Validity of TURN 180 Test to Distinguish Between the Fallers and Non-fallers
试验速览
- 阶段
- 不适用
- 入组人数
- 75
- 试验地点
- 1
- 主要终点
- Validity of TURN 180 Test
研究概览
简要总结
As the geriatric population continues to rise, the consequences of falls and fall-related injuries carry increasing socioeconomic significance. Fall during turning is 7.9 times more likely to result in hip fracture than a fall while walking straight. Hence, turning carries a significant risk for hip fracture. Turning is ubiquitous during activities of daily living, yet most gait research has focused on straight ahead walking.
Turning affects lower limb kinematics, kinetics, and step parameters. Therefore it appears to be a greater challenge for individuals with mobility problems. Turning ability is affected by age changes and balance confidence. TURN180 test was built to assess the parameters of turning. It has four major categories which are the most readily identified indictors of difficulty in turning while walking. These categories are: (1) the type of turn (or strategy) used to accomplish the turn, (2) the number of steps taken during the turn, (3) the time taken to accomplish the turn, and (4) staggering during the turn.
The purpose of this study is to explore the TURN180 test ability to evaluate the risk of falling in the elderly population and compare it to the known gold standard clinical test. This is a validation study of balance and mobility tests using a three-group sample of convenience. The independent elderly subjects (n=75) will be divided into three groups according to their falls history and undergo four balance tests: Timed "Up and Go" test (TUG), Tinetti Balance Test (Tinetti), Berg Balance Scale (BBS). The participants will be videotaped while performing the TUG test. Basic temporospatial aspects of turning during walking such as the number of steps taken during the turn and the time taken to accomplish the turn will be measured using both the slow-motion and stop-action capabilities of the VCR system and a time-code processor.
详细描述
Elderly people are the fastest growing segment of our population. As the geriatric population continues to rise, the consequences of falls and fall-related injuries carry increasing socioeconomic significance. One-third of community- dwelling elderly fall each year; 5% of these experience fracture or injury requiring hospitalization and expenses now exceed $20 billion annually.
The most common activities being performed at the time of fall-related hip fracture are walking forward and turning around. Although 40% of hip fractures occur during walking and 18% occur during turning. Cumming & Klineberg found that a fall while turning is 7.9 times more likely to result in hip fracture than a fall while walking straight. This evidence suggests that turning is a greater challenge for individuals with mobility problems than is walking straight ahead. Hence, turning carries a significant risk for hip fracture.
Nearly every daily activity that requires locomotion requires turning, yet most gait research has focused on straight ahead walking.Glaister et al (2007) show that while straight walking makes up the majority of steps taken during the four daily living tasks observed, non-straight steps still make up approximately 35-45% of all steps taken during a typical day.
An important and common component of mobility is changing travel direction when walking. Turning requires the central nervous system to coordinate whole-body reorientation toward a new travel direction, while continuing with the on-going step cycle. Balance maintenance during turning involves complex integration of multiple sensory systems (vestibular, visual, and somatosensory) and motor output. Aging is associated with a slow and progressive decline of the sensory and motor systems as well as their integrative functions.
Turning affects lower limb kinematics, kinetics, and step length. Significant age differences were found among healthy young and older adult subjects in their abilities to quickly turn or stop in order to avoid obstacles that suddenly appear; in the gait path much of the older adults' need for longer response times than those of the young was attributable to the lengthened first phase of their responses.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 90 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Age 65 years or older, man and woman.
- •Independent, and community dwelling.
- •Able to give informed consent.
- •Able to ambulate inside under close supervision for a distance of 10 m.
排除标准
- •Visual impairment that cannot be fixed by glasses.
- •Acute cardiopulmonary conditions (MI, Acute asthma).
- •S/p Myocardial infarction within last 3 month.
- •Severe congestive heart failure.
- •Neurologic pathologies (CVA, MS, Parkinson's Disease).
- •S/p Amputation of lower limb.
- •Acute low back pain, acute ankle/knee/hip joint inflammation or arthritis.
结局指标
主要结局
Validity of TURN 180 Test
时间窗: Each participant in the study will be assessed once. Sesion duration time - 1 hour.
TURN180 test was built to assess the parameters of turning. A Turn is defined as the beginning and end of the 180-degree reversal of direction at the turn line on the floor while walking. Basic temporospatial aspects of turning during walking such as the number of steps taken during the turn and the time taken to accomplish the turn is measured. The test has four major categories which are the most readily identified indicators of difficulty in turning while walking. These categories are: (1) the type of turn (or strategy) used to accomplish the turn, (2) the number of steps taken during the turn, (3) the time taken to accomplish the turn, and (4) staggering during the turn. The 4 characteristics developed to reflect a continuum from "no difficulty" to "definite indicators of difficulty" while turning during walking: The score in each category is from 0 to 2 points, so getting 0 points means - having no difficulty in turning and 8 points - severe difficulty in turning.
次要结局
- Time up and go (TUG)(Each participant in the study will be assessed once. Sesion duration time - 1 hour.)
- Tinneti Balance Assessment Tool(Each participant in the study will be assessed once. Sesion duration time - 1 hour.)
- Berg Balance Scale(Each participant in the study will be assessed once. Sesion duration time - 1 hour.)
研究者
Avner Herman Cohen
Proffesor MD
Clalit Health Services