When gait isn't straight forward: how do you assess the ability to turn?

For people with Parkinson’s Disease (PD), difficulty turning is a notorious cause of freezing and falls (Bloem et al, 2001; Stack and Ashburn, 1999; Nieuwboer et al, 1998; Yekutiel, 1993; Giladi et al, 1992) and may lead to a physiotherapy referral. What do therapists record when turning is assessed informally, perhaps during a standard mobility test? How do their findings guide them? Turning is poorly understood in comparison with straight forward gait: • Studies have been small, with young, healthy participants • ‘Step Count’ and ‘Turn Time’ have dominated the literature • Unsubstantiated claims have been made about ‘normal’ turning • Few existing measures have been validated • Laboratory-based protocols are unsuitable for use clinically or in PD research. A new measure, the video-based Standing Start 180º Turn Test (SS-180), has recently been developed at the University of Southampton (Stack, 2003) and a paper submitted to Physiotherapy detailing its design, validation against a laboratory-based ‘gold standard’ and initial reliability. The test is currently being used in a number of studies. The purpose of this article is to raise awareness of the SS-180 and to encourage consideration of the issues associated with difficulty turning from the clinical and research perspectives