Walking speed

Question 1

Walking speed is a powerful indicator of:

Answer 1

health and disease

Question 1

Walking speed correlates with:

Answer 1

functional ability

balance confidence

Question 2

Walking speed is predictive of

Answer 2

-future health status
–> prediction of post hospital discharge location (addition of FIM or cognition scores does not help better predict this)

-functional decline

-functional physiological changes
–> aids in prediction of falls and fear of falling

Question 3

What are the contributers to self-selected walking speed?

Answer 3

1.) individual’s health status

2.) motor control

3.) muscle performance and MSK condition

4.) sensory and perceptual function

5.) endurance and habitual activity level

6.) cognitive status

7.) motivation and mental health

8.) characteristics of the environment in which one walks

Question 4

Walking speed as a vital sign:

Answer 4

-indicator that can predict future events and reflect various underlying physiological processes

-there are normal and abnormal ranges –> can help define a differential diagnosis

-can reflect underlying processes

Question 5

NIH chose what as the standardized assessment to measure locomotion?

Answer 5

walking speed

Question 6

Walking speed variation by age and sex:

Answer 6

ADULT:
-male walking speed faster than female

After age 50:
-female gait speed declines at a faster rate than male gait sped
-male gait speed declines rapidly between 70s and 80s

Question 7

What functions can you perform at various walking speeds?

Answer 7

Self care - 0.67 m/s

Household activities - 0.89 m/s

Carrying groceries, light yard work 1.11 m/s

Climb several flights of stairs 1.33 m/s

Question 8

Critical speed needed for crossing the street

Answer 8

With 10 sec signal and 2 traffic lanes: 1.0 m/s

With 15 second signal and 4 traffic lanes: 1.2 m/s

Question 9

Walking speed predicts _______

Answer 9

how long you live

Question 10

At 8.5 years after study start date, what percent of ppl were alive in a study that looked at gait speed and categorized by red, yellow, and green category?

Answer 10

RED: <0.6 m/s
55-60%

YELLOW: 0.6-1.0 m/s
70-82%

GREEN: >1.0 m/s
90-95%

Question 11

If you are an older adult >65 years, how many more years can you live if your walking speed is >1.0 m/s (men vs women)

Answer 11

MEN:
-5-10 years more

WOMEN:
-8-13 years more

Question 12

Walking speed with age and sex can be a very strong predictor of:

Answer 12

survival

Question 13

If WS </= 0.65

Answer 13

then 3.8 times increased odds to die in 6 months

Question 14

MCID for walking speed

Answer 14

0.1 m/s

-walking speed is a modifiable risk factor

Question 15

0.1 m/s difference in gait speed at hospitalization may predict:

Answer 15

-poorer health status
-poorer physical function
-more disabilities
-more visits and rehab
-longer stays
-high inpatient costs

Question 16

Improvements of 0.1 m/s at 1 year can lead to:

Answer 16

-improved health status
-less ADL, IADL disability, better phys function
-fewer hospitalization days
-1 year cost reductions of $1,188 per 0.10 m/s

Question 17

Gait speed is multi-modal and slowing gait speed may reflect both damaged systems and a high energy cost of walking:

Answer 17

“Gait speed could be considered
a simple and accessible summary
indicator of vitality because
integrates known and
unrecognized disturbances in
multiple organ systems, many of
which affect survival.”

Question 18

What portion of the walk should be measured for walking speed and how many times should walking speed be measured?

Answer 18

middle 2/3 of the walk

3 times

Question 19

10 meter walk test accel/decel

Answer 19

5 meter accel zone

5 meter decel zone

10 meters in middle should b timed

20 meter total path

** use timer only during the central 10 meters

Question 20

4 meter walk test - accel and decel

Answer 20

1 meter accel/1 meter decel

6 meter path

Question 21

Benefits of fast WS test:

Answer 21

-can show larger deficits which might be missed or underestimated at submax walking speeds

-can suggest muscle strength and power losses

-may demonstrate age related decreases in motor units, impaired activation, diminished contraction speed and velocity, decreased nerve conduction velocity

Question 22

Is fast or self selected WS more energy efficient?

Answer 22

self selected

Question 23

What is considered an index of functional reserve?

Answer 23

fast WS

Question 24

Study outcomes comparing FWS and SSWS in 70s, 80s, and 90s:

Answer 24

-there is a similar difference between SSWS and FWS at each of the three decades

-decreases in gait speed happen at each decade for both walking speeds

-can increase WS by 0.4 m/s if SSWS > 1.0

-can increase WS by 0.3 if SSWS < 1.0 m/s

** absolute increase in walking speed may be more useful than % increase

Question 25

Is test-retest reliability good for walking speed?

Answer 25

yes

coefficients are 0.929 to 0.97