Walking speed: the functional vital sign.

Walking speed (WS) is a valid, reliable, and sensitive measure appropriate for assessing and monitoring functional status and overall health in a wide range of populations. These capabilities have led to its designation as the "sixth vital sign". By synthesizing the available evidence on WS, this scholarly review article provides clinicians with a reference tool regarding this robust measure. Recommendations on testing procedures for assessing WS, including optimal distance, inclusion of acceleration and deceleration phases, instructions, and instrumentation are given. After assessing an individual's WS, clinicians need to know what this value represents. Therefore, WS cut-off values and the corresponding predicted outcomes, as well as minimal detectable change values for specific populations and settings are provided.

[1]  P. Friedman,et al.  A prospective trial of serial gait speed as a measure of rehabilitation in the elderly. , 1988, Age and ageing.

[2]  JoAnne K. Gronley,et al.  Classification of walking handicap in the stroke population. , 1995, Stroke.

[3]  P. Goldie,et al.  Deficit and change in gait velocity during rehabilitation after stroke. , 1996, Archives of physical medicine and rehabilitation.

[4]  Richard W. Bohannon.  Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. , 1997, Age and ageing.

[5]  M. Woollacott,et al.  Balance control during walking in the older adult: research and its implications. , 1997, Physical therapy.

[6]  J. Arendzen,et al.  Ten-metre walk, with or without a turn? , 1998, Clinical rehabilitation.

[7]  S. Ho,et al.  Walking Speed and Stride Length Predicts 36 Months Dependency, Mortality, and Institutionalization in Chinese Aged 70 And Older , 1999, Journal of the American Geriatrics Society.

[8]  Y. Fujiwara,et al.  Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. , 2000, Age and ageing.

[9]  S. Studenski,et al.  Physical Performance Measures in the Clinical Setting , 2003, Journal of the American Geriatrics Society.

[10]  G. Lankhorst,et al.  Reproducibility of walking at self-preferred and maximal speed in patients with postpoliomyelitis syndrome. , 2004, Archives of physical medicine and rehabilitation.

[11]  S. Rubin,et al.  Prognostic Value of Usual Gait Speed in Well‐Functioning Older People—Results from the Health, Aging and Body Composition Study , 2005, Journal of the American Geriatrics Society.

[12]  H. Cohen,et al.  Walking speed predicts health status and hospital costs for frail elderly male veterans. , 2005, Journal of rehabilitation research and development.

[13]  I. Chi,et al.  Incidence and predictors of falls in the chinese elderly. , 2005, Annals of the Academy of Medicine, Singapore.

[14]  M. Montero‐Odasso,et al.  Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[15]  Matteo Cesari,et al.  Predictors of Combined Cognitive and Physical Decline , 2005, Journal of the American Geriatrics Society.

[16]  B. Dobkin.  Short-distance walking speed and timed walking distance: Redundant measures for clinical trials? , 2006, Neurology.

[17]  G. Ostir,et al.  Measures of lower body function and risk of mortality over 7 years of follow-up. , 2007, American journal of epidemiology.

[18]  K. Markides,et al.  Does 8‐Foot Walk Time Predict Cognitive Decline in Older Mexicans Americans? , 2007, Journal of the American Geriatrics Society.

[19]  Anne B. Newman,et al.  Gait Speed Predicts Decline in Attention and Psychomotor Speed in Older Adults: The Health Aging and Body Composition Study , 2007, Neuroepidemiology.

[20]  Jaana Paltamaa,et al.  Measuring Deterioration in International Classification of Functioning Domains of People With Multiple Sclerosis Who Are Ambulatory , 2008, Physical Therapy.

[21]  W Zijlstra,et al.  Distance to achieve steady state walking speed in frail elderly persons. , 2008, Gait & posture.

[22]  P. Macfarlane,et al.  Walkway Length Determination for Steady State Walking in Young and Older Adults , 2008, Research quarterly for exercise and sport.

[23]  James E. Graham,et al.  Assessing walking speed in clinical research: a systematic review. , 2008, Journal of evaluation in clinical practice.

[24]  J. Hollman,et al.  Minimum Detectable Change in Gait Velocity during Acute Rehabilitation following Hip Fracture , 2008, Journal of geriatric physical therapy.

[25]  Lewis H Kuller,et al.  Association Between Lower Digit Symbol Substitution Test Score and Slower Gait and Greater Risk of Mortality and of Developing Incident Disability in Well‐Functioning Older Adults , 2008, Journal of the American Geriatrics Society.

