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Arcada Working Papers 1/2020
ISSN 2342-3064
ISBN 978-952-7365-03-8
Walking speed in older physically active adults
– one-year follow-up study
Joachim Ring, Thomas Hellstén, Jyrki Kettunen
www.arcada.fi
2
Walking speed in older physically active adults
– one-year follow-up study
Joachim Ring
i
, Thomas Hellstén
ii
, Jyrki Kettunen
iii
Abstract
Walking is important for maintaining physical function. Gait-speed test is a reliable measure of
functional capacity and it is easily implemented in clinical settings. The aim of our study was to
investigate gait speed in one-year follow-up study among older physically active adults living at
home independently. Subjects (N=27) were people aged 65+, who participated in clinical tests at
Arcada in February 2017 (baseline) and in February 2018 (follow-up). Normal and brisk gait
speeds during a 10-meter distance indoors were calculated for each participant. During the one-
year follow-up period, the average normal gait speed decreased among the subjects from 1.56 m/s
to 1.48 m/s. None of the baseline variables studied explained the change in gait speed in our sub-
jects. In conclusion, the decline in gait speed during the one-year follow-up among physically ac-
tive older adults seems to be small. This is in line with the findings that health status, and physical
functioning of the subjects remained rather good during the follow-up.
Keywords: walking speed, physical function, older adults
I
Arcada University of Applied Sciences, Finland, Health and Welfare [ringnikl@arcada.fi]
ii
Arcada University of Applied Sciences, Finland, Health and Welfare [thomas.hellsten@arcada.fi]
iii
Arcada University of Applied Sciences, Finland, Health and Welfare [jyrki.kettunen@arcada.fi]
Arcada Working Papers 1/2020
ISSN 2342-3064
ISBN 978-952-7365-03-8
3
1 INTRODUCTION
There are many different physical performance measures available to determine a per-
son’s functional capacity. The ability to walk is one of the key functions to maintain in-
dependent living. Besides walking ability, walking speed has been of interest to scientists.
In his classic study, Bohannon [1] pointed out that gait-speed measures during a single
test are reliable, gait speed decreases with increased age, and that maximum gait speed
declines more steeply than normal (comfortable) gait speed with increasing age. The au-
thor also concluded that both maximum and normal gait-speed measures were reliable,
and correlated significantly with age, height, and lower-limb strength. Studenski et al. [2]
stated that a normal gait-speed test is a quick, inexpensive and reliable measure of func-
tional capacity with high inter-rater and test-retest reliability, and gait-speed represents
one test form that can be easily implemented in clinical settings and as a standard clinical
evaluation of older adults [3].
In their systematic review, Bohannon & Andrews [4] combined data from 41 articles, and
calculated normal gait speed for healthy individuals among different age groups. Accord-
ing to meta-analysis, the gait speed was relatively consistent for the decades from 20 to
29 years, and from 60 to 69 years for both genders. Thereafter, the average gait speed
seems to decline in both genders. For men, within the ages of 60-69 years, 70-79 years
and 80-99 years the average gait speed was 1.339 m/s, 1.262 m/s and 0.968 m/s, respec-
tively. For women the corresponding speed was 1.241 m/s, 1.132 m/s and 0.943 m/s.
Among the subjects aged 80 years or more, the average gait speed was below 1 m/s.
A systematic review by Peel and co-workers [5] focused on gait speed among geriatric
patients in clinical settings. They found that age, type of start (static or moving), permitted
walking aid, and distance were not significantly associated with gait speed. Interestingly,
they found that the reported average gait speeds were higher among younger than older
publications. Moreover, the effect of a higher proportion of female subjects in the study
population produced a decreased mean gait speed. The average gait speed “increased” by
0.013 m/s per year of publication, which ranged from 1988 to 2011. For every percentage
increase in the proportion of female participants in the study population, there was an
incremental decrease in gait speed of 0.003 m/s. Gait speed measured using maximal
compared with usual pace was significantly faster by 0.302 m/s.
