Identification of Disease-Specific Turning Movement Hallmarks: A Systematic Review towards Establishment of Disease Screening Algorithm

Abstract

Background: Patients with nervous system and musculoskeletal diseases display gait disturbance that is a leading cause of falls. Identification of disease-specific movement hallmarks is therefore an essential first step in preventing falls. Since turning, a common daily activity, is a unique movement that requires inter-limb spatial coordination, turning may be a suitable observational target for the identification of disease-specific movement disorder. However, to date, few comprehensive systematic review regarding disease-specific alterations in turning movement is available. Research question: This systematic review with meta-analysis summarized the level of knowledge regarding movement disorders during turning in patients with nervous system and musculoskeletal diseases. Methods: A systematic review was conducted of papers throughout 2021 in accordance with PRISMA guideline. Including criteria were (1) were published in a peer-reviewed journal, (2) were written in English, (3) included adult patients who were diagnosed with musculoskeletal or nervous system diseases, (4) had a control group of age-matched healthy adults, and (5) outcomes included turning parameters. Results: Meta-analysis revealed a significantly larger step number, longer turn duration, and shorter step length in patients with Parkinson's disease (PD) than in controls during the 180 degree turn, suggesting that these biomechanical alterations may be, at least in part, movement disorders associated with PD. Notably, this review identified methodological heterogeneity for turning movement assessments, which limited the identification of disease-specific movement disorders. Significance: This work serves as a call to action for the establishment of a standard assessment protocol towards the identification of disease-specific turning movement disorders and effective disease screening.