[26]  M. O. Olde Rikkert,et al.  Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients. , 2008, Journal of clinical epidemiology.

[27]  M. Inzitari,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 , 2009, The journal of nutrition, health & aging.

[28]  Christophe Tzourio,et al.  Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study , 2009, BMJ : British Medical Journal.

[29]  S. Studenski,et al.  Bradypedia: Is gait speed ready for clinical use? , 2009, The journal of nutrition, health & aging.

[30]  Richard W. Bohannon.  Measurement of Gait Speed of Older Adults is Feasible and Informative in a Home‐care Setting , 2009, Journal of geriatric physical therapy.

[31]  J. Echternach,et al.  Test-Retest Reliability and Minimal Detectable Change Scores for the Timed " Up & Go " Test , the Six-Minute Walk Test , and Gait Speed in People With Alzheimer Disease , 2018 .

[32]  John H Hollman,et al.  Responsiveness of 2 Procedures for Measurement of Temporal and Spatial Gait Parameters in Older Adults , 2010, PM & R : the journal of injury, function, and rehabilitation.

[33]  James E. Graham,et al.  Walking Speed Threshold for Classifying Walking Independence in Hospitalized Older Adults , 2010, Physical Therapy.

[34]  H. Blain,et al.  Balance and walking speed predict subsequent 8-year mortality independently of current and intermediate events in well-functioning women aged 75 years and older , 2010, The Journal of Nutrition, Health & Aging.

[35]  Nandini Dendukuri,et al.  Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. , 2010, Journal of the American College of Cardiology.

[36]  W. Evans,et al.  Energetics of walking in elderly people: factors related to gait speed. , 2010, The journals of gerontology. Series A, Biological sciences and medical sciences.

[37]  David R Bassett,et al.  2011 Compendium of Physical Activities: a second update of codes and MET values. , 2011, Medicine and science in sports and exercise.

[38]  S. Studenski,et al.  Gait speed and survival in older adults. , 2011, JAMA.

[39]  R. Holtzer,et al.  Relationship of clinic-based gait speed measurement to limitations in community-based activities in older adults. , 2011, Archives of physical medicine and rehabilitation.

[40]  Stacey L. Schepens,et al.  Measurement error and minimum detectable change in 4-meter gait speed in older adults , 2011, Aging clinical and experimental research.

[41]  S. Dahlin-Ivanoff,et al.  Effects of Walking Speed and Results of Timed Get-Up-and-Go Tests on Quality of Life and Social Participation in Elderly Individuals With a History of Osteoporosis-Related Fractures , 2011, Journal of aging and health.

[42]  L. Lipsitz,et al.  The Nonlinear Relationship Between Gait Speed and Falls: The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study , 2011, Journal of the American Geriatrics Society.

[43]  Kari Dunning,et al.  Estimating Clinically Important Change in Gait Speed in People With Stroke Undergoing Outpatient Rehabilitation , 2011, Journal of neurologic physical therapy : JNPT.

[44]  Vimonwan Hiengkaew,et al.  Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. , 2012, Archives of physical medicine and rehabilitation.

[45]  Association of walking speed in late midlife with mortality: results from the Whitehall II cohort study , 2012, AGE.

[46]  G. Moonen,et al.  A corrected version of the Timed-25 Foot Walk Test with a dynamic start to capture the maximum ambulation speed in multiple sclerosis patients. , 2012, NeuroRehabilitation.

[47]  Lucas R Nascimento,et al.  Different instructions during the ten-meter walking test determined significant increases in maximum gait speed in individuals with chronic hemiparesis. , 2012, Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil)).

[48]  Paul Cullinan,et al.  Reliability and validity of 4-metre gait speed in COPD , 2012, European Respiratory Journal.

[49]  A. Behrman,et al.  Minimal detectable change for spatial and temporal measurements of gait after incomplete spinal cord injury. , 2012, Topics in spinal cord injury rehabilitation.

[50]  Richard W. Bohannon,et al.  Gait speed is a responsive measure of physical performance for patients undergoing short-term rehabilitation. , 2012, Gait & posture.

[51]  Astrid Bergland,et al.  Investigation into the reliability and validity of the measurement of elderly people's clinical walking speed: A systematic review , 2012, Physiotherapy theory and practice.

