Development of a clinical measure of turning for older adults

Objective: The purpose of this study was to identify the characteristics present and observable when older adults safely and efficiently turn while walking and to develop and evaluate a clinical measure of turning based on these characteristics. Design: This was a validation study of balance and mobility tests using a three-group sample of convenience. Results: The reliability of a turn measure consisting of nine movement items was identified. Five of the turn measure items were able to discriminate between multiple faller and the other two groups. The two items dichotomously rated as yes or no were "seems steady throughout the turn" and "moves fluently without hesitation between turn and walk when exiting the turn." Three other items were, total turn score, the time taken to turn, and turn step number. These last two items also achieved strong correlation with existing balance measures and high sensitivity for identifying multiple fallers. These items form an easy-to-use clinical measure of turning for older adults. Conclusions: The turn measure developed in this investigation was found to be a reliable and valid clinical measure of turning while walking for older adults. Specific turn items were found to discriminate between groups of healthy and impaired older adults and had good sensitivity for identifying multiple fallers. The turn measure Is relatively quick to administer and score and uses equipment readily available in most clinical settings.