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Walking speed: The sixth vital sign

January 2009
Journal of Geriatric Physical Therapy 32(2):46-49

Authors:

Stacy L Fritz

University of South Carolina

Michelle Lusardi

Sacred Heart University

A collection of walking speed times that are linked to dependence, hospitalization, rehabilitation needs, discharge locations, and ambulation category.

…

Self selected walking speed categorized by gender and age (6-12 and teens, 47 20s-50s, 42 & 60s-80s 48 ).

…

Figures - uploaded by Stacy L Fritz

Content may be subject to copyright.

Content uploaded by Stacy L Fritz

Content may be subject to copyright.

Journal of Geriatric Physical Therapy Vol. 32;2:09

Clinical Assistant Professor, Physical erapy Program, De-

partment of Exercise Science, Arnold School of Public Health,

University of South Carolina, Columbia SC

Professor of Physical erapy & Geriatrics, Dept. of Physical

erapy & Human Movement Science, College of Education

& Health Professions, Sacred Heart University, Faireld, CT

Walking speed is “almost the perfect measure.”

A reliable,

valid,

2,3

sensitive

and specic

measure, self-selected walking

speed (WS), also termed gait velocity, correlates with functional

ability,

and balance condence.

It has the potential to pre-

dict future health status,

8,9

and functional decline

including

hospitalization,

discharge location,

12,13

and mortality.

Walk-

ing speed reects both functional and physiological changes,

is a discriminating factor in determining potential for rehabili-

tation,

and aids in prediction of falls

and fear of falling.

Furthermore, progression of WS has been linked to clinical

meaningful changes in quality of life

and in home and com-

munity walking behavior.

Due to its ease of use

and psycho-

metric properties, WS has been used as a predictor and outcome

measure across multiple diagnoses.

8,9,19,21-26

In addition, WS was

chosen by a panel of experts as the standardized assessment to

measure locomotion for the Motor Function Domain of the

NIH Toolbox.

Walking speed, like blood pres-

sure, may be a general indicator

that can predict future events and

reect various underlying physi-

ological processes.

While WS can-

not stand alone as the only predic-

tor of functional abilities, just at

blood pressure is not the only sign

of heart disease; WS can be used

as a functional “vital sign” to help

determine outcomes such as func-

tional status,

6,8

discharge location,

and the need for rehabilitation

(Figure 1).

Walking is a complex func-

tional activity; thus, many vari-

ables contribute to or inuence

WS. ese include, but are not

limited to, an individual’s health

status,

motor control,

muscle

performance and musculoskel-

etal condition,

30,31

sensory and

perceptual function,

endurance

and habitual activity level,

cog-

nitive status,

motivation and

mental health,

35,36

as well as the

characteristics of the environment

in which one walks.

While per-

formance measures used in conjunction with WS are often bet-

ter able to predict health status,

the use of WS alone can be

an excellent predictor.

11,20

For example, WS predicts the post

hospital discharge location 78% of the time, and the addition of

cognition or initial FIM scores does not signicantly strengthen

the ability of dening if a patient will be discharged to home or

to a skilled nursing facility.

Several standardized assessments and physical performance

tests reliably predict function and health related events. Yet the

consistent use of measures in physical therapy and other clinical

settings is not widely practiced.

Factors contributing to this

non-use of standardized assessments may include insucient

time, inadequate equipment or space, or lack of knowledge in

interpreting the assessment.

Walking speed is one standard-

ized measure that can be quickly and easily incorporated into

the PT examination/evaluation process.

Determining feasibility is the rst essential step in deciding

to use a test or measure in the clinic. e main questions clini-

cians should pose regarding a test’s or measure’s feasibility are:

(1) Is the test safe?

(2) Is it cost eﬀective?

(3) How easy is the test to administer? and

(4) How easily are the results of the test graded and interpreted?

White Paper: “Walking Speed: the Sixth Vital Sign”

Stacy Fritz, PT, PhD;

Michelle Lusardi, PT, PhD

0 mph 0.4 mph 0.9 mph 1.3 mph 1.8 mph 2.2 mph 2.7 mph 3.1 mph

10 meter walk time 50 sec 25 sec 16.7 sec 12.5 sec 10 sec 8.3 sec 7.1 sec

10 foot walk time 15.2 sec 7.6 sec 5 sec 3.8 sec 3 sec 2.5 sec 2.2 sec

ADL: activities of daily living; IADL: instrumental ADLs; D/C: discharged; WS: walking speed; mph: miles per hour;

sec: seconds

Figure 1. A collection of walking speed times that are linked to dependence, hospitalization,

rehabilitation needs, discharge locations, and ambulation category.

