To investigate (1) the intrarater, interrater, and test-retest reliability of the timed 360° turn test in subjects with stroke; (2) the concurrent validity of the timed 360° turn test by exploring its correlation with other measures of stroke-specific impairments; and (3) the cutoff times that best discriminate individuals with stroke from healthy older adults.
University-based rehabilitation center.
Individuals with chronic stroke (n=72) and healthy individuals (n=35) of similar age (N=107).
Main Outcome Measures
The timed 360° turn test was administered along with the Fugl-Meyer assessment of the lower extremity, measurement of muscle strength of ankle dorsiflexors and plantarflexors using a handheld dynamometer, Berg Balance Scale, limit of stability test, five times sit-to-stand (FTSTS) test, 10-m walk test, and timed Up and Go (TUG) test.
The 360° turn times showed excellent intrarater, interrater, and test-retest reliability in individuals with stroke. A minimal detectable change of .76 seconds was found for subjects turning toward the affected side and 1.22 seconds for subjects turning toward the unaffected side. The 360° turn times were found to correlate significantly with Fugl-Meyer assessment of the lower extremity scores, dosiflexor strength of the affected ankle, plantarflexor strength of both ankles, FTSTS test times, balance performance, gait speed, and TUG test times. The 360° turn times of 3.43 to 3.49 seconds were shown to discriminate reliably between individuals with stroke and healthy older adults.
The timed 360° turn test is a reliable and an easily administered clinical tool to assess the turning ability of subjects with chronic stroke.
List of abbreviations:AUC (area under the curve), BBS (Berg Balance Scale), FMA-LE (Fugl-Meyer assessment of the lower extremity), FTSTS (five times sit-to-stand), ICC (intraclass correlation coefficient), LOS (limit of stability), MDC (minimal detectable change), TUG (timed Up and Go)
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- Video task analysis of turning during activities of daily living.Gait Posture. 2007; 25: 289-294
- Turning capacity in ambulatory individuals poststroke.Am. J Phys Med Rehabil. 2009; 88: 873-883
- Gaze and postural reorientation in the control of locomotor steering after stroke.Neurorehabil Neural Repair. 2009; 23: 256-266
- Kinematics of turning 180 degrees during the timed Up and Go in stroke survivors with and without falls.Neurorehabil Neural Repair. 2010; 24: 358-367
- The timed “Up & Go”: a test of basic functional mobility for frail elderly persons.J Am Geriatr Soc. 1991; 39: 142-148
- Walking skill can be assessed in older adults: validity of the Figure-of-Eight Walk test.Phys Ther. 2010; 90: 89-99
- Measuring balance in the elderly: preliminary development of an instrument.Physiother Can. 1989; 4: 304-311
- Assessing risk for the onset of functional dependence among older adults: the role of physical performance.J Am Geriatr Soc. 1995; 43: 603-609
- Relaibility of impairment and physical performance measures for persons with Parkinson’s disease.Phys Ther. 1997; 77: 19-27
- Are scores on balalnce screening tests associated with mobility in older adults?.J Geriatr Phys Ther. 2006; 29: 35-39
- Reliability and validity of the abbreviated mental test (Hong Kong version) in residental care homes.J Am Geriatr Soc. 2010; 58: 2255-2257
- The post-stroke hemiplegic patient: a method for evaluation of physical performance.Scand J Rehabil Med. 1975; 7: 13-31
- Balance Master operator’s manual.NeuroCom International, Clackamas2002
- Simple method for measurement of lower extremity muscle strength.Am J Med. 1985; 78: 77-81
- Reliability of gait performance tests in men and women with hemiparesis after stroke.J Rehabil Med. 2005; 37: 75-82
- Relaibility of the Fugl-Meyer assessment for testing motor performance in patients following stroke.Phys Ther. 1993; 73: 447-454
- Test-retest reliability of hand-held dynamomety during a single sessions of strength assessment.Phys Ther. 1986; 66: 206-209
- Foot and ankle strength asssessment using hand-held dynamometry: reliability and aged-related differences.Gerontology. 2010; 56: 525-532
- The balance scale: reliability assessment with elderly residents and patients with an acute stroke.Scand J Rehabil Med. 1995; 27: 27-36
- Reliability and validity of measures obtained from stroke patients using the Balance Master.Arch Phys Med Rehabil. 1996; 77: 425-430
- 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity.Arch Phys Med Rehabil. 2010; 91: 407-413
- Responsiveness and predictability of gait speed and other disability measures in acute stroke.Arch Phys Med Rehabil. 2001; 82: 1204-1212
- The time Up & Go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke.Arch Phys Med Rehabil. 2005; 86: 1641-1647
- Foundations of clinical research: applications to practice.3rd ed. Prentice Hall, Upper Saddle River2007
- Reliability of physical performance and self-reported functional measures in an older population.J Gerontol A Biol Sci Med Sci. 1998; 53: M295-300
- Turning ability in stroke survivors: a review of literature.ISRN Rehabil. 2012; (Article ID 284924:8 pages)
- A structural equation model relating physical function, pain, impaired mobility (IM), and falls in older adults.Arch Gerontol Geriatr. 2012; 55: 645-652
- Energy generation and absorption at the ankle and knee during fast, natural and slow ccadences.Clin Orthop Relat Res. 1983; : 147-154
- Effects of head immobilization on the coordination and control of head and body reorientation and translation during steering.Exp Brain Res. 2001; 140: 223-233
- Balance ability, not muscle strength and exercise endurance, determines the performance of hemiparetic subjects on the timed-sit-to-stand test.Am J Phys Med Rehabil. 2010; 89: 497-504
- Correlations between Berg Balance Scale and gait speed in individuals with stroke wearing ankle-foot orthoses—a pilot study.Disabil Rehabil Assist Technol. 2014; 23: 1-4
- Analysis of the clinical factors determining natural and maximal gait speeds in adults with a stroke.Am J Phys Med Rehabil. 1999; 78: 123-130
- Gender differences in strength and muscle fiber characteristics.Eur J Appl Physiol Occup Physiol. 1993; 66: 254-262
- Age and gender differences in seven tests of functional mobility.J Neuroeng Rehabil. 2009; 6: 31-34
Published online: December 13, 2015
S.S.N. was supported by General Research Grant (grant no. 562413) from Hong Kong's Research Grants Council.
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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