[52]  S. Ng,et al.  Walkway lengths for measuring walking speed in stroke rehabilitation. , 2012, Journal of rehabilitation medicine.

[53]  A. LaCroix,et al.  Universal Health Outcome Measures for Older Persons with Multiple Chronic Conditions , 2012, Journal of the American Geriatrics Society.

[54]  Dimitra Koutsouki,et al.  The Effect of Treadmill Training on Gross Motor Function and Walking Speed in Ambulatory Adolescents with Cerebral Palsy: A Randomized Controlled Trial , 2012, American journal of physical medicine & rehabilitation.

[55]  Roee Holtzer,et al.  Depressive symptoms and gait dysfunction in the elderly. , 2012, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[56]  Chris J. Hass,et al.  Quantitative Normative Gait Data in a Large Cohort of Ambulatory Persons with Parkinson’s Disease , 2012, PloS one.

[57]  Richard W. Bohannon,et al.  Gait Speed Is Limited but Improves Over the Course of Acute Care Physical Therapy , 2012, Journal of geriatric physical therapy.

[58]  E. Scherder,et al.  Reliability of Six Physical Performance Tests in Older People With Dementia , 2012, Physical Therapy.

[59]  C. Annweiler,et al.  Gait speed, body composition, and dementia. The EPIDOS-Toulouse cohort. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[60]  L. Price,et al.  Test-retest reliability and sensitivity of the 20-meter walk test among patients with knee osteoarthritis , 2013, BMC Musculoskeletal Disorders.

[61]  N. Peel,et al.  Gait speed as a measure in geriatric assessment in clinical settings: a systematic review. , 2013, The journals of gerontology. Series A, Biological sciences and medical sciences.

[62]  M. Castell,et al.  Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care , 2013, BMC Family Practice.

[63]  Denise M. Peters,et al.  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 , 2013, Journal of geriatric physical therapy.

[64]  S. Ng,et al.  Assessing the Walking Speed of Older Adults: The Influence of Walkway Length , 2013, American journal of physical medicine & rehabilitation.

[65]  Satoshi Morita,et al.  Association between gait speed as a measure of frailty and risk of cardiovascular events after myocardial infarction. , 2013, Journal of the American College of Cardiology.

[66]  T. Manini,et al.  Neuromuscular determinants of maximum walking speed in well-functioning older adults , 2013, Experimental Gerontology.

[67]  Byoung-Hee Lee,et al.  An Ankle Proprioceptive Control Program Improves Balance, Gait Ability of Chronic Stroke Patients , 2013, Journal of physical therapy science.

[68]  E. Rydwik,et al.  The Test-Retest Reliability of 10 Meters Maximal Walking Speed in Older People Living in a Residential Care Unit , 2013, Journal of geriatric physical therapy.

[69]  M. Puthoff,et al.  Reliability and Responsiveness of Gait Speed, Five Times Sit to Stand, and Hand Grip Strength for Patients in Cardiac Rehabilitation , 2013, Cardiopulmonary physical therapy journal.

[70]  L. Ferrucci,et al.  Trajectories of gait speed predict mortality in well-functioning older adults: the Health, Aging and Body Composition study. , 2013, The journals of gerontology. Series A, Biological sciences and medical sciences.

[71]  L. Nogueira,et al.  Factors for Lower Walking Speed in Persons with Multiple Sclerosis , 2013, Multiple sclerosis international.

[72]  H. Makizako,et al.  Performance-based assessments and demand for personal care in older Japanese people: a cross-sectional study , 2013, BMJ Open.

[73]  Relationship between functional vision and balance and mobility performance in community-dwelling older adults , 2013, Aging Clinical and Experimental Research.

[74]  L. Quinn,et al.  Reliability and Minimal Detectable Change of Physical Performance Measures in Individuals With Pre-manifest and Manifest Huntington Disease , 2013, Physical Therapy.

[75]  Addie Middleton,et al.  Concurrent validity of walking speed values calculated via the GAITRite electronic walkway and 3 meter walk test in the chronic stroke population , 2014, Physiotherapy theory and practice.

[76]  Erin Long,et al.  Short-distance walking speed tests in people with Parkinson disease: reliability, responsiveness, and validity. , 2014, Gait & posture.

[77]  D. Brooks,et al.  Speed and distance requirements for community ambulation: a systematic review. , 2014, Archives of physical medicine and rehabilitation.