Journal of Geriatric Physical Therapy Vol. 32;2:09

An armative answer to all these questions, as there is with

WS, lends to feasibility of use in a clinical setting. Walking

speed is safe, requires no special equipment, adds no signi-

cant cost to an assessment, requires little additional time (can

be administered in less than 2 minutes

), is easy to calculate

(distance/time), and is easy to interpret based on published

norms

3,40-42

(Figure 2).

Figure 2. Self selected walking speed categorized by gender

and age (6-12 and teens,

20s-50s,

& 60s-80s

Walking speed can be quickly and accurately assessed in the

majority of physical therapy practice settings, including home

care, subacute and acute rehabilitation facilities, long-term care

facilities, out-patient oces, and schools, as well as during com-

munity wellness/screening activities.

Measurements of walk-

ing speed are highly reliable, regardless of the method for mea-

surement, for diﬀerent patient populations and for individuals

with known impairments aﬀecting gait.

3,42

Examination of WS

requires a stopwatch and as little as a 20 foot space to walk

forward.

While most reported normative values are based on

measuring in the middle two-thirds of a longer walkway, al-

lowing walking speed to reach a steady state, others have used

shorter distances.

44,45

If possible, timing WS three times dur-

ing the examination (with a few minutes of rest between trials)

and developing a mean WS value will provide a more accurate

estimate of actual self-selected walking speed than a single trial

would.

3,41,43

Figure 3 displays a suggested reliable, inexpensive method

to collect WS by using the 10 meter (m) walk test.

It re-

quires a 20 m straight path, with 5 m for acceleration, 10 m

for steady-state walking, and 5 m for deceleration. Markers are

placed at the 5 and 15 m positions along the path. e patient

begins to walk “at a comfortable pace”

at one end of the path, and continues

walking until he or she reaches the

other end. e Physical erapist uses

a stopwatch to determine how much

time it takes for the patient to traverse

the 10 m center of the path, starting

the stopwatch as soon as the patient’s

limb crosses the rst marker and stop-

ping the stopwatch as soon as the pa-

tient’s limb crosses the second marker.

If a full 20 m walkway is not available, shorter distances can

be used, as long as there is adequate room for acceleration and

deceleration (eg, 5 ft acceleration, 10 ft. steady state, 5 ft. de-

celeration).

While WS varies by age, gender, and anthropometrics, the

range for normal WS is 1.2-1.4m/sec.

is general guideline

can help in monitoring our patients, along with norms by age

42,47,48

(Figure 2), and other cited cutoﬀ points

6,8,11,12,46

(Figure

1). Interpretation of WS also includes understating what con-

stitutes true change and what change may be due to measure-

ment error.

In a recent study, with a diverse group of older

participants with varying diagnoses, 0.05 m/s was calculated as

the needed change for a small but meaningful improvement in

WS.

In addition, for patients who do not have normal walk-

ing speed, an improvement in WS of at least 0.1 m/s is a useful

predictor for well-being,

9,14

while a decrease in the same amount

is linked with poorer health status, more disability, longer hos-

pital stays, and increased medical costs.

e MDC scores are

specic to the population and will vary according to your cli-

ent’s presentation.

26,50

Walking speed is an easily accessible screening tool

that

should be performed to oﬀer insight into our patients function-

al capacity and safety. Physical therapists, as specialists in move-

ment and function, can use WS as a practical and informative

functional sixth “vital sign” for all patients; examining walking

speed in the same way that we routinely monitor blood pres-

sure, pulse, respiration, temperature, and pain.

is sixth “vi-

tal sign” provides a relevant functional perspective to the health

status provided by the system-level vital signs assessed on most

visits to physicians’ oces.

is review summarizes the strong psychometric properties

of WS and robust evidence for using this clinical measurement.

Walking speed is easily measurable, clinically interpretable,

and a potentially modiable risk factor.

For these reasons, us-

ing WS as the sixth vital sign is both pragmatic and essential.

