Gait Speed as an Objective Measure
Objective[edit | edit source]
The speed at which a person walks can be influenced by a number of factors, both voluntary and involuntary, and marks a functional skill that underpins a majority of the tasks that are essential to a person’s ability to function on a daily basis. Given this, walking speed, which is more commonly referred to as gait speed in the clinical setting, is a metric that is extremely valuable for practitioners when examining aspects of functional mobility in their patients. Additionally, given its ability to be influenced by multiple body systems (i.e. central nervous system, musculoskeletal system), gait speed is often used as a predictor of overall health and function, especially in older adults.
Gait speed has been considered by some to be a "Vital Sign," much like blood pressure and heart rate, and it's predictive ability has been linked with a myriad of common outcomes including hospitalization, fall risk, cognitive decline, disability, and mortality.
The objective of this page is to provide an overview of gait speed, methods of measurement, and implications for clinical practice. Please note that this page pertains specifically to gait speed as a measured value and not tests such as the 10-Meter Walk Test, whose results are recorded as a gait speed.
Intended Population[edit | edit source]
Gait speed can be measured in pretty much any population, but it is most commonly used as a predictive measure in the older adult population.
Method of Use[edit | edit source]
Gait speed at it's simplest form is a function of how long it takes a person to travel a given distance. As such, speed is determined by the following equation:
Speed (s) = distance (d) ÷ time (t)
Given this, any procedure with can supply these two variables (distance and time) can yield a gait speed for the chosen testing circumstances. This results in many variations of how gait speed is measured, with no one set methods used across the board.
Certain parameters can be of interest when looking specifically at how gait speed is measured, and there have been many suggestions regarding the standardization of procedures. Mehmet, Robinson, and Yang performed a systematic review of approximately 50 studies looking specifically at the methods of measuring gait speed between investigators. Below are components they looked at and the variations they found:
- Timing device / Measuring tool, digital stopwatch, analogue stopwatch, accelerometer, photocell triggered computer stopwatch, walking system (i.e. GAITRite).
- Measurement distance, ranging from 2.4 meters to 15 meters; 3, 4, and 6 meters were the most commonly used distances.
- Timing points - Acceleration and deceleration zones were sometimes used with time measured between the two middle points. of a four-point course.
- Use of walking aids, walking aids were generally allowed, but in some cases, they were not permitted.
- Number of trials, two trials were performed most commonly.
- Walking pace, pace was commonly specified as normal or self-selected, although fast pace was sometimes measured.
Given the wide variation in protocol and measurement methods, Mehmet, Robinson, and Yang suggest the following standard procedure for determining gait speed:
- Patient walks at a comfortable pace with appropriate walking-aid .
- Straight path and flat surface.
- 9-meter total distance, with the first and last 2.5 meters used for acceleration and deceleration.
- Time recorded for the middle 4 meters.
- Handheld stopwatch.
- Fastest of 2 trials is recorded.
- Gait Speed (m/s) = 4 meters ÷ Time (seconds).
The following video depicts the general structure and execution of a test measuring gait speed.
Normative and Predictive Data[edit | edit source]
Typical gait speeds across various settings:
- Acute care (hospital): o.455 m/s.
- Subacute / rehab facility: 0.529 m/s.
- Outpatient: 0.739 m/s.
- Acute care (hospital): 0.749 m/s.
- Subacute / rehab facility: 0.822 m/s.
- Outpatient: 1.033 m/s
Typical gait speeds based on age:[edit | edit source]
- Woman age 70-79 comfortable pace: 1.13 m/s.
- Men age 70-79 comfortable pace: 1.26 m/s.
- Woman age 80-99 comfortable pace: 0.94 m/s.
- Men age 80-99 comfortable pace: 0.97 m/s.
Predictive values for community dwelling older adults:[edit | edit source]
- <0.8 m/s - predictive of poor clinical outcomes.
- < 0.6 m/s - predictive of continued decline in individuals already experiencing poor outcomes.
Predicted ambulatory level in post stroke populations based on gait speed[edit | edit source]
- Household ambulator: <0.4 m/s
- Limited community ambulator: 0.4 - 0.8 m/s
- Unlimited community ambulator: >0.8 m/s
Reliability[edit | edit source]
Given the variability in procedure and applicable populations, data regarding reliability is often determined with regard to specific populations or modes of determining gait speed.
Normal gait speed in adults measured using 4-meter distance:
- Test-retest reliability (Inter-class correlation): 0.406 (Low reliability)
- Minimal detectable change w/ 95% confidence (MDC95%): 0.5 m/s
Normal gait speed in healthy older adults comparing 4 meter and 10-meter distances:
- Test-retest reliability (Inter-class correlation) for 4-meter distance: 0.96 (High reliability).
- Test-retest reliability (Inter-class correlation) for 10-meter distance: 0.98 (High reliability).
Gait speed in adults with hemiparesis following stroke using 10-meter distance[edit | edit source]
- Test-retest reliability (Inter-class correlation) for normal gait speed: 0.94 (excellent reliability).
- Test-retest reliability (Inter-class correlation) for fast gait speed: 0.97 (excellent reliability)
Validity[edit | edit source]
Similar to reliability, validity is also quite specific to particular populations and given testing parameters.
Criterion validity for community dwelling older adults using 8 feet and 20 feet distances:
- Age, gender, knee extension force, waist circumference, and stature as predictive aspects of gait speed
- 8 feet distance: Multiple correlation R = 0.459
- 20 feet distance: Multiple correlation R = 0.506
- Older age, female gender, shorter height, lesser knee extension force, and larger waist circumference are correlated with slower gait speeds
References[edit | edit source]
- ↑ Nancye MP, Suzanne SK, and Kerenaftali K, Gait Speed as a Measure in Geriatric Assessment in Clinical Settings: A Systematic Review, The Journals of Gerontology: Series A 2013; 68(1): 39–46.
- ↑ 2.0 2.1 2.2 2.3 2.4 Mehmet H, Robinson SR, Yang AWH. Assessment of Gait Speed in Older Adults. J Geriatr Phys Ther 2020; 43(1):42-52.
- ↑ PaulPotterPT. Gait Speed Test. Available from: https://www.youtube.com/watch?v=JtiTtxfGFOY [last accessed 9/11/2014].
- ↑ 4.0 4.1 Peel NM, Kuys SS, Klein K. Gait Speed as a Measure in Geriatric Assessment in Clinical Settings: A Systematic Review. The Journals of Gerontology: Series A. 68(1); 2013: 39–46.
- ↑ Abellan van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009 Dec; 13(10): 881-9.
- ↑ Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke. 1995;26(6): 982-9.
- ↑ Schmid A, Duncan PW, Studenski S, Lai SM, Richards L, Perera S, Wu SS. Improvements in speed-based gait classifications are meaningful. Stroke. 2007; 38(7): 2096-100.
- ↑ Bohannon RW, Wang YC. Four-Meter Gait Speed: Normative Values and Reliability Determined for Adults Participating in the NIH Toolbox Study. Arch Phys Med Rehabil. 2019; 100(3): 509-513.
- ↑ Peters DM, Fritz SL, Krotish DE. Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther. 2013; 36(1): 24-30.
- ↑ Flansbjer UB, Holmbäck AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005; 37(2): 75-82.
- ↑ Bohannon RW. Population representative gait speed and its determinants. J Geriatr Phys Ther. 2008; 31(2): 49-52.