The floor 3 meters from the front legs of the chair is marked with a line of colored tape and the center of the line is marked with an “X.” Subjects are instructed to get up from the chair, walk at their normal pace to the line, step on the X, turn around, walk back to the chair, turn around and sit down.
To assess the potential effect on the TUG of neuromuscular fatigue or facilitation, which are characteristic of LEM, the 3TUG test consists of 3 laps, performed as follows: The subject is seated in a standard 18” high straight-backed armchair. The 3TUG test was developed to provide a simple, non-invasive measure of disease severity in patients with LEM, who typically have weakness in thigh and hip girdle muscles that causes difficulty walking, climbing stairs and arising from a chair. 1– 3 Their test-retest reproducibility is high (intra-class correlation of 0.985–0.988, p<0.001), and it has been suggested that a change of even 3.5 4 to 4 5 seconds, or 29.8%, 4 may represent a clinically significant change. Timed-Up-and-Go (TUG) tests measure the time it takes a subject to arise from a chair, walk a short distance and return to the chair these tests have been used mainly to assess mobility in Parkinsonism and the elderly. In this paper, we report the intra-rater reliability (reproducibility) and inter-rater agreement of a new measure, the Triple Timed-Up-and-Go (3TUG) test, for assessing clinical function in patients with LEM. No single outcome measure has been used or observed to quantify the functional disability in Lambert-Eaton myasthenia (LEM).
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