration. Select the default mode.
Also apply default settings for selected camera settings and camera configuration settings. Select live mode for realtime settings and click on marker sets to configure the marker settings. For the calibration of ground axis, select the XY axis and choose millimeters in calibration units.
Click on calibrate to select the calibration variation. Then select initial calibration and click on the L-shaped button. Place the L-shaped calibrator at the center of the field to ensure visibility by all cameras.
Then check the screen to confirm that all 12 cameras detect four reflective markers. If any camera detects three or less markers. Reduce lightness and threshold at the left of the screen.
If any camera detects five or more markers. Check the field and cover the unwanted markers. Next, click on the T-shaped button and wave it in the field to ensure all cameras capture it.
Then select the Z axis in calibration of up axis and use millimeters for calibration units. Have the doctors verify the effectiveness of camera capture by waving the markers in each corner of the field. Click on finish to complete the calibration process and click save calibration.
To begin, set up the test area and software for ITUG test attach reflective markers to the participant's seven cervical spin processes, 10 thoracic spinous processes, the left acromion and the right acromion. Right click the reflective markers on the right line of the screen to name them as C7, T10, left shoulder, and right shoulder. Present the ITUG test instructions to the participants.
Ask the participants to rise from the chair, walk three meters at their preferred speed, turn around, return, and sit while the participant is performing the ITUG test. Click on the start and pause buttons on the screen of the computer. Next, enter the participant's name in the system for data collection purposes and press the record button to start the data recording.
After recording, review the video to identify the ITUGs test sub phases. Similarly define the phase two time, phase two body sway, phase three time. Phase three, body sway, angular velocity of phase three, phase four time, phase four body sway and phase five time.
Finally, evaluate the falling risk of the participant by using the Downton fall risk index. For this study, 13 aged participants with a high risk of falling and 11 participants with a low risk of falling were studied. Despite no significant differences in sex, age, or overall tug test scores between the groups, high risk individuals had notably longer durations in specific eye tug test phases and lower angular velocity during turning suggesting impaired mobility, a significant correlation was found between DFRI scores and the duration of several IT test phases, but not with body sway metrics indicating specific mobility challenges correlated with fall risk.
Overview
The instrumented Timed Up and Go (iTUG) test is a novel approach to analyze body sway and gait using motion capture technology. This study investigates the subcomponents of the iTUG test and their correlation with traditional TUG test metrics.
Key Study Components
Area of Science
- Neuroscience
- Gait analysis
- Motion capture technology
Background
- The iTUG test enhances traditional TUG assessments.
- It provides detailed insights into time and body sway variables.
- Recent studies link TUG components to cognitive function.
- This method may assist in cognitive impairment screening.
Purpose of Study
- To analyze iTUG test subcomponents using motion capture.
- To determine correlations between iTUG subtasks.
- To highlight advantages over traditional TUG tests.
Methods Used
- Setup of a standardized iTUG test area with 12 cameras.
- Incorporation of traditional TUG setups, including a chair.
- Use of motion capture to gather detailed data.
- Comparison of time and body sway variables across groups.
Main Results
- Some time variables differed significantly between groups.
- Body sway variables showed varying results based on fall risk levels.
- The iTUG test revealed more detailed metrics than traditional methods.
- Potential implications for cognitive function assessment were noted.
Conclusions
- The iTUG test offers a refined analysis of gait and balance.
- It may serve as a valuable tool for fall risk assessment.
- This method could enhance cognitive impairment screening processes.
Frequently Asked Questions
Executive Industry Relevance
Quantitative mobility assessment using motion capture in the instrumented Timed Up and Go (iTUG) test enables early detection of fall risk in aged adults, addressing a critical inflection point in translational research for neurodegenerative and mobility disorders. By dissecting subcomponents of the TUG test, this approach enhances predictive confidence and supports mechanistic de-risking in target validation for movement-related interventions. The method's granularity positions it as a reusable platform for both discovery-stage and preclinical mobility biomarker development.
Strategic Applications in Biopharma R&D
Early Discovery & Target Validation
- Enables quantitative interrogation of mobility-related hypotheses through subtask-specific time and body sway metrics.
- Supports functional target validation by correlating movement subcomponents with fall risk indices.
- Facilitates mechanistic de-risking by distinguishing between time-based and sway-based mobility impairments.
Screening & Assay Development
- Prepares validated, reproducible movement assays for downstream compound or intervention screening.
- Standardizes quantitative outputs for cross-study and cross-cohort comparability.
- Enables scalable, high-fidelity data capture for screening readiness and platform reuse.
Translational & Preclinical Research
- Aligns mobility phenotypes with translational biomarkers relevant to neurodegenerative and aging-related disorders.
- Supports continuity from early discovery through preclinical validation by linking quantitative movement metrics to risk indices.
- Provides predictive de-risking for candidate interventions targeting mobility or cognitive decline.
Pipeline & Workflow Integration
The iTUG motion capture workflow bridges early discovery, lead identification, and preclinical research by providing standardized, quantitative mobility phenotyping.
- Discovery Biology: Supports hypothesis testing and pathway clarification for movement and fall risk mechanisms.
- Screening: Delivers reproducible, quantitative outputs for assay development and compound evaluation.
- Analytics: Generates time and body sway metrics enabling robust statistical comparison across risk groups.
- Translational Research: Connects movement subtask metrics to established fall risk indices for biomarker alignment.
- Enterprise Reuse: Establishes a scalable, standardized platform for repeated use across studies and cohorts.
Operational & Enterprise Impact
- Scientific Value: Increases predictive confidence and reduces mechanistic ambiguity in mobility-related target validation.
- Operational Value: Enhances standardization, reproducibility, and scalability of movement phenotyping workflows.
- Strategic Value: Improves go/no-go decisions and capital efficiency by enabling early risk stratification.
- Portfolio Impact: Supports risk-adjusted prioritization and advancement of mobility and neurodegeneration programs.
Implementation Considerations
- Requires expertise in motion capture technology and quantitative movement analysis.
- Demands dedicated instrumentation, including multi-camera motion capture systems and calibration protocols.
- Necessitates cross-team standardization of test setup, marker placement, and data analysis pipelines.
- Adaptation across different model systems or populations may require protocol adjustments.
- Practical limitations include the need for controlled environments and specialized analytical infrastructure.
