Kinematics of turning during walking over ground and on a rotating treadmill post-stroke

This seems like it would be incredibly important on preventing falls. So what does your therapist have as a protocol for turning other than never do it?
http://www.jneuroengrehab.com/content/11/1/127/abstract
anez Pav¿i¿, Zlatko Matja¿i¿ and Andrej Olen¿ek

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Journal of NeuroEngineering and Rehabilitation 2014, 11:127  doi:10.1186/1743-0003-11-127
Published: 23 August 2014

Abstract (provisional)

Background

After neurological injury, gait rehabilitation typically focuses on task oriented training with many repetitions of a particular movement. Modern rehabilitation devices, including treadmills, augment gait rehabilitation. However, they typically provide gait training only in the forward direction of walking, hence the mechanisms associated with changing direction during turning are not practiced. A regular treadmill extended with the addition of rotation around the vertical axis is a simple device that may enable the practice of turning during walking. The objective of this study was to investigate to what extent pelvis and torso rotations in the transversal plane, as well as stride lengths while walking on the proposed rotating treadmill, resemble those in over ground turning.

Methods

Ten neurologically and orthopedically intact subjects participated in the study. We recorded pelvis and torso rotations in the transversal plane and the stride lengths during over ground turning and while walking on a rotating treadmill in four experimental conditions of turning. The similarity between pelvis and torso rotations in over ground turning and pair-matching walking on the rotating treadmill was assessed using intra-class correlation coefficient (ICC - two-way mixed single measure model). Finally, left and right stride lengths in over ground turning as well as while walking on the rotating treadmill were compared using a paired t-test for each experimental condition.

Results

An agreement analysis showed average ICC ranging between 0.9405 and 0.9806 for pelvis and torso rotation trajectories respectively, across all experimental conditions and directions of turning. The results of the paired t-tests comparing left and right stride lengths showed that the stride of the outer leg was longer than the stride of the inner leg during over ground turning as well as when walking on the rotating treadmill. In all experimental conditions these differences were statistically significant.

Conclusions

In this study we found that pelvis rotation and torso rotation are similar when turning over ground as compared to walking on a rotating treadmill. Additionally, in both modes of turning, we found that the stride length of the outer leg is significantly longer than the stride length of the inner leg.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.