A test of gait speed assesses an individual's functional mobility. It is simple to perform, and it requires minimal space, equipment, and time. Gait Speed can be performed with populations of varying abilities and diagnoses. Gait speed has been used as a predictor of decline in functional mobility.
5 minutes
<5 minutes
Adult
18 - 64
yearsElderly adult
65 +
yearsReviewed by Jill Heitzman, PT, DPT, GCS, NCS, CWS, CEEAA, FACCWS in November 2013; Updated by Jessica Donovan, MOTS & OTD Student.
Gait speed is the most valid and reliable among older adults (aged 65+)
Gait speed is a reliable predictor of potential for hospitalization and decline in function
Gait speed is more commonly assessed using the 10-meter walk test or the 6-minute walk test
Women have an overall slower gait speed than men, especially among older adults
(Palombaro, Craik, Mangione, & Tomlinson, 2006; n = 92; 6 months post fracture)
Hip Fracture: (Hollman et al., 2008)
Stroke:
(Perera, Mody, Woodman, & Studenski, 2006; n = 692)
Community-Dwellers:
(Montero-Odasso et al., 2005)
Low gait speed (at risk for falls/admissions/adverse events): <0.7m/sec
Mean gait speed: 0.7-1.0m/sec
High functioning gait speed: >1.1m/sec
(Bohannon et al., 2008)
|
Gait Speed: m/sec
|
|||
|
Gender |
Age |
3M |
6M |
|
Female |
50-59 |
1.1 (0.24) |
1.109 (0.22) |
|
|
60-69 |
0.99 (0.24) |
1.0 (0.23) |
|
|
70-79 |
0.917 (0.24) |
0.929 (0.24) |
|
|
80+ |
0.762 (0.216) |
0.783 (0.219) |
|
Male |
50-59 |
1.115 (0.235) |
1.122 (0.20) |
|
|
60-69 |
1.03 (0.23) |
1.033 (0.20) |
|
|
70-79 |
0.954 (0.244) |
0.957 (0.23) |
|
|
80+ |
0.844 (0.24) |
0.832 (0.22) |
Community Dwellers:
(Bohannon et al., 1997; n = 230)
Excellent reliability: ICC = 0.903 (comfortable)
Excellent reliability: ICC = 0.910 (maximum)
(Steffen, Hacker, & Mollinger, 2002; n = 96)
Excellent interrater reliability, intrarater reliability, and test-retest reliability: ICC = 0.90 - 0.96, r = 0.89-1.00
Community Dwellers:
Correlation with age, height and LE muscle strength
r = .190 to .251 (comfortable gait speed)
r = .292 to .558 (maximum gait speed)
(Bohannon et al., 2008)
Correlation with shorter (3m) distances to longer (6 m) distances
r = .933
BMI has a higher correlation to the longer gait speed:
r = -.081 for 6M walk
r = -.78 for 3M walk
(Steffen, Hacker, & Mollinger, 2002)
Correlation with Balance Master weight shift tasks: r = -.49 to -.72
Correlation with Berg Balance Scale: r = .81
Correlation with TUG: r = -.75
Predictor of independent physical function:
Sensitivity 80%
Specificity 89%
COPD: (Kon et al., 2013; n = 586)
|
Test |
SEM |
SEM% |
|
Usual 4MGS (stopwatch) |
0.05 |
4.4 |
|
Usual 4MGS (timer) |