Cesari and co-workers [6] investigated walking speed as a prognostic factor for health
problems among well-functioning older adults. They found that a normal gait speed of
less than 1 m/s identifies persons at high risk of health-related outcomes. Participants with
a gait speed of less than 1 m/s presented a significantly higher risk of persistent lower-
limb limitation, persistent severe lower-limb limitation, hospitalization and death within
one year. In addition, the relationship between walking speed and risk of falling is of
interest. Verghese et al. [7] pointed out that each 0.1 m/s decrease in gait speed was as-
sociated with a 7% increased risk for falls, and participants with a slow gait speed (≤ 0.7
m/s) had a 1.5-fold increased risk for falls compared with those with normal gait speed.
We have had the possibility to follow a cohort of well-functioning older adults who have
participated in weekly group exercise sessions in Arcada University of Applied Sciences
located in Helsinki (Arcada). In this one-year follow-up study, we investigate gait speed
4
among older physically active adults living at home independently. We were especially
interested in the baseline factors explaining changes in gait speed during the follow-up.
2 MATERIAL AND METHODS
Detailed descriptions of the participants and methods have been previously reported [8]
in Arcada working papers -series.
Briefly, the subjects (N=27) were well-functioning older adults aged 65+, who partici-
pated in clinical tests at Arcada in February 2017 (i.e. at baseline) and in February 2018
(follow-up). The participants also completed a standard pre-test health-screening ques-
tionnaire.
Documentation for each subject included age, sex, height, weight, body mass index (BMI,
kg/m2), and leisure time activity metabolic equivalent (MET) index [9, 10]. In addition,
the subjects self-rated their functional capacity, state of health, and leisure time physical
activity using an ordinal scale from 0 to 10. They also performed the “Timed-Up & Go”
test (TUG) [11].
The last two tests were normal and brisk gait speeds. The gait speed was calculated for
each participant by dividing the test distance in meters by the time required to traverse it
in seconds. Photocells was used to measure the time the subjects walked a 10-meter dis-
tance indoors. The test started from a standing position, and the subjects walked 4 meters
to accelerate and 4 meters to decelerate before and after the 10-meter test distance. For
the usual pace walking trial, the subjects were instructed to walk at their normal, com-
fortable speed. For the brisk speed walking trial, they were asked to walk as fast as they
could safely without running.
The ethical committee of the Hospital District of Helsinki and Uusimaa (HUS) approved
the study protocol.
Statistical analysis
The statistical analysis was done with a Statistical Package for the Social Sciences 25.0
(IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). The de-
scriptive data are presented as means and standard deviations (SD), and an independent
samples t-test was used to analyse differences between genders. Repeated samples t-test
were used to analyse changes in walking speed between baseline and follow-up. Pearson’s
correlation coefficient was used to analyse the relationship between change in gait speed,
and different covariates. Finally, we used a multiple linear regression analysis to investi-
gate the factors explaining the variation in the change in gait speed.
3 RESULTS
All the subjects participated in the follow-up examination. The one and only difference
between genders in age, BMI, health-related factors (Table 1), physical function or phys-
ical activity (Table 2) of the subjects at baseline was brisk gait speed. Male subjects had
5
on average a slightly faster brisk gait speed compared to their female counterparts (Table
2).
During the one-year follow-up period, the average normal gait speed decreased among
the subjects (Table 3), but there was no gender difference in this change (mean male 0.12
m/s vs. mean female 0.03 m/s, P=0.169).
Female Male P-value
N=13 N=14
Age; years, mean (SD)
1
73.0 (3.0) 73.1 (4.0) 0.919
BMI
2
, mean (SD)
1
25.1 (4.0) 25.9 (2.9) 0.532
State of health
3
, mean (SD)
1
8.0 (0.8) 8.1 (1.3) 0.865
Health related quality of life
4
, mean
(SD)
1
8.7 (0.9) 8.4 (0.9) 0.453
At least one physician-diagnosed
chronic disease, % (n) 60 (9) 40 (6) 0.273
1
SD: Standard deviation
2
BMI: Body Mass Index, kg/m²
Table 1. Characteristics of the subjects at baseline clinical examination in 2017.
