Teach Us to Turn in the Kitchen

Having PTs walk me in straight lines in the PT gym and walk around the block after I went home did not prepare me for the problem solving I need do while walking.  In the hospital I was in a wheelchair, but after I got home I had to teach myself to safely turn 180 degrees while standing with the support of a cane to shut the bathroom door and turn again to flush the toilet.  

Here is another example.  The photo shows the turns I take to prepare a glass of iced tea and a bowl of cereal with a sliced banana for breakfast.  Turning away from a counter is a fall hazard because it is done by stepping backwards.  I have impaired balance so my inner ear does not tell me how far away from vertical I have stepped.  After I fell and broke my forearm while turning I got scared.  Now I use itsy bitsy baby steps to backup and turn before taking normal size steps in the new forward direction.

Research on this topic is emerging.  Chen trained stroke survivors on a straight OR a turning-based treadmill (1). Subjects walked on a round treadmill that turned underneath them as they walked in one place while holding onto parallel bars.  Subjects who learned to to accommodate the constant change created by the round treadmill were significantly better at turning while walking on level ground.  Not being able to sahomeafterstroke.blogspot.comfely turn while being distracted by a purposeful activity has serious implications. 

1. Chen, I, Yang, Y, Chan, R, Wang, R. Turning-based treadmill training improves turning
    performance and gait symmetry after stroke. Neurorehabilitation and Neural Repair. 2014;28
    (1):45-55.