Photography of people walking on cobblestone street at sunset.

 

Walking Speed: The 6th Vital Sign

Routinely when a patient is being examined, 5 key vital signs are measured including blood pressure, heart rate, respiration rate, temperature, and pain levels. These vital signs have always been measured and used in predicting the health and wellbeing of the patient as well as giving an indication into their risk of mortality. New evidence has now supported the introduction of a sixth vital sign that can directly interpret someone’s future risk of mortality.

This 6th vital sign is walking speed. Walking speed also often referred to by physiotherapists as gait speed in the clinical setting, and is a metric that is extremely valuable for practitioners when examining aspects of functional mobility in their patients. The speed at which a person walks can be influenced by a number of factors, both voluntary and involuntary, and marks a functional skill that underpins a majority of the tasks that are essential to a person’s ability to function on a daily basis. Walking speed is influenced by multiple body systems including (e.g. central nervous system, musculoskeletal system) which is why it is often used as a predictor of overall health and function, especially in older adults.

Walking speed in the older population has been linked directly to a number of common poor outcomes including hospitalisation, falls risk, cognitive decline, disability and mortality.

What factors affect my walking speed?

Walking is a complex functional activity and is influenced by a number of different factors including but not limited to an individual’s:

  • health status

  • motor control

  • balance and coordination

  • muscle performance and musculoskeletal condition

  • sensory and perceptual function

  • endurance and average activity level

  • cognitive status

  • motivation and mental health

  • environment they walk in.

How do I compare to the average?

Below you can find the average comfortable walking speed in terms of metres covered per second for your age group and specific to your gender if you’re over the age of 50.

  • Men aged 50-59 comfortable pace: 1.43 m/s

  • Woman aged 50-59 comfortable pace: 1.31 m/s

  • Men aged 60-69 comfortable pace: 1.34 m/s

  • Woman aged 60-69 comfortable pace: 1.24 m/s

  • Woman aged 70-79 comfortable pace: 1.13 m/s.

  • Men aged 70-79 comfortable pace: 1.26 m/s.

  • Woman aged 80-99 comfortable pace: 0.94 m/s.

  • Men aged 80-99 comfortable pace: 0.97 m/s.

How slow do I have to be before I am at risk?

  • If your walking speed is less than 0.8 m/s this is predictive of poor clinical outcomes such as previously listed: hospitalisation, falls risk, cognitive decline, disability and mortality

  • If your walking speed is less than 0.6 m/s this is predictive of continued decline in individuals already experiencing the poor outcomes listed above.

How can I test my walking speed?

Luckily for you, at 3D Physiotherapy Health Group all of our physiotherapists are able to conduct some quick, simple and easy tests to evaluate not only your walking speed but also other factors that may be contributing to your potential reduced walking speed.

The most commonly used test is called a 10-metre walk test and yes, it is as simple as it sounds. It requires a 20 m straight path, with 5 m for acceleration, 10 m for steady-state walking, and 5 m for deceleration. Markers are placed at the 5 and 15 m positions along the path.  The patient begins to walk “at a comfortable pace” at one end of the path and continues walking until he or she reaches the other end.  The Physical Therapist uses a stopwatch to determine how much time it takes for the patient to traverse the 10 m center of the path, starting the stopwatch as soon as the patient’s limb crosses the first marker and stopping the stopwatch as soon as the patient’s limb crosses the second marker. If a full 20m path is not available, shorter distances can be used, if there is adequate room for acceleration and deceleration (eg, 5 ft acceleration, 10 ft. steady state, 5 ft. deceleration).

Our team of physiotherapists may also measure static and dynamic balance, coordination, muscle strength, reaction times and anything else deemed appropriate to give us the best perception of each individual patient to create a tailored program specific to you.

How much do I have to improve to make a difference?

In a recent study, with a diverse group of older participants with varying diagnoses, 0.05 m/s was calculated as the needed change for a small but meaningful improvement in walking speed. This means you can feel a meaningful improvement just by covering an additional 5cm each second!

For patients who do not have average walking speed, an improvement of at least 0.1 m/s is also shown to be a useful predictor for improving well-being, while a decrease in the same amount is linked with poorer health status, more disability, longer hospital stays, and increased medical costs.

How can I improve my walking speed?

Step 1 Book in with any of our amazing physiotherapists to complete a proper assessment of you walking speed and all the factors that can influence this. This gives us baseline measures to compare back against to show you how much you have improved and also gives us a greater insight into exactly what areas we need to focus on to improve your walking speed.

Step 2 Begin your tailored program focusing on aspects of function like coordination, dynamic balance, agility and muscular strength. It’s time to get to work and reap the rewards!

Step 3 One of our physiotherapists may deem you appropriate for one of our incredible group classes that specifically target muscular strength, balance, reaction time, coordination, and neuromuscular control in the older population. These classes include GLA:D (targeted towards those with osteoarthritis), Strong Movers and Strong for Life (both strength and conditioning program for older adults at varying skill levels). More information regarding these classes can be found on our website.

Step 4 Re-assess! At the end of your program we will re-test your walking speed and other relevant measures to see your improvement!

Step 5 Celebrate! You’ve now successfully reduced your risk of poor outcomes such as hospitalisation, falls risk, cognitive decline, disability and mortality and you’re well on your way to living a healthier lifestyle.

Post by Jed Rodda, Physiotherapist

References

Fritz, S., & Lusardi, M. (2009). White paper:“walking speed: the sixth vital sign”. Journal of geriatric physical therapy, 32(2), 2-5. doi: 10.1519/00139143-200932020-00002

 Hardy, S. E., Perera, S., Roumani, Y. F., Chandler, J. M., & Studenski, S. A. (2007). Improvement in usual gait speed predicts better survival in older adults. Journal of the American Geriatrics Society, 55(11), 1727-1734. DOI: 10.1111/j.1532-5415.2007.01413.x

 Samson, M. M., Crowe, A., De Vreede, P. L., Dessens, J. A., Duursma, S. A., & Verhaar, H. J. (2001). Differences in gait parameters at a preferred walking speed in healthy subjects due to age, height and body weight. Aging clinical and experimental research, 13, 16-21. https://doi.org/10.1007/BF03351489