Turns and Turn-Related Falls: Stepping on a Rotating Platform as a Potential Approach to Foster Adapted Muscular and...

Falls remain the leading cause of injury-related death among older adults, with turning accident often producing the most severe consequences, such as hip fractures and a resulting decline in independence. Despite curved-path walking accounting for the majority of daily locomotion, most interventions insufficiently target the coordinated action of lower limb, pelvic and trunk muscles underlying safe turning. This leaves a large proportion of older adults and patients with motricity problems and movement disorders at heightened risk of life-altering injuries. Addressing this gap requires innovative strategies that proactively build on recent physiological research and improve turning strength and neuromuscular control of steering. Gait problems have often been addressed through the use of linear treadmills, which emphasise the symmetry and automaticity of walking but ignore the fact that more than half of daily locomotion involves deviations from the trajectory. In this perspective article, we review the differences between linear and curved walking. We also put forward the hypothesis that a turntable rotating parallel to the horizontal plane represents a potential solution. Such a device could allow individuals to step in place while the surface moves beneath them, simulating the natural rotation of legs, pelvis, and trunk involved in turning. The exercise is designed to train the muscle synergies and proprioceptive responses critical for turning, while minimising stress on vestibular systems, and enhancing task-specific neuroplasticity and proprioception.