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A secondary analysis of gait after a 4-week postural intervention for older adults with hyperkyphosis

Article

Full-text available

Feb 2025
BMC MUSCULOSKEL DIS

Background Thoracic hyperkyphosis (HK), common in older adults, has been linked to impairments in physical function, mobility, balance, gait, and falls. Our pilot study used a novel 4-week manual therapy and exercise intervention for HK and showed improved posture and function. This secondary analysis aims to explore 1) the changes in gait parameters after a novel intervention for HK, 2) the correlations between posture and gait variables at baseline, and 3) pre- to post intervention. Methods This secondary analysis uses data from a quasi-experimental, single group pilot study. Participants with HK underwent pre- and post intervention measurements in posture, function, and unique to this secondary analysis, gait parametrics of velocity (V), step length (SL), double limb support (DLS), and step width (SW) using the GAITRite® electronic walkway. Paired t-tests compared pre- and post intervention gait parameters. Pearson correlation coefficients were utilized to investigate correlations between all variables at baseline and in pre- and post intervention change values. Results Fourteen women and 8 men (aged 65.9 years ±9.2; range 52 - 90) completed 12 treatments (3 times/week for 4-weeks). Statistically significant improvement (p≤.001) occurred pre- to post for postural measures: height (M=0.73cm ±0.54), Kyphotic index (-2.41 ±2.96), Block (-1.17cm ±1.22), Acromion to table (ATT) (-1.85cm ±1.42), and 3 gait measures: V (M=0.087m/s ±0.09), SL (2.34cm ±2.55), and DLS (- 0.031sec ±0.04). SW improvement was not statistically significant. Block and ATT measures were moderately correlated with V, SL, SW (Block only), and DLS (ATT only) at baseline. Strong correlations were found among V, SL, and DLS at baseline and in pre- to post change scores, but no correlation between change scores of posture and gait. Conclusions This study shows that a clinically practical 4-week PT intervention may benefit older adults with HK by demonstrating improved posture and gait parameters. Further research is warranted. Trial registration This study was retrospectively registered on 16/09/2019 under ClinicalTrials.gov Identifier: NCT04114331.

Gait Speed Modifies Efficacy of Home-Based Exercise for Falls in Older Adults With a Previous Fall: Secondary Analysis of a Randomized Controlled Trial

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Jan 2025
PHYS THER

Objective: Exercise is an evidence-based strategy for preventing falls. However, its efficacy may vary based on individual characteristics, like gait speed. The study examined whether baseline gait speed modified the effects of home-based exercise on subsequent falls among older adults. Methods: This is a secondary analysis of a 12-month, randomized controlled trial in community-dwelling adults who were ≥ 70 years old and who had fallen within the previous 12 months. Participants were randomized to either 12 months of home-based exercise (n = 172) or standard of care (n = 172). This study examined intervention effects on fall rates at 6 and 12 months stratified by baseline gait speed (slow [<0.80 m/s] or normal [≥0.80 m/s]) using negative binomial regressions. Baseline gait speed was investigated as a potential modifier of the intervention effects on mobility and cognitive function using linear mixed modeling. Results: At baseline, 134 participants had slow (exercise = 70; standard of care = 64) and 210 had normal (exercise = 102; standard of care = 108) gait speeds. For participants with slow gait speed, exercise reduced fall rates by 44% at 6 months (incidence rate ratio = 0.56; 95% CI = 0.33 to 0.95) but not at 12 months (incidence rate ratio = 0.63; 95% CI = 0.38 to 1.03) compared with standard of care; for participants with normal gait speed, there was no significant effect of exercise on fall rates at 6 or 12 months. Gait speed modified intervention effects; in the exercise group, participants with slow gait showed significant improvements in the Timed "Up & Go" Test at 6 months (estimated mean difference = -4.05; 95% CI = -6.82 to -1.27) and the Digit Symbol Substitution Test at 12 months (estimated mean difference = 2.51; 95% CI = 0.81 to 4.21). Conclusion: Older adults with slow gait speed had a reduction in subsequent falls in response to exercise at 6 months. Gait speed modified the effects of exercise on mobility and cognition. Impact: Older adults with slow gait speed may be a target population for exercise-based fall prevention.

