Investigation into the reliability and validity of the measurement of elderly people's clinical walking speed: A systematic review

Abstract

The number of available walking tests has increased dramatically over the past decades. Therefore, it is highly important to help clinicians choose the most appropriate walking test for a specific setting. This systematic review aimed to critically evaluate the reliability, validity, and responsiveness of clinical walking speed in a broad population of elderly persons living in the community, sheltered housing, or institutions. Literature searches were performed in several different databases. Key words were based on the topic of the measurement properties of performance-based clinical tools for quantifying walking. The instrument selected for review was walking speed. The methods and results of all the evaluated measurement properties were rated by using a standard checklist for appraising the qualitative attributes and measurement properties of the instrument. A total number of 3,781 abstracts were reviewed, and 86 articles were chosen for inclusion. Habitual walking speed seems to be highly reliable in community-dwelling people and residents in mixed settings. There have not been any studies that accord with our inclusion and exclusion criteria that have evaluated the reliability of maximum walking speed in an aged population. Walking speed is a highly valid test, both at habitual and maximum speed. Few studies gave information about responsiveness for walking speed, which means that these results cannot be evaluated properly. Habitual walking speed is a reliable measure, but maximum walking speed needs further evaluation. Both habitual and maximum walking speeds are valid instruments, and they predict death, hospitalization/institutionalization, and decline in mobility.

Walking Speed: The Functional Vital Sign

“…Procedures differ in regards to distance (2 meters to 40 meters) (Rydwik et al, 2012), start (static versus dynamic) (PhanBa et al, 2012), path (straight versus turn) (van Herk, Arendzen, & Rispens, 1998), speed (self-selected versus maximal) (Rydwik et al, 2012), instruction (e.g. "walk at a comfortable pace" versus " walk as if you are taking a stroll through the park") (Nascimento et al, 2012), and timing instrument (e.g.…”

“…The White Paper: "Walking Speed: the Sixth Vital Sign" published in 2009 consolidated available evidence on a robust measure, walking speed (Adell, Wehmhorner, & Rydwik, 2013;Afilalo et al, 2010;Castell et al, 2013;Graham, Fisher, Berges, Kuo, & Ostir, 2010;Peters, Fritz, & Krotish, 2013;Quach et al, 2011;Rydwik, Bergland, Forsen, & Frandin, 2012;Shimada et al, 2013;Verghese, Wang, & Holtzer, 2011). Since publication of the original article, evidence has emerged regarding updated recommendations on testing protocols.…”

“…For this reason, the authors decided to follow-up the original white paper with recent evidence regarding this robust tool. As a valid (Rydwik et al, 2012;Verghese et al, 2011), reliable (Peters, Fritz, et al, 2013;Rydwik et al, 2012), and sensitive (Goldberg & Schepens, 2011;van Iersel, Munneke, Esselink, Benraad, & Olde Rikkert, 2008) measure, WS tests have found a home in both clinical (Peel, Kuys, & Klein, 2013) and research (Graham, Ostir, Fisher, & Ottenbacher, 2008) settings. Not only is WS indicative of an individual's functional capacity (Verghese et al, 2011) and general health status (Cesari et al, 2005;Studenski et al, 2011), the measure has been shown to be predictive of a range of outcomes, including response to rehabilitation (Goldie, Matyas, & Evans, 1996), functional dependence (Purser et al, 2005;Shimada et al, 2013;Shinkai et al, 2000), frailty (Castell et al, 2013), mobility disability (Cesari et al, 2005) (Rosano, Newman, Katz, Hirsch, & Kuller, 2008), cognitive decline (Alfaro-Acha, Al Snih, Raji, Markides, & Ottenbacher, 2007) (Inzitari et al, 2007), falls (Montero-Odasso et al, 2005) (Chu, Chi, & Chiu, 2005), institutionalization (Woo, Ho, & Yu, 1999), hospitalization (Montero-Odasso et al, 2005) (Cesari et al, 2005), cardiovascular-related events and mortality (Dumurgier et al, 2009;Matsuzawa et al, 2013), as well as all-cause mortality (Studenski et al, 2011) (Blain et al, 2010).…”

Walking speed in elderly outpatients depends on the assessment method

“…It is a quick and easy measure and is not limited to specific equipment. Furthermore, it is a valid, sensitive, and specific measure with high inter-rater and testretest reliability (Bellet et al 2012;Munoz-Mendoza et al 2011;Nasuti et al 2013;Rydwik et al 2012). Currently, there are many methods to assess walking speed varying in pace (i.e., normal or as fast as possible), static or dynamic start, and walking distance or time.…”

“…Previous research showed conflicting results regarding methodologically induced variance in assessed walking speed in elderly (Ng et al 2013;Peters et al 2013). This hampers comparison of the different studies and may affect the clinical interpretation of walking speed (Graham et al 2008b;Rydwik et al 2012).…”