Meaningful change and responsiveness in common physical performance measures in older adults. Improvement in usual gait speed predicts better survival in older adults. Physical performance measures in the clinical setting. Prognostic value of usual gait speed in well-functioning older people--results from the Health, Aging and Body Composition Study. Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Is timed up and go better than gait speed in predicting health, function, and falls in older adults? Quantitative gait analysis under dual-task in older people with mild cognitive impairment: a reliability study Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Executive function, memory, and gait speed decline in well-functioning older adults. Test-Retest Reliability and Minimal Detectable Change Scores for the Timed “Up & Go” Test, the Six-Minute Walk Test, and Gait Speed in People With Alzheimer Disease Functional Gait Assessment: Concurrent, Discriminative, and Predictive Validity in Community-Dwelling Older Adults Temporal and spatial features of gait in older adults transitioning to frailty. Gait Speed and Decline in Gait Speed as Predictors of Incident Dementia Prognostic significance of potential frailty criteria. Test-Retest Reliability and Minimal Detectable Change on Balance and Ambulation Tests, the 36-Item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in People With Parkinsonism Gait speed and hospitalization among ambulatory hemodialysis patients: USRDS special study data.
OBJECTIVES To estimate the magnitude of small meaningful and substantial individual change in physical performance measures and evaluate their responsiveness . DESIGN Secondary data analyses using distribution- and anchor-based methods to determine meaningful change . SETTING Secondary analysis of data from an observational study and clinical trials of community-dwelling older people and subacute stroke survivors . PARTICIPANTS Older adults with mobility disabilities in a strength training trial ( n=100 ) , subacute stroke survivors in an intervention trial ( n=100 ) , and a prospect i ve cohort of community-dwelling older people ( n=492 ) . MEASUREMENTS  Gait speed , Short Physical Performance Battery ( SPPB ) , 6-minute-walk distance ( 6MWD ) , and self-reported mobility . RESULTS Most small meaningful change estimates ranged from 0.04 to 0.06 m/s for gait speed , 0.27 to 0.55 points for SPPB , and 19 to 22 m for 6MWD . Most substantial change estimates ranged from 0.08 to 0.14 m/s for gait speed , 0.99 to 1.34 points for SPPB , and 47 to 49 m for 6MWD . Based on responsiveness indices , per-group sample sizes for clinical trials ranged from 13 to 42 for substantial change and 71 to 161 for small meaningful change . CONCLUSION Best initial estimates of small meaningful change are near 0.05 m/s for gait speed , 0.5 points for SPPB , and 20 m for 6MWD and of substantial change are near 0.10 m/s for gait speed , 1.0 point for SPPB , and 50 m for 6MWD . For clinical use , substantial change in these measures and small change in gait speed and 6MWD , but not SPPB , are detectable . For research use , these measures yield feasible sample sizes for detecting meaningful change OBJECTIVES To estimate the relationship between 1-year improvement in measures of health and physical function and 8-year survival . DESIGN Prospect i ve cohort study . SETTING Medicare health maintenance organization and Veterans Affairs primary care programs . PARTICIPANTS Persons aged 65 and older ( N=439 ) . MEASUREMENTS Six measures of health and function assessed at baseline and quarterly over 1 year . Participants were classified as improved at 1 year , transiently improved , or never improved for each measure using a priori definitions of meaningful change : gait speed ( usual walking pace over 4 m ) , 0.1 m/s ; Short Physical Performance Battery , 1 point ; Medical Outcomes Study 36-item Short Form Health Survey physical function , 10 points ; EuroQol , 0.1 point ; National Health Interview activity of daily living scale , 2 points ; and global health change , two levels or reaching the ceiling . Mortality was ascertained from the National Death Index . Covariates included demographics , comorbidity , cognitive function , and hospitalization . RESULTS Of the six measures , only improved gait speed was associated with survival . Mortality after 8 years was 31.6 % , 41.2 % , and 49.3 % for those with improved , transiently improved , and never improved gait speed , respectively . The survival benefit for improvement at 1 year persisted after adjustment for covariates ( hazard ratio=0.42 , 95 % confidence interval=0.29 - 0.61 , P<.001 ) and was consistent across subgroups based on age , sex , ethnicity , initial gait speed , healthcare system , and hospitalization . CONCLUSION Improvement in usual gait speed predicts a substantial reduction in mortality . Because gait speed is easily measured , clinical ly interpretable , and potentially modifiable , it may be a useful " vital sign " for older adults . Further research is needed to determine whether interventions to improve gait speed affect survival OBJECTIVES To assess the ability of gait speed alone and a three-item lower extremity performance battery to predict 12-month rates of hospitalization , decline in health , and decline in function in primary care setting s serving older adults . DESIGN Prospect i ve cohort study . SETTING Primary care programs of a Medicare health maintenance organization ( HMO ) and Veterans Affairs ( VA ) system . PARTICIPANTS Four hundred eighty-seven persons aged 65 and older . MEASUREMENTS  Lower extremity performance Established Population for Epidemiologic Studies of the Elderly ( EPESE ) battery including  gait speed , chair st and s , and t and em balance tests ; demographics ; health care use ; health status ; functional status ; probability of repeated admission scale ( Pra ) ; and primary physician 's hospitalization risk estimate . RESULTS Veterans had poorer health and higher use than HMO members . Gait speed alone and the EPESE battery predicted hospitalization ; 41 % ( 21/51 ) of slow walkers ( gait speed < 0.6 m/s ) were hospitalized at least once , compared with 26 % ( 70/266 ) of intermediate walkers ( 0.6 - 1.0 m/s ) and 11 % ( 15/136 ) of fast walkers ( > 1.0 m/s ) ( P < .0001 ) . The relationship was stronger in the HMO than in the VA . Both performance measures remained independent predictors after accounting for Pra . The EPESE battery was superior to gait speed when both Pra and primary physician 's risk estimate were included . Both performance measures predicted decline in function and health status in both health systems . Performance measures , alone or in combination with self-report measures , were more able to predict outcomes than self-report alone . CONCLUSION Gait speed and a physical performance battery are brief , quantitative estimates of future risk for hospitalization and decline in health and function in clinical population s of older adults . Physical performance measures might serve as easily accessible " vital signs " to screen older adults in clinical setting OBJECTIVES To define clinical ly relevant cutpoints for usual gait speed and to investigate their predictive value for health-related events in older persons . DESIGN Prospect i ve cohort study . SETTING Health , Aging and Body Composition Study . PARTICIPANTS Three thous and forty-seven well-functioning older persons ( mean age 74.2 ) . MEASUREMENTS Usual gait speed on a 6-m course was assessed at baseline . Participants were r and omly divided into two groups to identify ( Sample A ; n=2,031 ) and then vali date ( Sample B ; n=1,016 ) usual gait-speed cutpoints . Rates of persistent lower extremity limitation events ( mean follow-up 4.9 years ) were calculated according to gait speed in Sample A. A cutpoint ( defining high- ( < 1 m/s ) and low risk ( > or = 1 m/s ) groups ) was identified based on persistent lower extremity limitation events . The predictive value of the identified cutpoints for major health-related events ( persistent severe lower extremity limitation , death , and hospitalization ) was evaluated in Sample B using Cox regression analyses . RESULTS A grade d response was seen between risk groups and health-related outcomes . Participants in the high-risk group had a higher risk of persistent lower extremity limitation ( rate ratio (RR)=2.20 , 95 % confidence interval (CI)=1.76 - 2.74 ) , persistent severe lower extremity limitation ( RR=2.29 , 95 % CI=1.63 - 3.20 ) , death ( RR=1.64 , 95 % CI=1.14 - 2.37 ) , and hospitalization ( RR=1.48 , 95 % CI=1.02 - 2.13 ) than those in the low-risk group . CONCLUSION Usual gait speed of less than 1 m/s identifies persons at high risk of health-related outcomes in well-functioning older people . Provision of a clinical ly meaningful