Patterns of Selection of Human Movements I: Movement Utility, Metabolic Energy, and Normal Walking Gaits

Preprint

Aug 2016

Stuart Hagler

The biomechanics of the human body allow humans a range of possible ways of executing movements to attain specific goals. Nevertheless, humans exhibit significant patterns in how they execute movements. We propose that the observed patterns of human movement arise because subjects select those ways to execute movements that are, in a rigorous sense, optimal. In this project, we show how this proposition can guide the development of computational models of movement selection and thereby account for human movement patterns. We proceed by first developing a movement utility formalism that operationalizes the concept of a best or optimal way of executing a movement using a utility function so that the problem of movement selection becomes the problem of finding the movement that maximizes the utility function. Since the movement utility formalism includes a contribution of the metabolic energy of the movement (maximum utility movements try to minimize metabolic energy), we also develop a metabolic energy formalism that we can use to construct estimators of the metabolic energies of particular movements. We then show how we can construct an estimator for the metabolic energies of normal walking gaits and we use that estimator to construct a movement utility model of the selection of normal walking gaits and show that the relationship between avg. walking speed and avg. step length predicted by this model agrees with observation. We conclude by proposing a physical mechanism that a subject might use to estimate the metabolic energy of a movement in practice.

Gait Speed Estimation from Millimeter-Wave Wireless Sensing

Conference Paper

Full-text available

Dec 2024

Gait speed is an important indicator of human health. Monitoring patients' gait speed can help doctors assess the recovery process, but traditional clinician observation fails to track in home scenarios. Compared to vision-based and wearable approaches, radio frequency signals offer an easily deployable and light free solution protecting user privacy in home scenarios. Therefore, we proposed a millimeter-wave (mmWave) system to accurately extract walking periods from collected trials and calculate gait speeds. To evaluate the robustness and reliability of our system and determine the optimal mounting position, we collected data from 5 volunteers with normal walking speeds and imitated various abnormal gait patterns and walking speeds. The results show that the mmWave device mounted near the ground outperforms across all volunteers than the one mounted near the ceiling, achieving an average estimation error of 0.02 m/s in abnormal gait evaluations.

Sarcopenia screening based on the assessment of gait with inertial measurement units: a systematic review

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Oct 2024
BMC Geriatr

Background Gait variables assessed by inertial measurement units (IMUs) show promise as screening tools for aging-related diseases like sarcopenia. The main aims of this systematic review were to analyze and synthesize the scientific evidence for screening sarcopenia based on gait variables assessed by IMUs, and also to review articles that investigated which gait variables assessed by IMUs were related to sarcopenia. Methods Six electronic databases (PubMed, SportDiscus, Web of Science, Cochrane Library, Scopus and IEEE Xplore) were searched for journal articles related to gait, IMUs and sarcopenia. The search was conducted until December 5, 2023. Titles, abstracts and full-length texts for studies were screened to be included. Results A total of seven articles were finally included in this review. Despite some methodological variability among the included studies, IMUs demonstrated potential as effective tools for detecting sarcopenia when coupled with artificial intelligence (AI) models, which outperformed traditional statistical methods in classification accuracy. The findings suggest that gait variables related to the stance phase such as stance duration, double support time, and variations between feet, are key indicators of sarcopenia. Conclusions IMUs could be useful tools for sarcopenia screening based on gait analysis, specifically when artificial intelligence is used to process the recorded data. However, more development and research in this field is needed to provide an effective screening tool for doctors and health systems.

Gait Speed and All‐Cause Mortality in Whole‐Spectrum Chronic Kidney Disease: A Systematic Review and Meta‐Analysis Included 6217 Participants

