Rock Valley
Physical Therapy
“Making Better
Lives”
Rock On
www.rockvalleypt.com
The Official Newsletter of Rock Valley Physical Therapy
V o l u m e
Inside This
Issue:
The Facts
1
The Evidence
1
Mythbusters
2
References
2
Coffee on Us
2
Did You
Know?
Conversion m/s to
mph: 1 m/s = 2.24
mph
1 ,
I s s u e
5
J u l y
Walking Speed: The Facts
There is significant evidence to suggest that people with decreased walking tolerance, strength, and balance are dying sooner. There is also significant evidence
that sitting time alone increases risk of death.
Walking speed is a powerful indicator of functional status for patients with varying diagnoses; however, it is not routinely assessed by the medical community.
Walking Speed: The Evidence
The functional requirements for community living aging adults1 are identified as follows:
Conversion mph to
m/s: 1 mph = .447
m/s
1.
1203 feet (366.7 meters) to complete an errand in the community
2.
Gait speed of 1.2 m/s or 2.68 mph
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Contact Us:
3.
Need to carry an average of 6.7 lb. package
amy.johnson@
rockvalleypt.
com
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rockvalleypt.
com
What’s
Next?
August 2011:
ASTYM
2 0 1 1
A significant increase in mortality existed among subjects with increased time to perform the 400 meter walk
test. (948 men and women; this was further adjusted for
depression, education, smoking, BMI, sedentary, chronic
disease.)2,3 For each additional minute of longer performance time, risk of death increased 35%.4
Walking speed, walking less than 400 meters, and decreased lower extremity strength
are strong predictors for nursing home placement. Loss of leg strength is the strongest
single predictor for subsequent institutionalization, stronger than disease diagnosis. 5,6
A change in gait speed by .10 m/s (.22 mph) has been shown to be a meaningful
change in community dwelling older adults, hospitalized male veterans, and patients
with a hip fracture. A 2011 study in the Journal of American Medical Association
found that a change of .10 m/s (.33 mph) increased survival over a 10 year period.7
9901 N. Knoxville Ave, Suite D • Peoria, Illinois 61615 • (309) 243-1989 • Fax (309)243-8138
Mythbusters
Page 2
Myth: There is not a reliable, valid, sensitive and specific tool to measure gait
velocity or walking speed.
Fact: The figure displays a suggested reliable, inexpensive method to calculate
gait velocity by using the 10 meter walk test. Set up a 20 meter path in your
clinic, with the central 10 meters being the timing area. Start your patient at the
beginning of the 20 meter line and ask them to walk “at a comfortable pace” to
the end of the line. Using a stopwatch, time from when the patient’s leading limb
(toe) crosses the first 10 meter line until the leading limb crosses the second line
demarcating the end of the 10 meter timed area. This gives the patient 5 meters
on either side to accelerate and decelerate respectively. 8
Acceleration
10 Meter Walk– Timed Section
Deceleration
Myth: There is no predictive value in assessment of walking speed.
Fact: Gait speed correlates well with functional ability, future health status
Coffee
On Us
Don’t throw away that
newsletter yet! Fax us
your company letterhead and the name of a
contact person from
your office. From the
entries received over the
next two weeks, one
clinic will be selected to
win Starbucks for up to
twenty people.
and the patient’s confidence in balance.
< 0.6 m/s (1.34 mph)
Increased risk for dependence in ADL and risk of hospitalization (seniors)
< 1.0 m/s (2.24 mph)
Need intervention to reduce fall risk (seniors)
> 1.0 m/s (2.24 mph)
Independent in ADLs, more likely to be discharged home after
a hospitalization and less likely to be hospitalized (seniors)
References
1 Shumway-Cook A, et al. Environmental demands associated with community mobility in older adults
with and without disabilities. Phys Ther. 2002;82:670-681.
2 Chang M, et al. Incidence of loss of ability to walk 400 meters in a functionally limited older population. J Am Geriatr Soc. 2004;52:2094-8.
3 Vestergaard S, et al. Characteristis of 400-meter walk test performance and subsequent mortality in
older adults. Rejunenation Res. 2009;12:177-84.
4 Newman AB, et al. Association of long-distance corridor walking performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA. 2006;295:2018-2026.
5 Guralnik JM, et al. Validation and use of performance measures of functioning in a non-disabled
older population: MacArthur studies of successful aging. Aging. 1994;6:410-419.
6 Judge JO, et al. Step length reductions in advanced age: the role of ankle and hip kinetics. J Geritol A
Biol Sci Med Sci. 1996;51:M303-M312.
7 Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):5058.
8 Fritz S, Lusardi M. White paper: “Walking speed: the sixth vital sign.” J Geriatr Phys Ther. 2009;32
(2):2-5.
9901 N. Knoxville Ave, Suite D • Peoria, Illinois 61615 • (309) 243-1989 • Fax (309)243-8138