0.05 |
4.4 |
|
Usual 10MGS (timer) |
0.04 |
3.3 |
|
Maximal 4MGS (stopwatch) |
0.08 |
4.8 |
|
Maximal 4MGS (timer) |
0.08 |
4.8 |
|
Maximal 10MGS (timer) |
0.07 |
4.0 |
Interobserver SEM: 1.14%
Test-retest reliability SEM: 1.5%
COPD: (Kon et al., 2014)
0.11m/s (anchored against ISW)
0.08 m/s (anchored against self-reported improvement)
COPD: (Kon et al., 2013)
Slow: <0.8 m/s
Normal: ≥0.8 m/s
COPD: (Liston & Brouwer, 1996)
|
Walking Speed Protocol |
Mean Speed ± SD (m/s) |
Minimum-Maximum (m/s) |
|
Usual 4MGS (stopwatch) |
1.13 ± 0.23 |
0.68-1.74 |
|
Usual 4MGS (timer) |
1.14 ± 0.24 |
0.68-1.82 |
|
Usual 10MGS (timer) |
1.27 ± 0.24 |
0.87-2.00 |
|
Maximal 4MGS (stopwatch) |
1.68 ± 0.37 |
0.98-2.50 |
|
Maximal 4MGS (timer) |
1.69 ± 0.38 |
0.93-2.67 |
|
Maximal 10MGS (timer) |
1.77 ± 0.39 |
1.05-2.78 |
(4MGS= 4-meter gait speed; 10MGS= 10 meter gait speed)
COPD: (Kon et al., 2013)
Significant increase in mean 4GMS with pulmonary rehabilitation = 0.08 m/s
COPD: (Liston & Brouwer, 1996)
Excellent test-retest reliability at usual and maximal pace for 4MGS (ICC ≥ .95)
|
Test |
ICC (95% CI) |
Mean Difference (95% CI) |
|
Usual 4MGS (stopwatch) |
0.95 (0.92-0.97) |
0.01 (-0.03- 0.01) |
|
Usual 4MGS (timer) |
0.95 (0.91-0.97) |
<0.01 (-0.02- 0.02) |
|
Usual 10MGS (timer) |
0.95 (0.95-0.98) |
<0.01 (-0.02- 0.01) |
|
Maximal 4MGS (stopwatch) |
0.95 (0.93-0.97) |
0.02 (-0.04- 0.01) |
|
Maximal 4MGS (timer) |
0.95 (0.92-0.97) |
0.02 (-0.05- 0.01) |
|
Maximal 10MGS (timer) |
0.95 (0.96-0.98) |
0.03 (-0.05- <0.01) |
Excellent test-retest reliability (ICC = 0.97, 95% CI, 0.95-0.98)
COPD: (Kon et al., 2013)
COPD: (Kon et al., 2013)
Convergent:
Excellent correlations with 4MGS and ISAW (p = 0.78, p < 0.001)
Discriminant:
Negative correlation with MRC dyspnea scale (p = -0.55, p < 0.001)
Negative correlation with SGRQ (p = -0.44, p < 0.001)
COPD: (Kon et al., 2013)
COPD: (Kon et al., 2013)
4MGS is responsive to intervention and declines with time
Smallest real change = 0.02 m/s
Substantial real change = 0.11 m/s
Older Adults: (Pulignano et al., 2016; n = 331; mean age = 78 years (6); 43% women; community-dwelling with history of chronic heart failure)
Older Adults: (Pulignano et al., 2016)
Aged 65 and Older: (Studenski et al., 2003)
Clinically Valid Cut Point: 0.6 m/s to 1.0 m/s
Aged 70 and above: (Peel, Kuys, & Klein, 2013)
Age 70-79 comfortable gait speed:
Men: 1.13 m/s
Women: 1.26 m/s
Age 80-99 comfortable gait speed:
Men: 0.94 m/s
Women: 0.97 m/s
Predictor of poor clinical outcomes: 0.8 m/s
Predictor of further functional decline in already impaired individuals: 0.6 m/s
Adults 75 and above: (Montero-Odasso et al., 2005).