Article

Full-text available

Feb 2025

Background The quantitative relationship between gait speed and mortality risk in patients with chronic kidney disease remains unclear. This study aimed to conduct a meta‐analysis to estimate the risk of mortality associated with gait speed in chronic kidney disease (CKD) patients. Methods Relevant studies published were identified through literature searches using Embase, PubMed and Web of Science. Prospective cohort studies of adult CKD patients that examined the relationship between gait speed and mortality were included. Random effects meta‐analyses based on restricted maximum likelihood to were used to calculate relative risk (RR) and 95% confidence interval (95% CI). The results of meta‐analyses were assessed using Grading of Recommendations, Assessment, Development and Evaluation framework. Results Seventeen prospective cohort studies involving 6217 CKD patients (mean age range: 51.6–81.85 years; 44.3%–84% male) were included. Pooled analysis of 12 studies (n = 4233) showed that lower gait speed was associated with a higher risk of all‐cause mortality compared to higher gait speed (RR = 2.138; 95% CI: 1.794–2.548; p < 0.001; I² = 16.0%; high‐certainty evidence) in CKD patients. Dose–response meta‐analysis of 6 studies (n = 1650) revealed that each 0.1 m/s increase in gait speed was associated with a 25.7% lower risk of all‐cause mortality (RR = 0.743; 95% CI: 0.580–0.955; p = 0.018; I² = 45.0%; high‐certainty evidence). Conclusions Slower gait speed is a strong predictor of all‐cause mortality in CKD patients, including those undergoing dialysis or kidney transplantation. Gait speed assessment should be incorporated into routine clinical evaluations to identify high‐risk patients and guide interventions aimed at improving physical function and survival outcomes. Trial Registration: PROSPERO registration number: CRD42022340135

ASE: Practical Acoustic Speed Estimation Beyond Doppler via Sound Diffusion Field

Preprint

Full-text available

Dec 2024

Passive human speed estimation plays a critical role in acoustic sensing. Despite extensive study, existing systems, however, suffer from various limitations: First, previous acoustic speed estimation exploits Doppler Frequency Shifts (DFS) created by moving targets and relies on microphone arrays, making them only capable of sensing the radial speed within a constrained distance. Second, the channel measurement rate proves inadequate to estimate high moving speeds. To overcome these issues, we present ASE, an accurate and robust Acoustic Speed Estimation system on a single commodity microphone. We model the sound propagation from a unique perspective of the acoustic diffusion field, and infer the speed from the acoustic spatial distribution, a completely different way of thinking about speed estimation beyond prior DFS-based approaches. We then propose a novel Orthogonal Time-Delayed Multiplexing (OTDM) scheme for acoustic channel estimation at a high rate that was previously infeasible, making it possible to estimate high speeds. We further develop novel techniques for motion detection and signal enhancement to deliver a robust and practical system. We implement and evaluate ASE through extensive real-world experiments. Our results show that ASE reliably tracks walking speed, independently of target location and direction, with a mean error of 0.13 m/s, a reduction of 2.5x from DFS, and a detection rate of 97.4% for large coverage, e.g., free walking in a 4m

\times

4m room. We believe ASE pushes acoustic speed estimation beyond the conventional DFS-based paradigm and will inspire exciting research in acoustic sensing.

Current Studies in Basic Sciences, Engineering and Technology 2024

Book

Full-text available

Dec 2024

The fields of science, engineering, and technology demonstrate constant progress and innovation in pushing humankind’s limits. This work, titled “Current Studies in Basic Sciences, Engineering, and Technology 2024”, brings together the most current studies, research, and discoveries in these fields. Today, research conducted in a wide range from basic sciences to engineering and technology aims to find solutions to the challenges faced by humanity. This book includes studies presented by distinguished researchers in a wide range of fields, from physics to biology, from chemistry to computer science. Each article and chapter aim to provide the reader with in-depth information on the subject. The content of the book focuses on the challenges, innovations, and discoveries faced by scientists and engineers. In this way, we believe that our readers will not only update their current knowledge but also gain a perspective on the technological and scientific trends of the future. While preparing this work, we brought together many valuable pieces of content that are the product of intense collaboration between editors and authors. We believe that these studies will foster progress in academia and industry. Finally, we hope that this book, “Current Studies in Basic Sciences, Engineering and Technology 2024”, will increase your interest in the fields of science, engineering, and technology and enable you to gain more in-depth knowledge of these subjects.

Integrating Wearable Sensor Technology and Machine Learning for Objective m-CTSIB Balance Score Estimation

Conference Paper

Jul 2024

This study marks the first endeavor to utilize wearable technology combined with machine learning to objectively assess the Modified Clinical Test of Sensory Interaction on Balance (m-CTSIB). We focus on developing an affordable, easily accessible method for balance assessment, critical for adults at risk of falls and cognitive decline. Our novel approach uses a single inertial measurement unit sensor (APDM, INC.) to gather lumbar accelerometer and gyroscope data. This data is accompanied by ground truth scores obtained from m-CTSIB tests on a force plate (Falltrak II, MedTrak VNG, Inc.) from 34 participants aged 21 to 88. Using XGBOOST, we achieve a remarkable 0.94 correlation using accelerometer data and 0.90 with gyroscope data in the test dataset, demonstrating a strong correlation with actual scores in a subject-wise leave-one-out cross-validation. Offering objectivity, affordability, and potential for remote monitoring, our innovative approach holds promise for enhancing the diagnosis and management of balance disorders in adults, thereby improving their quality of life and independence.

