The Reliability, Validity, and Responsiveness of the Timed 360° Turn Test in Patients With Parkinson's Disease

Difficulty in turning is common after Parkinson's Disease. Patients with Parkinson's Disease take a greater number of steps, longer duration, narrower base of support in turning. Thus, turning ability is systematically investigated in Parkinson's Disease. The aim of this study to invastigate reliability, validity, and responsiveness of the timed 360° turn test in Patients with Parkinson's Disease.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease
• Intervention / Treatment: Other: the timed 360° turn test; Other: Berg Balance Scale; Other: Four Square Step Test; Other: Functional Reach Test; Other: Trunk Impairment Scale; Other: Timed Up and Go Test; Other: Hoehn and Yahr Scale; Other: Unified Parkinson's Disease Rating Scale

Detailed Description

At baseline, the timed 360° turn test, Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Scale, Berg Balance Scale, Functional Reach Test, Timed Up and Go Test, Four Square Step Test and Trunk Impairment Scale was applied to the patients with Parkinson's Disease when the patients were "on" period. The timed 360° turn test was repeated after seven days from the first application when patients with Parkinson's Disease were "on" period to evaluate its reliability.

• Study Type: Observational
• Enrollment (Actual): 86

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey, 06560
    • Fatih Söke

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 36 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients with Parkinson's Disease who apply to the Gazi University, Department of Physiotherapy and Rehabilitation will be invited to this study.

Description

Inclusion Criteria:

• at least 40 years of age,
• neurologist-diagnosed Parkinson's Disease
• Hoehn & Yahr (H&Y) stages 1 to 4,
• were able to walk 10 m with or without aids

Exclusion Criteria:

• visual, auditory, and orientational problems affecting study results
• orthopedic problems affecting walking,
• other neurologic conditions, cardiovascular, musculuskeletal, and vestibular disease

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients with Parkinson's Disease; Patients with Parkinson's Disease Parkinson's Disease (Hoehn and Yahr stage 1-4)	Other: the timed 360° turn test; Turning ability is assessed by using the timed 360° turn test.; Other: Berg Balance Scale; Functional balance is assessed by using the Berg Balance Scale.; Other: Four Square Step Test; The Four Square Step Test measures dynamic balance.; Other: Functional Reach Test; The Functional Reach Test assesses limits of stability.; Other: Trunk Impairment Scale; Trunk performance is assessed by using the trunk impairment scale.; Other: Timed Up and Go Test; Functional mobility is assessed by using the timed up and go test.; Other: Hoehn and Yahr Scale; Disease stage is assessed by the Hoehn and Yahr Scale.; Other: Unified Parkinson's Disease Rating Scale; The Unified Parkinson's Disease Rating Scale assesses disease severity.
Healthy Controls; Healthy People	Other: the timed 360° turn test; Turning ability is assessed by using the timed 360° turn test.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The timed 360° turn test	Turning ability is assessed by using the timed 360° turn test. In the timed 360° turn test, a piece of colored tape is placed on the floor to mark the starting position. Each subject was required to stand with arms by his/her side and feet comfortably apart and pointing to the tape. Timing was started from the word "go" and stopped when subject's shoulders were facing forward again. The time taken to complete the turn was recorded (in seconds) by a stopwatch.	10 seconds

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Berg Balance Scale	Functional balance is assessed by using the Berg Balance Scale. During the test, participants are asked to perform 14 tasks frequently used in daily life activities. Each item is scored between 0 (unable to perform the task) and 4 (task is performed independently) according to the ability of the person while performing the task. The highest possible score is 56 points. A higher score indicates better balance.	15 minutes
Trunk Impairment Scale	Trunk performance is assessed by using the trunk impairment scale. The Trunk Impairment Scale consists of three subscales: static sitting balance, dynamic sitting balance and co-ordination. A higher score indicating a better performance.	20 minutes
Functional Reach Test	The Functional Reach Test assesses balance by measuring the limits while the patient reaches forwards as far as possible, having the arms in 90° flexion and without lifting the heels off the floor.	15 seconds
Four Square Step Test	The Four Square Step Test measures dynamic balance and clinically assesses the person's ability to step over objects forward, sideways, and backward. A square was formed by 4 canes resting flat on the floor. The participants were instructed to try and complete the sequence as fast as possible without touching the canes with both feet, making contact with the floor in each square.	15 seconds
Timed Up and Go Test	Functional mobility is assessed by using the timed up and go test. The timed up and go test measures the time that a patient needs to stand up from a chair, walk a 3-m distance, come back and sit back on the chair.	10 seconds
Hoehn and Yahr Scale	Disease stage is assessed by the Hoehn and Yahr Scale. The Hoehn and Yahr scale is a commonly used diagnostic tool for quantifying the progression of Parkinson's Disease symptoms. Stages range from 0 (no signs of disease) to 5 (requiring a wheelchair, or bedridden unless assisted).	1 minutes
Unified Parkinson's Disease Rating Scale	The Unified Parkinson's Disease Rating Scale is increasingly used as a gold standard reference scale and includes four components (Part I, Mentation, Behavior and Mood; Part II, Activities of Daily Living; Part III, Motor;Part IV, Complications). A lower score indicates lower disease severity.	15 minutes

Collaborators and Investigators

• Sponsor: Gazi University
• Investigators: Principal Investigator: Fatih Söke, Gazi University

Publications and helpful links

General Publications

• Schenkman M, Cutson TM, Kuchibhatla M, Chandler J, Pieper C. Reliability of impairment and physical performance measures for persons with Parkinson's disease. Phys Ther. 1997 Jan;77(1):19-27. doi: 10.1093/ptj/77.1.19.
• Stack E, Ashburn A. Dysfunctional turning in Parkinson's disease. Disabil Rehabil. 2008;30(16):1222-9. doi: 10.1080/09638280701829938.
• Kluger BM, Brown RP, Aerts S, Schenkman M. Determinants of objectively measured physical functional performance in early to mid-stage Parkinson disease. PM R. 2014 Nov;6(11):992-8. doi: 10.1016/j.pmrj.2014.05.013. Epub 2014 May 28.
• Stack EL, Ashburn AM, Jupp KE. Strategies used by people with Parkinson's disease who report difficulty turning. Parkinsonism Relat Disord. 2006 Mar;12(2):87-92. doi: 10.1016/j.parkreldis.2005.08.008. Epub 2005 Dec 9.
• Shiu CH, Ng SS, Kwong PW, Liu TW, Tam EW, Fong SS. Timed 360 degrees Turn Test for Assessing People With Chronic Stroke. Arch Phys Med Rehabil. 2016 Apr;97(4):536-544. doi: 10.1016/j.apmr.2015.11.010. Epub 2015 Dec 13.
• Giladi N, McMahon D, Przedborski S, Flaster E, Guillory S, Kostic V, Fahn S. Motor blocks in Parkinson's disease. Neurology. 1992 Feb;42(2):333-9. doi: 10.1212/wnl.42.2.333.

Study record dates

Study Major Dates

• Study Start (Actual): July 20, 2018
• Primary Completion (Actual): August 10, 2018
• Study Completion (Actual): August 20, 2018

Study Registration Dates

• First Submitted: July 3, 2018
• First Submitted That Met QC Criteria: July 13, 2018
• First Posted (Actual): July 16, 2018

Study Record Updates

• Last Update Posted (Actual): October 24, 2018
• Last Update Submitted That Met QC Criteria: October 23, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: Parkinson's Disease; Validity; Reliability; The Timed 360° Turn Test
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease
• Other Study ID Numbers: 441

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No