Energetics of walking in elderly people: factors related to gait speed.

Muscle Metabolism DPU, Research and Development, GlaxoSmithKline, Research Triangle Park, NC 27709, USA.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences (Impact Factor: 4.98). 12/2010; 65(12):1332-7. DOI: 10.1093/gerona/glq137
Source: PubMed

ABSTRACT Slow walking speed in elderly people predicts increased morbidity and mortality. We examined factors that may be associated with decreased habitual walking speed in older men and women.
Older (range: 60-88 years, mean = 72.5 years) men (n = 25) and women (n = 24) were recruited. The Short Physical Performance Battery, body composition, VO(₂peak) on a treadmill, VO₂ and rated perceived exertion during 10 minutes of walking at habitual gait speed and at a walking speed of 0.9 m/s, muscle strength, and level of physical activity were measured.
VO(₂peak) was strongly related to habitual gait speed (r = .744, p < .001) and remained significant even after controlling for age, muscle strength, and gender. Compared with the tertile of fastest walkers (mean gait speed, 1.37 ± 0.04 m/s), the tertile of slowest walkers (0.87 ± 0.02 m/s) were older (p < .001), shorter (p = .026), had lower lean body mass (p = .011), lower strength ( p < .001), less self-reported daily physical activity (p = .102), and higher relative (to VO(₂peak)) intensity during walking at their habitual speed (65.3% ± 3.9% vs 54.3% ± 2.1% of VO(₂peak), p = .013).
VO(p₂eak) was strongly associated with habitual walking speed, suggesting that as aerobic capacity declines with age, the exertion associated with habitual gait speed increases. A slowing of walking speed may be a response to increased perception of exertion. The extent to which exercise training affects habitual gait speed and fatigue is not clear.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this article is to provide rehabilitation professionals with an overview of psychological resilience and how it is relevant to their practice. Older adults who are able to adjust to the physical changes associated with aging are often identified as resilient. Assessment of resilience and encouraging positive emotions may provide rehabilitation professionals with additional knowledge of how to help patients recover and thrive. Psychological resilience refers to the ability to respond flexibly to changing situations and to bounce back from negative emotional experiences such as those that may be encountered during physical rehabilitation.
    Topics in Geriatric Rehabilitation 07/2014; 30(3):176-180. DOI:10.1097/TGR.0000000000000025 · 0.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: With aging, customary gait patterns change and energetic efficiency declines, but the relationship between these alterations is not well understood. If gait characteristics that develop with aging explain part of the decline in energetic efficiency that occur in most aging individuals, then efforts to modify these characteristics could delay or prevent mobility limitation. This study characterizes gait patterns in older persons with and without knee pain and tests the hypothesis that changes in gait characteristics due to knee pain are associated with increased energetic cost of walking in older adults. Study participants were 364 men and 170 women aged 60 to 96 years enrolled in the Baltimore Longitudinal Study of Aging (BLSA), of whom 86 had prevalent knee pain. Gait patterns were assessed at participant self-selected usual pace in the gait laboratory, and the energetic cost of walking was assessed by indirect calorimetry during self-selected usual pace walking over 2.5 min in a tiled corridor using a portable equipment. Participants with knee pain were less energetically efficient than those without pain (oxygen consumption 0.97 vs. 0.88 ml/(10 m · 100 kg); p = 0.002) and had slower gait speed and smaller range of motion (ROM) at the hip and knee joints (p < 0.05, for all). Slower gait speed and lower knee ROM in participants with knee pain and longer double support time and higher ankle ROM in participants without knee pain were associated with lower energetic efficiency (p < 0.05, for all). Slower gait speed and lower knee ROM were correlates of knee pain and were found to mediate the association between age and oxygen consumption. Although knee pain is associated with a higher energetic cost of walking, gait characteristics associated with energetic efficiency differ by pain status which suggests that compensatory strategies both in the presence and absence of pain may impact gait efficiency.
    Journal of the American Aging Association 02/2015; 37(1):9754. DOI:10.1007/s11357-015-9754-4 · 3.45 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Among community-dwelling older adults, mean values for gait speed vary substantially depending not only on the population studied, but also on the methodology used. Despite the large number of studies published in developed countries, there are few population-based studies in developing countries with socioeconomic inequality and different health conditions, and this is the first study with a representative sample of population. To explore this, the association of lower gait speed with sociodemographic, anthropometric factors, mental status and physical health was incorporated participants’ weight (main weight) in the analysis of population of community-dwelling older adults living in a developing country. Methods This was a cross-sectional population based on a sample of 1112 older adults aged 60 years and over from Health, Wellbeing and Aging Study cohort 2010. Usual gait speed (s) to walk 3 meters was stratified by sex and height into quartiles. Multiple regression analysis was performed to investigate the independent effect of each factor associated with a slower usual gait speed. Results The average walking speed of the elderly was 0.81 m/s – 0.78 m/s among women and 0.86 m/s among men. In the final model, the factors associated with lower gait speed were age (OR = 3.56), literacy (OR = 3.20), difficulty in one or more IADL (OR = 2.74), presence of cardiovascular disease (OR = 2.15) and sedentarism. When we consider the 50% slower, we can add the variables handgrip strength, and the presence of COPD. Conclusions Gait speed is a clinical marker and an important measure of functional capacity among the elderly. Our findings suggest that lower walking speed is associated with age, education, but especially with modifiable factors such as impairment of IADL, physical inactivity and cardiovascular disease. These results reinforce how important it is for the elderly to remain active and healthy.
    BMC Geriatrics 04/2015; 15(1). DOI:10.1186/s12877-015-0031-2 · 2.00 Impact Factor