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The measurement properties and performance characteristics among older people of TURN180, a test of dynamic postural
C Fitzpatrick1, J M Simpson, J D Valentine
1Psychology Department, Conquest Hospital, St Leonards-on-Sea, UK.
Objectives:
To establish the measurement properties of TURN180, a test of dynamic postural stability.
Design:
One physiotherapist conducted three trials of TURN 180, one of which was also observed by a second therapist.
Setting:
A day unit for elderly people accepting both inpatients and outpatients.
Subjects:
Sixty-six people (mean age 82.45 years), only six (9.1%) of whom could walk without using a walking aid.
Main Measurement:
The number of steps that a person takes to step around 180 degrees. A step is defined as any attempt on the subject's part to take a step, successful or not.
Results:
Repeatability is good, intraclass correlation coefficient = 0.828; the minimal detectable change revealed that in order to be considered a real improvement the number of steps the person takes to complete the postintervention TURN180 must be 28-29% fewer than the preintervention count. As long as the protocol is followed carefully, between-observer agreement is good, with differences between two observers rarely exceeding one step. People who had fallen in the previous year took statistically significantly more steps than those who had not done so to complete TURN180. Requesting written as well as oral consent seems to reduce the likelihood of an elderly patient agreeing to participate in a study.
Conclusion:
TURN180 yields repeatable (retest reliable) and valid data about a person's dynamic postural stability, especially the minimal detectable change which allows clinicians to judge whether any change in their patient's performance is real.