Journal of Evaluation in Clinical Practice Psychometric Evaluation of the Icelandic Version of the Modified Dynamic Gait Index for Community-Dwelling Older Adults With Balance Impairments

Article

Full-text available

Dec 2024

Rationale Optimal mobility is crucial for healthy aging, particularly among older adults with balance impairments. This research examines the psychometric properties of the modified Dynamic Gait Index (mDGI) translated into Icelandic, highlighting its suitability for evaluating mobility in this demographic group and within the context of healthy aging. Addressing the scarcity of international psychometric research on the mDGI, this study contributes to the translation of geriatric outcome measures into different languages, enhancing clinical applications and international research. Aim To assess the reliability and validity of the mDGI among Icelandic older adults experiencing balance impairments. Methods This methodological study included 30 participants, aged 67–91 years, receiving outpatient physical therapy for balance impairments. The participants completed two mDGI assessments 4–7 days apart, and additional assessments using the 10‐meter walking test (10MWT), Timed Up and Go (TUG), Activities‐specific Balance Confidence (ABC) scale, and Short Form Health Survey (SF‐36) subscales. Analysis included evaluating the mDGI's total scale and subscales' reliability and validity using Intraclass Correlation Coefficient ( ICC 3,1 ), Standard Error of Measurement ( SEM ), Cronbach's alpha, and Spearman's rho. Results The mDGI demonstrated high relative reliability ( ICC 3,1 = 0.95 for total mDGI; 0.73–0.92 for all subscales) and strong absolute reliability ( SEM for total mDGI = 1.32; two subscales = 1.17–1.43). Internal consistency was robust (alpha for total mDGI = 0.9; two subscales = 0.86–0.89). Construct validity was confirmed by mDGI's correlations with 10MWT, TUG, and SF‐36 social and physical functioning subscales. No floor or ceiling effects were observed in mDGI total scores. Conclusion The Icelandic version of the mDGI provides reliable and valid measures for evaluating balance and gait in older adults with balance impairments. Its sound psychometric properties support its use in similar demographic settings globally, providing a reliable tool for geriatric care practitioners and researchers worldwide.

Functional community ambulation: What are your criteria?

Article

Jan 1986

Determining meaningful changes in gait speed after hip fracture

Conference Paper

Jun 2006

Background and Purpose. Older subjects after hip fracture walk more slowly than age-matched peers. The extent to which they walk more slowly is difficult to define because the standard error of the measure (SEM), sensitivity to change, and clinically important change have not been reported for gait speed. The purposes of this study were to quantify the SEM for habitual and fast gait speeds among older subjects after hip fracture, to define the minimal detectable change (MDC), and to estimate the minimal clinically important difference (MCID) for habitual gait speed. Subjects. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. Methods. An estimate of the MDC was determined by use of the SEM.. The MCID was determined from expert opinion and from a receiver operating characteristic (ROC) curve. Results. The SEM and the MDC were 0.08 m/s and 0.10 m/s for habitual speed and fast speed, respectively. Both methods of MCID estimation identified 0.10 m/s as a meaningful change in habitual gait speed. Discussion and Conclusion. The estimated MCID for gait speed of 0.10 m/s was supported by clinical expert opinion and the cutoff point of the ROC curve.

Efficient use of performance measures in the clinical setting

Article

Sep 1997

Functional community ambulation: What are your criteria?