cutpoint for usual gait speed may facilitate its use in clinical and research setting OBJECTIVES The purpose of this study was to test the value of gait speed , a clinical marker for frailty , to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery . BACKGROUND It is increasingly difficult to predict the elderly patient 's risk posed by cardiac surgery because existing risk assessment tools are incomplete . METHODS A multicenter prospect i ve cohort of elderly patients undergoing cardiac surgery was assembled at 4 tertiary care hospitals between 2008 and 2009 . Patients were eligible if they were 70 years of age or older and were scheduled for coronary artery bypass and /or valve replacement or repair . The primary predictor was slow gait speed , defined as a time taken to walk 5 m of ≥ 6 s. The primary end point was a composite of in-hospital post-operative mortality or major morbidity . RESULTS The cohort consisted of 131 patients with a mean age of 75.8 ± 4.4 years ; 34 % were female patients . Sixty patients ( 46 % ) were classified as slow walkers before cardiac surgery . Slow walkers were more likely to be female ( 43 % vs. 25 % , p = 0.03 ) and diabetic ( 50 % vs. 28 % , p = 0.01 ) . Thirty patients ( 23 % ) experienced the primary composite end point of mortality or major morbidity after cardiac surgery . Slow gait speed was an independent predictor of the composite end point after adjusting for the Society of Thoracic Surgeons risk score ( odds ratio : 3.05 ; 95 % confidence interval : 1.23 to 7.54 ) . CONCLUSIONS Gait speed is a simple and effective test that may identify a subset of vulnerable elderly patients at incrementally higher risk of mortality and major morbidity after cardiac surgery OBJECTIVES To identify the most responsive method of measuring gait speed , to estimate the responsiveness of other outcome measures , and to determine whether gait speed predicts discharge destination in acute stroke . DESIGN A prospect i ve cohort study . SETTING Five acute-care hospitals . PATIENTS Fifty subjects with residual gait deficits after a first-time stroke . INTERVENTIONS Five- ( 5mWT ) and 10-meter walk tests ( 10mWT ) at comfortable and maximum speeds , with 2 evaluations conducted an average + /- st and ard deviation ( SD ) of 8 + /- 3 and 38 + /- 5 days poststroke . MAIN OUTCOME MEASURE St and ardized response mean ( SRM = mean change/SD of change ) was used to estimate responsiveness for each walk test , the Berg Balance Scale , the Barthel Index , the Stroke Rehabilitation Assessment of Movement ( STREAM ) , and the Timed Up and Go ( TUG ) . RESULTS The SRMs were 1.22 and 1.00 for the 5mWT , and .92 and .83 for the 10mWT performed at a comfortable and maximum pace , respectively . The SRMs for the Berg Balance Scale , the Barthel Index , the STREAM , and the TUG were 1.04,.99,.89 , and .73 , respectively . The probability of discharge to a rehabilitation center for persons walking at < or = 0.3 m/s or > 0.6 m/s at the first evaluation was.95 and .22 , respectively . CONCLUSIONS The 5mWT at a comfortable pace is recommended as the measure of choice for clinicians and research ers who need to detect longitudinal change in walking disability in the first 5 weeks poststroke OBJECTIVES To assess whether the Timed Up and Go ( TUG ) is superior to gait speed in predicting multiple geriatric outcomes . DESIGN Prospect i ve cohort study . SETTING Medicare health maintenance organization and Veterans Affairs primary care clinics . PARTICIPANTS Adults aged 65 and older ( N=457 ) . MEASUREMENTS Baseline gait speed and TUG  were used to predict health decline according to EuroQol and Medical Outcomes Study 36-item Short Form Survey ( SF-36 ) global health ; functional decline according to National Health Interview Survey ( NHIS ) activities of daily living ( ADLs ) score and SF-36 physical function index ; hospitalization ; and any falls and multiple falls over 1 year . RESULTS Mean age was 74 , and 44 % of participants were female . Odds ratios for all outcomes were equivalent for gait speed and TUG . Using area under the receiver operating characteristic curve of 0.7 or greater for acceptable predictive ability , gait speed and TUG each alone predicted decline in global health , new ADL difficulty , and falls , with no difference in predictive ability between performance measures . Neither performance measure predicted hospitalization , EuroQol decline , or