3
Self-reported state of health with a scale from 0 to 10, where 10 is the best possible health
4
Self-reported health related quality of life with a scale from 0 to 10, where 10 is the best
possible quality of life
Female
(N=13)
Male
(N=14) Difference
mean (SD)
1
mean (SD)
1
mean (95% CI)
2
Timed up and go (TUG); seconds 8.5 (1.0) 8.8 (1.2) -0.4 (-1.19 to 0.48)
Walking, normal speed; (m/s) 1.5 (0.2) 1.6 (0.1) -0.2 (-0.14 to 0.10)
Walking, brisk speed; (m/s) 2.0 (0.3) 2.2 (0.2) -0.2 (-0.4 to -0.1)
METh/week
3
26.8 (28.5) 20.6 (15.0) 6.3 (-10.7 to 23.3)
1
SD: Standard deviation
Table 2. Function and physical activity of the subjects at baseline in 2017.
3
METh/week: Metabolic equivalent hours in week
2
95% CI: 95% Confidence intervals
6
We entered various variables in the correlation analysis to find the variables associated
with the change in normal walking speed as a continuous variable. Surprisingly, there
was no statistically significant association between the change in normal walking speed
and different variables (all P-values between 0.178 and 0.919). Therefore, our data did
not allow us to conduct further analysis to investigate the factors explaining the variation
in the change in walking speed.
4 DISCUSSION
The aim of the study was to investigate the changes in the gait speed during a one-year
follow-up among older physically active adults living at home independently. The mean
normal gait speed decreased slightly among the subjects. Unfortunately, none of the base-
line variables studied explained the change in gait speed in our subjects.
It is well known that walking ability is one of key functions to stay independent. Follow-
ing the gait speed in older adults is one possibility to identify persons at risk. Cesari et al.
[6] concluded in their prospective cohort study focused on well-functioning older adults
that a normal gait speed less than 1 m/s identifies persons at high risk of health-related
outcomes. In their sample, the mean normal gait speed was 1.17 m/s. Participants with a
gait speed of less than 1 m/s presented a significantly higher risk of persistent lower-limb
limitation, persistent severe lower-limb limitation, hospitalization and death within one
year. Our study participants walked faster than those in Cesari and co-workers’ study, and
none of them had a gait speed slower than 1 m/s. These are in line with the findings that
our subjects rated their health and function as rather good at baseline and at follow-up as
well.
In contrast to Bohannon’s study [1], where his conclusion was that maximum gait speed
declines more steeply than normal gait speed with increasing age, in our study the normal
gait speed declined during the follow-up time. However, our sample did not include sub-
jects in poor health condition, and the follow-up time was only one year. In addition, the
changes in gait speed were small.
Perera et al. [12] have published recommendations for criteria for meaningful change in
gait speed. They recommended that the cut-off point of moderate (substantial) meaningful
substantial change for normal gait speed is 0.10 m/s among older adults. The proportion
with at least a 0.10 m/s decline in gait speed was 41% (n=11) in our study. However,
there were no differences in state of health, or in physical functioning, nor in physical
Table 3. Walking speed of the subjects in 2017 and 2018.
At baseline in 201 7
(N=27)
At follow-up in
2018 (N=27) Difference
Walking, normal speed; (m/s) 1.56 (0.17) 1.48 (0.18) 0.08 (0.11 to 0.14)
Walking, brisk speed; (m/s) 2.11 (0.28) 2.15 (0.33) -0.04 (-0.12 to 0.04)
1
SD: Standard deviation
2
95% CI: 95% Confidence intervals
mean (95% CI)
2
mean (SD)
1
mean (SD)
1
7
activity at follow-up between the subjects with or without decline in gait speed (all P-
values >0.05).
In conclusion, the decline in gait speed during the one-year follow-up among physically
active older adults seems to be small. This is in line with the findings that health status,
and physical functioning of the subjects remained rather good during the follow-up.
Acknowledgements
We wish to thank Nigel Kimberley, for the final correction of the language of the manu-
script.
8
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