Article

Jan 1986

Functional Performance in Community Living Older Adults

Article

Dec 2003
J Geriatr Phys Ther

Purpose: Routinely, physical therapists use a variety of physical performance tests to determine functional status of older adults. Whereas many commonly used instruments have been evaluated for some aspects of reliability and validity, few studies report typical performance for community living older adults, especially those who are 80 years and older and use an assistive ambulatory device. The aim of this study was to determine reference values of 7 functional tests for older adults by decade of age, gender, and assistive device use. Methods: Seventy-six older adults (age 66-101 years) participated in functional assessment clinics that included measures of comfortable gait speed, fast gait speed, Berg Balance Scale, Timed Up and Go, timed sit to stand, 6 minute walk, and Physical Performance Test. Results: For each functional test administered, means, standard deviations, and confidence intervals are presented by age, gender, and assistive device use. Regression analyses suggest that age and assistive device use are important factors in performance on functional tests. Conclusion: This study reports typical functional status of community living older adults. Such information may be useful in describing functional limitations and monitoring change in physical performance of older adults. (C) 2003 Lippincott Williams & Wilkins, Inc.

Minimum Detectable Change in Gait Velocity During Acute Rehabilitation Following Hip Fracture

Article

Dec 2007
J Geriatr Phys Ther

Feasibility of robotic‐assisted locomotor training in children with central gait impairment

Article

Dec 2007
DEV MED CHILD NEUROL

Intensive, task-specific training enabled by a driven gait orthosis (DGO) may be a cost-effective means of improving walking performance in children. A paediatric DGO has recently been developed. This study was the first paediatric trial aimed to determine the feasibility of robotic-assisted treadmill training in children with central gait impairment (n=26; 11 females, 15 males; mean age 10y 1mo [SD 4y]; range 5y 2mo-19y 5mo). Diagnoses of the study group included cerebral palsy (n=19; Gross Motor Function Classification System Levels I–IV), traumatic brain injury (n=1), Guillain-Barré syndrome (n=2), incomplete paraplegia (n=2), and haemorrhagic shock (n=1), and encephalopathy (n=1). Sixteen children were in-patients and 10 were outpatients. Twenty-four of the 26 patients completed the training which consisted of a mean of 19 sessions (SD 2.2; range 13–21) in the in-patient group and 12 sessions (SD 1.0; range 10–13) in the outpatient group. Gait speed and 6-Minute Walking Test increased significantly (p<0.01). Functional Ambulation Categories and Standing dimension (in-patient group p<0.01; outpatient group p<0.05) of the Gross Motor Function Measure improved significantly. DGO training was successfully integrated into the rehabilitation programme and findings suggest an improvement of locomotor performance.

Prognostic value of usual gait speed in well-functioning older people--results from the Health, Aging and Body Composition Study

Article

Nov 2004

Predictors of Gait Speed in Patients after Hip Fracture

Article

Jan 2008

Purpose: Following hip fracture, patients demonstrate greatly reduced walking speeds 1 year later compared with age-matched elders. The purpose of our study was to examine the factors that relate to gait speed in patients after hip fracture. Methods: Forty-two men and women (mean age 79 +/- 7.5 years) who sustained a hip fracture participated in this study. Linear regression analysis was used to determine a statistical model that best predicted gait speed, the dependent variable. Gait speed was measured with a computerized gait mat. The independent variables were age, sex, height, weight, time post-fracture, medications, mental status, depression, balance confidence, Medical Outcome Studies, Short Form (SF-36), balance, and lower extremity isometric force. All subjects were discharged from physical therapy services, and measurements were taken, on average, 17 weeks post-fracture. Results: Using stepwise regression, 72% of the variance in gait speed was explained by summed lower extremity strength normalized by body weight, general health (SF-36), and balance confidence (Activities-specific Balance Confidence Scale). Conclusions: Impairments (summed lower extremity strength) and risk factors (perception of general health and balance confidence) are important predictors of gait speed in elders after hip fracture.

Measurement of Gait Speed of Older Adults is Feasible and Informative in a Home-care Setting

Article

Jan 2009
J Geriatr Phys Ther

Richard Wallace Bohannon

Although gait speed is widely recommended as a measure of activity limitation, it is not routinely used clinically with older adults. This retrospective study was undertaken to determine whether the measurement of gait speed is feasible and informative in a home care setting. The therapy records of 27 ambulatory patients were examined for gait speed measures and other relevant data. Gait speed was documented for all patients. It was significantly lower than that of age and sex matched normals. A wide range of speeds were noted for patients who required total assistance or were completely independent according to Functional Independence Measure criteria or who were able to walk at least 150 feet. Measurement of the gait speed of older adults is feasible in a home care setting. Its sensitivity to limitations not revealed by other measures provides support for broader use.