Walking speed: the functional vital sign

Abstract

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.

Figure 1

Depiction of walking speeds and the associated outcomes. m/s, meters per second; ↑, increased; LE, lower extremity; indep, independent; ADL, activities of daily living; AD, Alzheimer’s disease; 2x, two times; yo, years old; d/c, discharge * Able to climb several flights of stairs **More likely to require long term hospital care than d/c home or nursing home 1. (Studenski et al., 2003), 2. (Montero-Odasso et al., 2005), 3. (Cesari et al., 2005), 4. (Shimada et al., 2013), 5. (Ainsworth et al., 2011), 6. (Studenski, 2009), 7. (Inzitari et al., 2007), 8. (Atkinson et al., 2005), 9. (Ostir, Kuo, Berges, Markides, & Ottenbacher, 2007), 10. (Abellan van Kan et al., 2012), 11. (Friedman, Richmond, & Baskett, 1988), 12. (Graham, Fisher, Berges, Kuo, & Ostir, 2010), 13. (Perry, Garrett, Gronley, & Mulroy, 1995), 14. (Salbach et al., 2013)

Figure 2

Recommendations for assessment of walking speed