|
Gait Velocity (GS) Category |
Gait Velocity |
|
High |
1.1 m/s |
|
Median |
0.7-1.1 m/s |
|
Low |
<0.7 m/s |
>1 m/s= “normal” in older adults without disability
<0.7 m/s= predictor of adverse events
Older Adults with Heart Failure: (Pulignano et al., 2016)
Slow: gait speed < or = to 0.65 m/s
Intermediate: gait speed = 0.66-0.99 m/s
Fast: gait speed > or = to 1.0 m/s
Age 70 and above: (Peel, Kuys, & Klein, 2013)
Usual pace gait speed estimate= 0.58 m/s (95% CI: 0.001-0.006)
Maximal pace= 0.89 m/s (95% CI: 0.75-1.02)
Gate speed increased per year: mean 0.013 m/s (95% CI: 0.003-0.023)
Usual and Maximal Pace Gait Speed in Clinical Settings
|
Pace |
Location |
Gait Speed Estimates (m/s) |
SE |
95% CI |
|
Usual |
Acute |
0.455 |
0.057 |
0.344-0.567 |
|
Subacute |
0.529 |
0.046 |
0.438-0.619 |
|
|
Ambulatory |
0.739 |
0.046 |
0.648-0.831 |
|
|
Maximal |
Acute |
0.749 |
0.080 |
0.592-0.905 |
|
Subacute |
0.822 |
0.057 |
0.711-0.933 |
|
|
Ambulatory |
1.033 |
0.063 |
0.910-1.156 |
Adults Aged 75 and above: (Montero-Odasso et al., 2005).
Results 2 years post-test (8m/usual speed):
|
Gait Velocity |
High: >1.1 m/s (n=34) |
Median: 0.7-1.0 m/s (n=42) |
Low: <0.7 m/s (n=25) |
Relative Risk |
P value |
|
Subjects with adverse events |
20% |
34% |
72% |
High-Low GV: 3.5 (1.7-7.0) Intermediate-Low GV: 2.1 (1.3–3.4 |
.002
.001 |
|
New falls |
12% |
24% |
60% |
High-Low GV: 5.4 (2.0-14.3) Intermediate-Low GV: 2..6 (1.4-4.9) |
<.0005 |
|
Hospitalization |
8.8% |
17% |
52% |
High-Low GV: 5.9 (1.9–18.5
Intermediate-Low: 3.0 (1.4–3.6)
|
<.005 |
|
Need for caregiver |
3% |
17% |
28% |
High-Low GV: 9.5 (1.3–72.5)
Intermediate-Low: 1.64 (0.7–4.1)
|
<.007 |
|
Nursing home placement |
0% |
0% |
12% |
N/A |
|
|
Fracture |
3% |
10% |
8% |
High-Low GV: 2.7 (0.3-28.4)
Intermediate-Low: 0.8 (0.8-4.2)
|
|
|
Death |
0% |
10% |
8% |
N/A |
|
Relative Risk between high and low GV (95% CI) = 3.5 (1.7-7.0), p < .002)
RR between intermediate and low GV= 2.1 (1.3-3.4), p < .001
Older Adults with Heart Failure: (Pulignano et al., 2016)
Slow: gait speed < or = to 0.65 m/s
Intermediate: gait speed = 0.66-0.99 m/s
Fast: gait speed > or = to 1.0 m/s
Aged 65 and older: (Studenski et al., 2003)
Over 2 weeks:
Excellent test-retest reliability (ICC > .90)
Aged 70 and older: (Verghese et al., 2011; Verghese & Xue, 2011)
Aged 65 and Older: (Studenski et al., 2003)
Aged 70 and Older: (Verghese et al., 2011; Verghese & Xue, 2011)
Adults Aged 70 and Older: (Verghese et al., 2011; Verghese & Xue, 2011)
Concurrent Validity
Adults Aged 65 and Older: (Studenski et al., 2003)
Excellent correlation with GS and Pra score at 1 year in HMO population (r = 0.686)
Predictive Validity:
Adults Aged 65 and Older: (Studenski et al., 2003)
Excellent predictive validity of GS at 1 year in HMO population (r = 0.677)
Adequate predictive validity of GS at 1 year in VA population (r = 0.532)
Aged 65 and Older: (Studenski et al., 2003)
|
Area Under ROC curve for major outcomes: |
||
|
Outcome |
Gait Speed |
Gait Speed and Self-report |
|
Pra score* HMO VA Pooled |
0.677 0.578 0.644 |
0.686 0.580 0.656 |
|
Physician risk assessment HMO VA Pooled |
0.683 0.506 0.630 |
0.690 0.603 0.657 |
|
Pra score* and physician risk assessment HMO VA Pooled |
0.683 0.506 0.630 |
0.701 0.602 0.673 |
|
Global health change HMO VA Pooled |
0.625 0.743 0.691 |
0.701 0.820 0.741 |
|
Eroquel score HMO VA Pooled |
0.578 0.631 0.587 |
0.662 0.672 0.653 |
|
Functional Status HMO VA Pooled |
0.690 0.748 0.721 |
0.773 0.830 0.798 |
*Pra= hospitalization risk by probability of repeated admission
Adults Aged 65 and Older: (Studenski et al., 2003)
Not statistically assessed, however:
Out of 32 staff:
> 50% felt assessment was very acceptable
Remaining felt assessment was acceptable
Out of 60 participants:
58 felt assessment was acceptable or very acceptable
2 felt assessment was less than acceptable
"An expert working group recently identified the 4MGS as the most appropriate functional test for interventional trials in frail older adults" (Kon et al., 2013).
