Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals (original) (raw)
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Aging Clinical and Experimental Research, 2020
Background There is a paucity of reliability data for walking speed tests in complex conditions to assess functioning in healthy older individuals. Aims To evaluate the absolute intra-and intertest reliability of walking speed performed in basic and complex conditions in healthy older individuals. Methods Fifty-two men and women of mean age 69.7 ± 3.2 years were tested for habitual and maximal walking speed. Maximal speed was also assessed under different conditions, including walking on a path of reduced width; picking up objects; stepping over hurdles; stepping over hurdles wearing sunglasses and finally, carrying a box. Two testing sessions (separated by 4 weeks) of two trials each were administered. Reliability was analysed by intra-class correlation coefficient (ICC), minimal detectable change (MDC) and Bland-Altman plots with limits of agreement (LOA). Results Intrasession ICCs ranged from good to excellent (0.89-0.95) except for picking up objects (0.44). Intersession ICCs were moderate to good (0.60-0.78) and %MDCs were acceptable (14-24%). Bland-Altman plots suggested a good agreement between the two testing sessions at group level (mean differences from-0.02 to − 0.11 m/s), and limited agreement between testing sessions at individual level (upper LOA from 0.13 to 0.37 m/s and lower LOA from − 0.29 to − 0.49 m/s). Conclusions Complex walking speed tests are generally reliable measures displaying good and moderate intra-and intersession reliability. Such tests seem a more suitable functional assessment tool for heathy older subjects compared with simple walking. Some learning effect may be present and further reliability studies are needed.
Journal of Nutrition Health & Aging, 2009
Introduction The use of a simple, safe, and easy to perform assessment tool, like gait speed, to evaluate vulnerability to adverse outcomes in community-dwelling older people is appealing, but its predictive capacity is still questioned. The present manuscript summarises the conclusions of an expert panel in the domain of physical performance measures and frailty in older people, who reviewed and discussed the existing literature in a 2-day meeting held in Toulouse, France on March 12–13, 2009. The aim of the IANA Task Force was to state if, in the light of actual scientific evidence, gait speed assessed at usual pace had the capacity to identify community-dwelling older people at risk of adverse outcomes, and if gait speed could be used as a single-item tool instead of more comprehensive but more time-consuming assessment instruments. Methods A systematic review of literature was performed prior to the meeting (Medline search and additional pearling of reference lists and key-articles supplied by Task Force members). Manuscripts were retained for the present revision only when a high level of evidence was present following 4 pre-selected criteria: a) gait speed, at usual pace, had to be specifically assessed as a single-item tool, b) gait speed should be measured over a short distance, c) at baseline, participants had to be autonomous, community-dwelling older people, and d) the evaluation of onset of adverse outcomes (i.e. disability, cognitive impairment, institutionalisation, falls, and/or mortality) had to be assessed longitudinally over time. Based on the prior criteria, a final selection of 27 articles was used for the present manuscript. Results Gait speed at usual pace was found to be a consistent risk factor for disability, cognitive impairment, institutionalisation, falls, and/or mortality. In predicting these adverse outcomes over time, gait speed was at least as sensible as composite tools. Conclusions Although more specific surveys needs to be performed, there is sufficient evidence to state that gait speed identifies autonomous community-dwelling older people at risk of adverse outcomes and can be used as a single-item assessment tool. The assessment at usual pace over 4 meters was the most often used method in literature and might represent a quick, safe, inexpensive and highly reliable instrument to be implemented.
Gait speed and step-count monitor accuracy in community-dwelling older adults
Medicine and science in sports and exercise, 2008
Accurate assessment of physical activity (PA) is necessary to identify the sedentary older individual who is in need of activity intervention. Activity monitors are quite popular, although it has been suggested that they are less accurate at slow gait speeds.
Physical therapy, 2020
Background. Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective. The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design. A cross-sectional design was used. Methods. The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper-and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results. The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations. The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion. The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs.
Gait & Posture, 2012
Physical performance measures predict health and function in older populations. Walking speed in particular has consistently predicted morbidity and mortality. However, single brief walking measures may not reflect a person's typical ability. Using a system that unobtrusively and continuously measures walking activity in a person's home we examined walking speed metrics and their relation to function. In 76 persons living independently (mean age, 86) we measured every instance of walking past a line of passive infra-red motion sensors placed strategically in their home during a four-week period surrounding their annual clinical evaluation. Walking speeds and the variance in these measures were calculated and compared to conventional measures of gait, motor function and cognition. Median number of walks per day was 18 AE 15. Overall mean walking speed was 61 AE 17 cm/s. Characteristic fast walking speed was 96 cm/s. Men walked as frequently and fast as women. Those using a walking aid walked significantly slower and with greater variability. Morning speeds were significantly faster than afternoon/ evening speeds. In-home walking speeds were significantly associated with several neuropsychological tests as well as tests of motor performance. Unobtrusive home walking assessments are ecologically valid measures of walking function. They provide previously unattainable metrics (periodicity, variability, range of minimum and maximum speeds) of everyday motor function.
Physiological and Psychological Predictors of Walking Speed in Older Community-Dwelling People
Gerontology, 2005
However, the other sensorimotor, balance and psychological measures each provided important independent information. The combined set of variables explained 40% of the variance in SMWS (multiple r = 0.63). Conclusions: The fi ndings indicate that in community-dwelling older people, self-selected walking speed is infl uenced not only by lower limb strength but also by balance, reaction time, vision, pain and emotional well-being.
Archives of gerontology and geriatrics
Understanding the mechanisms that contribute to walking speed decline can provide needed insight for developing targeted interventions to reduce the rate and likelihood of decline. Examine the association between gait characteristics and walking speed decline in older adults. Participants in the Baltimore Longitudinal Study of Aging aged 60 to 89 were evaluated in the gait laboratory which used a three dimensional motion capture system and force platforms to assess cadence, stride length, stride width, percent of gait cycle in double stance, anterior-posterior mechanical work expenditure (MWE), and medial-lateral MWE. Usual walking speed was assessed over 6m at baseline and follow-up. Gait characteristics associated with meaningful decline (decline ≥0.05m/s/y) in walking speed were evaluated by logistic regression adjusted for age, sex, race, height, weight, initial walking speed and follow-up time. Among 362 participants, the average age was 72.4 (SD=8.1) years, 51% were female, 27...