physical function decline . As a continuous variable , TUG did not add predictive ability to gait speed for any outcome . CONCLUSION Gait speed predicts most geriatric outcomes , including falls , as does TUG . The time taken to complete TUG may not add to information provided by gait speed , although its qualitative elements may have other utility Background Reliability of quantitative gait assessment while dual-tasking ( walking while doing a secondary task such as talking ) in people with cognitive impairment is unknown . Dual-tasking gait assessment is becoming highly important for mobility research with older adults since better reflects their performance in the basic activities of daily living . Our purpose was to establish the test-retest reliability of assessing quantitative gait variables using an electronic walkway in older adults with mild cognitive impairment ( MCI ) under single and dual-task conditions . Methods The gait performance of 11 elderly individuals with MCI was evaluated using an  electronic walkway ( GAITRite ® System ) in two sessions , one week apart . Six gait parameters ( gait velocity , step length , stride length , step time , stride time , and double support time ) were assessed under two conditions : single-task ( sG : usual walking ) and dual-task ( dG : counting backwards from 100 while walking ) . Test-retest reliability was determined using intra-class correlation coefficient ( ICC ) . Gait variability was measured using coefficient of variation ( CoV ) . Results Eleven participants ( average age = 76.6 years , SD = 7.3 ) were assessed . They were high functioning ( Clinical Dementia Rating Score = 0.5 ) with a mean Mini-Mental Status Exam ( MMSE ) score of 28 ( SD = 1.56 ) , and a mean Montreal Cognitive Assessment ( MoCA ) score of 22.8 ( SD = 1.23 ) . Under dual-task conditions , mean gait velocity ( GV ) decreased significantly ( sGV = 119.11 ± 20.20 cm/s ; dGV = 110.88 ± 19.76 cm/s ; p = 0.005 ) . Additionally , under dual-task conditions , higher gait variability was found on stride time , step time , and double support time . Test-retest reliability was high ( ICC>0.85 ) for the six parameters evaluated under both conditions . Conclusion In older people with MCI  , variability of time-related gait parameters increased with dual-tasking suggesting cognitive control of gait performance . Assessment of quantitative gait variables using an electronic walkway is highly reliable under single and dual-task conditions . The presence of cognitive impairment did not preclude performance of dual-tasking in our sample supporting that this methodology can be reliably used in cognitive impaired older individuals OBJECTIVE to investigate and compare the predictive values of four physical performance measures for the onset of functional dependence in older Japanese people living at home . DESIGN a population -based prospect i ve cohort study . SETTING Nangai village , Akita Prefecture , Japan . METHODS out of the population aged 65 years and older living in Nangai ( n = 940 ) in 1992 , we measured h and grip-strength , one-leg st and ing , and usual and maximum walking speeds  in 736 subjects who were independent in the five basic activities of daily living . Their functional status was assessed each year for the subsequent 6 years . The outcome event was the onset of functional dependence , defined as a new disability in one or more of the five basic activities of daily living , or death of a subject who had shown no disability at the previous follow-up . RESULTS even after controlling for age , sex and a number of chronic conditions , lower scores on each baseline performance measure showed increased risk for the onset of functional dependence . Maximum walking speed  was most sensitive in predicting future dependence for those aged 65 - 74 years , while usual walking speed was most sensitive for people aged > or = 75 years . CONCLUSION  walking speed  was the best physical performance measure for predicting the onset of functional dependence in a Japanese rural older population BACKGROUND In community-dwelling older adults , global cognitive function predicts longitudinal gait speed decline . Few prospect i ve studies have evaluated whether specific executive cognitive deficits in aging may account for gait slowing over time . METHODS Multiple cognitive tasks were administered at baseline in 909 participants in the Health , Aging , and Body