The 360° Turn Test is a measure of dynamic balance. The person tested turns in a complete circle (360 degrees) while time to complete and/or number of steps to complete the turn are recorded.
1
Less than 5 minutes
Adult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by Terry Ellis PT, PhD, NCS and Laura Savella sPT, & the PD Edge Task Force of the Neurology Section of the APTA.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
|
Abbreviations: |
|
|
HR |
Highly Recommend |
|
R |
Recommend |
|
LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
|
NR |
Not Recommended |
Recommendations Based on Parkinson Disease Hoehn and Yahr stage:
|
I |
II |
III |
IV |
V |
|
|
PD EDGE |
R |
R |
R |
R |
R |
Recommendations for entry-level physical therapy education and use in research:
|
Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
|
|
PD EDGE |
|
No |
No |
Not reported |
|
VEDGE |
|
Yes |
No |
Psychometric properties for the 360 Degree Turn Test were tested on populations of patients primarily in H&Y Stages 1-3; no studies on this measure have included H&Y Stages 4 or 5.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Older Adults
(Gill et al, 1995; n = 563; mean age = 79.1(4.7); community dwelling adults > 70 years old)
Older Adults
(Gill et al, 1995)
Descriptive data; Sample divided into 4 quartiles & “unable” group based on time to complete 360 Degree Turn (seconds)
Inter-quartile Ranges for 360 Degree Turn Test (seconds): Range (seconds) and number of subjects
|
1st |
2nd |
3rd |
4th |
Unable to complete turn |
|
1.1 - 2.4 n = 137 |
2.5 - 2.9 n = 129 |
3.0 - 3.8 n = 132 |
3.9 - 23 n = 150 |
n = 12 |
(Dai et al, 2012; Non-fall group: n = 372; mean age = 71(9.3); Fall group: n = 139; mean age = 75(11); recruited from senior center)
Descriptive data on 360 Degree Turn Test (seconds)
Older Adults:
Test-retest reliability (Tager et al, 1998; n = 199; 42% aged 55-69, 60% aged >70; ambulatory community dwellers)
Significant improvements (practice effects) found on 360 degree turn test (# of steps); measured 48 hours apart
Older Adults
(Berg, 1989 n = 38 participants who had a fall in the last 2 months; mean age = 73; a variety of diagnostic categories (none excluded))
Inter-rater Reliability of 360 Degree Turn Test (seconds) (within the Berg Balance Test)
Intra-rater reliability (for 360 degree turn item)
Older Adults
(Schubert et al, 2006 n = 195 community dwelling older adults; mean age = 80.9(5.9))
Convergent validity of the 360 degree turn test (seconds) with:
Patients who score < 3.8 seconds on the 360 degree Turn Test were more likely to perform well on tasks of walking speed (Odds Ratio = 20.7) and Timed Chair Rise(s) (Odds Ratio = 8.5) compared to those who performed well on the Tandem Stance Test
(Dite et al, 2002) Convergent validity of the 360 Degree Turn Test (seconds) with
(Lipsitz et al, 1991; Fallers (2+ falls in past 6 months); n = 70; mean age = 87(6); Non-fallers: no falls past 6 months and no more that 1 fall in 2 years prior;n = 56; mean age = 87 (5); Independent and partially dependent ambulatory nursing home residents)
Older Adults
(Gill et al, 1997; Primary study group: n = 586, mean age = 78.9 (4.8); ADL Independent at baseline & 1 year, alive for 3 year follow up; Secondary group: n= 775; mean age = 79.3(5.1); ADL Independent at baseline & alive at 1 year follow up; data set included people with chronic diseases including Parkinson’s)
Parkinson’s Disease
Descriptive data
(Schenkman et al, 1997; n = 15 total, mean age 74.5; H&Y Stage 2: n = 8 and H&Y Stage 3: n = 7)
n = 14 subjects tested
Descriptive data;
(Schenkman et al, 2011: n = 150 participants (derived from multiple studies); mean age unknown; H&Y Range = 1-3)
|
H&Y Stage |
360 Degree Turn Time (s) |
360 Degree Turn Steps (#) |
|
1-1.5 |
3.33(0.98) |
6.33(0.93) |
|
2 |
3.91(1.37) |
7.55(1.96) |
|
2.5 |
4.81(1.58) |
8.66(2.66) |
|
3 |
7.34(3.60) |
11.04(3.61 |
|
Cohen’s f |
0.30 |
0.25 |
(Franzen et al, 2009; n = 15 male subjects with dx PD H&Y stages 2-3; mean age = 64(9); n = 15 healthy, age& sex matched controls; Allowed subjects to initiate 360 Degree Turn)
Descriptive data mean scores on 360 Degree Turn Test (seconds)
Parkinson’s Disease
Test-retest reliability (Schenkman et al, 1997)
Parkinson’s Disease
(Schenkman et al, 2002; n = 34; subset of Total Sample: n = 42 independent community dwelling adults with PD; mean age = 63.7(11.5); H&Y Stage mean = 2.07(0.79))
Convergent Validity of 360 Degree Turn Test (seconds) with:
Convergent Validity of 360 Degree Turn Test (steps) with:
Berg, K. (1989). "Measuring balance in the elderly: preliminary development of an instrument." Physiotherapy Canada 41(6): 304-311.
Dai, B., Ware, W. B., et al. (2012). "A structural equation model relating physical function, pain, impaired mobility (IM), and falls in older adults." Arch Gerontol Geriatr 55(3): 645-652. Find it on PubMed
Dite, W. and Temple, V. A. (2002). "Development of a clinical measure of turning for older adults." Am J Phys Med Rehabil 81(11): 857-866; quiz 867-858. Find it on PubMed
Gill, T. M., Williams, C. S., et al. (1997). "The role of change in physical performance in determining risk for dependence in activities of daily living among nondisabled community-living elderly persons." Journal of clinical epidemiology 50(7): 765-772.
Gill, T. M., Williams, C. S., et al. (1995). "Assessing risk for the onset of functional dependence among older adults: the role of physical performance." Journal of the American Geriatrics Society 43(6): 603-609.
Lipsitz, L. A., Jonsson, P. V., et al. (1991). "Causes and correlates of recurrent falls in ambulatory frail elderly." J Gerontol 46(4): M114-122. Find it on PubMed
Schenkman, M., Cutson, T. M., et al. (1997). "Reliability of impairment and physical performance measures for persons with Parkinson's disease." Phys Ther 77(1): 19-27. Find it on PubMed
Schenkman, M., Cutson, T. M., et al. (2002). "Application of the continuous scale physical functional performance test to people with Parkinson disease." Journal of Neurologic Physical Therapy 26(3): 130-138. Find it on PubMed
Schenkman, M., Ellis, T., et al. (2011). "Profile of functional limitations and task performance among people with early- and middle-stage Parkinson disease." Phys Ther 91(9): 1339-1354. Find it on PubMed
Shubert, T. E., Schrodt, L. A., et al. (2006). "Are scores on balance screening tests associated with mobility in older adults?" J Geriatr Phys Ther 29(1): 35-39. Find it on PubMed
Tager, I. B., Swanson, A., et al. (1998). "Reliability of physical performance and self-reported functional measures in an older population." J Gerontol A Biol Sci Med Sci 53(4): M295-300. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.