Objective: The aim of this study is to investigate differences of gait characteristics according to direction of turning more and less affected side (MAS and LAS), and to find efficient turning direction in Parkinson’s disease (PD).

Background: Turning constitute significant portion in daily locomotion and it is challenging in PD. Successful turning requires coordinated adjustment of inside and outside step. Characteristic asymmetry of motor symptoms in PD might trouble this coordination according to turning direction.

Methods: Nineteen PD and 13 control right-handed subjects participated and performed forward gait and 360o turning in preferred speed under 3D motion analysis system. Characteristics of gait during forward gait and turning according to direction of MAS and LAS were analyzed and compared. MAS of ten patients was left, and nine patents was right. In control subjects, left side was regarded as MAS.

Results: PD patient showed shorter step length in forward gait, shorter step length and slower walking speed during turning compared to control subjects. Similar but greater differences were found in detailed comparison of MAS and LAS step, especially at turning. There was no difference between MAS and LAS step at forward gait and turning in control group, except for step speed at turning. In PD patients, exaggerated differences between MAS and LAS step at both turning direction. Moreover, PD patient with right MAS showed decreased adjustment of MAS step according to turning direction and less efficient turning to LAS direction.

Conclusions: PD patients showed exaggerated difference between MAS and LAS step according to turning direction and less efficient left turn in right side – dominant PD patients. These findings could suggest that turning to more affected direction might be better turning strategy for patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/direction-of-turning-in-parkinsons-disease-more-affected-side-or-less-affected-side/