The effect of different test protocols and walking distances on gait speed in older persons
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ORIGINAL ARTICLE
The effect of different test protocols and walking distances on gait speed in older persons Sebastian Krumpoch1 · Ulrich Lindemann2 · Anja Rappl3 · Clemens Becker2 · Cornel C. Sieber1,4 · Ellen Freiberger1 Received: 23 August 2020 / Accepted: 28 August 2020 © The Author(s) 2020
Abstract Background and aims Walking is the core physical activity of older persons. The assessment of walking capacity is increasingly important for clinical purposes and clinical research. Differences between assessment tools and protocols for short walks to obtain gait characteristics can be responsible for changes, e.g., in gait speed from 0.1 to 0.2 m/s. The purpose of this study was to generate further knowledge for the harmonization and/or standardization of short walk-test protocols for assessing gait characteristics under supervised conditions. Methods For this cross-sectional study, 150 community-dwelling older adults (mean age 80.5 ± 4.5 years) were recruited. Participants performed eight walks differing in the distance (8-versus 4-m), static versus dynamic trials and comparing different test speed instructions (usual versus maximal) on an electronic walkway. Results A meaningful significant difference in mean usual gait speed was documented comparing the 4-m dynamic and static test protocol (0.12 m/s; p = 0.001). For the same comparison over an 8-m distance (dynamic versus static) and for the comparison between usual gait speed over 4-and 8-m, the differences in gait speed were smaller, but still statistically significant (p = 0.001). Conclusions Gait speed was faster, if the test protocol did not include a static start or stop. The differences were greater for a shorter walking distance. This aspect should be considered for the comparison of study results and is particularly relevant for systematic reviews and meta-analyses. Keywords Acceleration phase · Deceleration phase · Gait speed · Aged · Test protocol
Introduction Walking is a core activity of older persons and a relevant component to overall mobility. Evidence exists that a decline in gait speed of older persons is associated with many * Sebastian Krumpoch [email protected] 1
Institute for Biomedicine of Aging, Friedrich-AlexanderUniversity of Erlangen-Nürnberg, Kobergerstr. 60, 90408 Nuremberg, Germany
2
Department of Geriatrics and Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital, Auerbachstr. 110, 70376 Stuttgart, Germany
3
Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University of Erlangen-Nürnberg, Waldstr. 6, 91054 Erlangen, Germany
4
Department of Medicine, Kantonsspital Winterthur, Brauerstr. 15, 8400 Winterthur, Switzerland
negative health outcomes, such as death [1], frailty [2] or hospital admission [3]. Gait speed is increasingly acknowledged as a “vital sign” [4]. To be used in clinical practice, gait speed measurements should be standardized and for clinical research the results should be at least harmonized [5]. Assessing gait speed is not trivial. Gait char
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