Walking speed Flashcards
Walking speed is a powerful indicator of:
health and disease
Walking speed correlates with:
functional ability
balance confidence
Walking speed is predictive of
-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
What are the contributers to self-selected walking speed?
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
Walking speed as a vital sign:
-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
NIH chose what as the standardized assessment to measure locomotion?
walking speed
Walking speed variation by age and sex:
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
What functions can you perform at various walking speeds?
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
Critical speed needed for crossing the street
With 10 sec signal and 2 traffic lanes: 1.0 m/s
With 15 second signal and 4 traffic lanes: 1.2 m/s
Walking speed predicts _______
how long you live
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?
RED: <0.6 m/s
55-60%
YELLOW: 0.6-1.0 m/s
70-82%
GREEN: >1.0 m/s
90-95%
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)
MEN:
-5-10 years more
WOMEN:
-8-13 years more
Walking speed with age and sex can be a very strong predictor of:
survival
If WS </= 0.65
then 3.8 times increased odds to die in 6 months
MCID for walking speed
0.1 m/s
-walking speed is a modifiable risk factor
0.1 m/s difference in gait speed at hospitalization may predict:
-poorer health status
-poorer physical function
-more disabilities
-more visits and rehab
-longer stays
-high inpatient costs
Improvements of 0.1 m/s at 1 year can lead to:
-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
Gait speed is multi-modal and slowing gait speed may reflect both damaged systems and a high energy cost of walking:
“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.”
What portion of the walk should be measured for walking speed and how many times should walking speed be measured?
middle 2/3 of the walk
3 times
10 meter walk test accel/decel
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
4 meter walk test - accel and decel
1 meter accel/1 meter decel
6 meter path
Benefits of fast WS test:
-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
Is fast or self selected WS more energy efficient?
self selected
What is considered an index of functional reserve?
fast WS
Study outcomes comparing FWS and SSWS in 70s, 80s, and 90s:
-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
Is test-retest reliability good for walking speed?
yes
coefficients are 0.929 to 0.97
