College of Allied Health Professions
University of Nebraska Medical Center
University of Nebraska Medical Center

Gait, Strength, and Balance Tools

  • Timed Up and Go Test: The Timed Up and Go (TUG) Test (TUG Instructions; TUG Video) allows a health care provider to observe and time a person’s ability to stand up and down from a chair, walk a short distance, and perform a turn. The Centers for Disease Control recommends that an older adult who takes ≥ 12 seconds to complete the TUG is at risk of falling.
  • 30-Second Chair Stand Test: The 30-second Chair Stand (30-second chair stand Instructions; 30-second chair stand Video) tests functional leg strength and endurance. Normative reference values exist for men and women of various ages. Performance below these normative reference values for one’s age and sex indicates a risk for falls.
  • 4-Stage Balance Test: The 4-Stage Balance Test (4-stage balance test Instructions; 4-stage balance test Video) assesses a person’s ability to maintain static standing balance for 10 seconds in a series of progressively harder standing positions. An older adult who is unable to hold the third position (tandem standing) for at least 10 seconds is considered at risk of falling.
  • Evidence-Based Fall Prevention Programs: The National Council on Aging lists several structured, evidenced-based fall prevention programs to which patients can be referred. Most include an exercise component, and many also include education on a variety of topics related to fall risk reduction. Your local Area Agency on Aging, or Health Department (see Nebraska Health Departments as an example) may offer these programs, as might local physical therapy clinics, fitness centers, churches, or other community organizations.

Quality Improvement Tools to Apply to Gait, Strength, and Balance Assessment and Intervention

  • Aim Statement Worksheet.* The Aim Statement Worksheet from the Institute for Healthcare Improvement is a resource that can be used to help you create an aim statement for an improvement project.
  • Quality Improvement Project Measures Worksheet.* The Quality Improvement Project Measures Worksheet from the Institute for Healthcare Improvement is a resource that can be used to help you develop outcome, process, and balancing measures for an improvement project.
  • Quality Improvement Project Change Concepts Worksheet.* The Quality Improvement Project Change Concepts Worksheet from the Institute for Healthcare Improvement is a resource that can be used to help you explore and select from change concepts that might be relevant to an improvement project.
  • Plan-Do-Study-Act (PDSA) Worksheet.* The PDSA Worksheet from the Institute for Healthcare Improvement is a resource that can be used to guide documentation of PDSA cycles to test changes within an improvement project.
*The resources available from the Institute for Healthcare Improvement can be downloaded for free from their website, but ask for your first and last name, organization, and email address to download.