Bohannon, R. W. (1997). Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age and Ageing, 26, 15-19. Find it on PubMed
Bohannon, R. W. (2008). Population representative gait speed and its determinants. Journal of Geriatric Physical Therapy, 31, 49-52. Find it on PubMed
Hollman, J. H., Beckman, B. A., Brandt, R. A., Merriwether, E. N., Williams, R. T., Nordrum, J. T. (2008). Minimum detectable change in gait velocity during acute rehabilitation following hip fracture. Journal of Geriatric Physical Therapy, 31, 53-56. Find it on PubMed
Kon, S., Patel, M., Canavan, J., Clark, A., Jones, S., Nolan, C., Cullinan, P., Polkey, M. and Man, W. (2013). Reliability and validity of 4-metre gait speed in COPD. European Respiratory Journal, 42(2), 333-340. Find it on PubMed
Kon, S., Patel, M., Canavan, J., Clark, A., Jones, S., Nolan, C., Cullinan, P., Polkey, M. and Man, W. (2014). The 4-metre gait speed in COPD: responsiveness and minimal clinically important difference. The European Respiratory Journal, 43(5), 1298-1305. Find it on PubMed
Montero-Odasso, M., Schapira, M., Soriano, E. R., Varela, M., Kaplan, R., Camera, L. A., Mayorga, L. M. (2005). Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. Journal of Gerontology: Biological Sciences, 60, 1304-1309. Find it on PubMed
Palombaro, K. M., Craik, R. L., Mangione, K .K., Tomlinson, J. D. (2006). Determining meaningful changes in gait speed after hip fracture."Journal of Geriatric Physical Therapy, 31, 53-56. Find it on PubMed
Perera, S., Mody, S. H., Woodman, R. C., Studenski, S. A. (2006). Meaningful change and responsiveness in common physical performance measures in older adults. Journal of American Geriatric Society, 54, 743-749. Find it on PubMed
Pulignano, G., Del Sindaco, D., Di Lenarda, D., Alunni, G., Senni, M., Tarantini, L., Cioffi, G., Denitza Tinti, M., Barbati, G., Minardi, G., & Uguccioni, M. (2016). Incremental value of gait speed in predicting prognosis of older adults with heart failure: Insights from the IMAGE-IF study. JACC: Heart Failure, 4(4), 289-298. Find it on PubMed
Steffen, T. M., Hacker, T. A., Mollinger, L. (2002). Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Physical Therapy, 82, 128-137. Find it on PubMed
Studenski, S., Perera, S., Wallace, D., Chandler, J. M., Duncan, P. W., Rooney, E., Fox, M., Guralnik, J. M. (2003). Physical performance measures in the clinical setting. Journal of the American Geriatrics Society, 51(3), 314–322. Find it on PubMed
Verghese, J., & Xue, X. (2011). Predisability and gait patterns in older adults. Gait & Posture, 33(1), 98-101. Find it on PubMed
Verghese, J., Holtzer, R., Oh-Park, M., Derby, C., Lipton, R., Wang, C. (2011) Inflammatory markers in gait speed decline in older adults. Journal of Gerontology: Series A, Volume 66A(10), 1083-1089. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.