Three-level rating of turns while walking

Research concerning the assessment of turns during walking in healthy older adults is scarce. This study compared three independent assessments of entry and exit points of turns during walking; participant, clinical rater, and a computer algorithm. Nineteen non-demented and nondisabled older adults (mean age 75.40 +/- 5.52 years) participated in the current study. Results revealed that overall the three assessment methods were consistent (68-100% agreement). However, participants determined their turn exit point before the algorithm, (-304.53 +/- 326.67 ms), t(18) = -4.06, p = .001, 95% CI [-461.98, -147.08], and clinical rater, (-225.79 +/- 303.79 ms), t(18) = -3.24, p = .005, 95% CI [-372.21, -79.37]. The differences in turn determination between the algorithm and rater were significant at turn entry points (131.24 +/- 127.25 ms), t(18) = 4.50, p < .001, 95% CI [69.91, 192.58] but not at turn exit points (-78.74 +/- 259.66 ms), t(18) = -1.32, p < .20, 95% CI [-203.89, -46.41]. Greater time discrepancies in assessing turn exit points between the participants and both the algorithm and clinical rater were associated with worse visuospatial performance. Despite the relatively small difference among the three assessments of turns, they were consistent and can be utilized interchangeably. Further studies are necessary to determine whether differences in the ability to accurately determine turns entry and exit points are related to fall risk in normal and disease populations. (C) 2014 Elsevier B.V. All rights reserved.