Composition Study Cognitive Vitality Sub study ( mean age 75.2 ± 2.8 years , 50.6 % women , 48.4 % black ) . Usual gait speed ( m/s ) over 20 minutes was assessed at baseline and over a 5-year follow-up . RESULTS Poorer performance in each cognitive task was cross-sectionally associated with slower gait independent of demographic and health characteristics . In longitudinal analyses , each 1 SD poorer performance in global function , verbal memory , and executive function was associated with 0.003 - 0.004 m/s greater gait speed decline per year ( p = .03-.05 ) after adjustment for baseline gait speed , demographic , and health characteristics . CONCLUSIONS In this well-functioning cohort , several cognitive tasks were associated with gait speed cross-sectionally and predicted longitudinal gait speed decline . These data are consistent with a shared pathology underlying cognitive and motor declines but do not suggest that specific executive cognitive deficits account for slowing of usual gait in aging Background : With the increasing incidence of Alzheimer disease ( AD ) , determining the validity and reliability of outcome measures for people with this disease is necessary . Objective : The goals of this study were to assess test-retest reliability of data for the Timed “ Up & Go ” Test ( TUG ) , the  Six-Minute Walk Test  ( 6MWT ) , and gait speed and to calculate minimal detectable change ( MDC ) scores for each outcome measure . Performance differences between groups with mild to moderate AD and moderately severe to severe AD ( as determined by the Functional Assessment Staging [ FAST ] scale ) were studied . Design : This was a prospect i ve , nonexperimental , descriptive method ological study . Methods : Background data collected for 51 people with AD included : use of an assistive device , Mini-Mental Status Examination scores , and FAST scale scores . Each participant engaged in 2 test sessions , separated by a 30- to 60-minute rest period , which included 2 TUG trials , 1 6MWT trial , and 2 gait speed trials using a computerized gait assessment system . A specific cuing protocol was followed to achieve optimal performance during test sessions . Results : Test-retest reliability values for the TUG , the 6MWT , and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately ( intraclass correlation coefficients ≥.973 ) ; however , individual variability of performance also was high . Calculated MDC scores at the 90 % confidence interval were : TUG=4.09 seconds , 6MWT=33.5 m ( 110 ft ) , and gait speed=9.4 cm/s . The 2 groups were significantly different in performance of clinical tests , with the participants who were more cognitively impaired being more physically and functionally impaired . Limitations : A single research er for data collection limited sample numbers and prohibited blinding to dementia level . Conclusions : The TUG , the 6MWT , and gait speed are reliable outcome measures for use with people with AD , recognizing that individual variability of performance is high . Minimal detectable change scores at the 90 % confidence interval can be used to assess change in performance over time and the impact of treatment Background The Functional Gait Assessment ( FGA ) is a reliable and valid measure of gait-related activities . Objective The purpose of this study was to determine the concurrent , discriminative , and predictive validity of the FGA in community-dwelling older adults . Design This was a prospect i ve cohort study . Methods Thirty-five older adults aged 60 to 90 years completed the Activities-specific Balance Confidence Scale ( ABC ) , Berg Balance Scale ( BBS ) , Dynamic Gait Index ( DGI ) , Timed “ Up & Go ” Test ( TUG ) , and Functional Gait Assessment ( FGA ) during one session . Falls were tracked by having participants complete a monthly fall calendar for 6 months . Spearman correlation coefficients were used to determine concurrent validity among the ABC , BBS , TUG , DGI , and FGA . To determine the optimum scores to classify fall risk , sensitivity ( Sn ) , specificity ( Sp ) , and positive and negative likelihood ratios ( LR+ and LR− ) were calculated for the FGA in classifying fall risk based on the published criterion scores of the DGI and TUG and for the FGA , TUG , and DGI in identifying prospect i ve falls . Receiver operator curves with area under the curve were used to determine the effectiveness of the FGA in classifying fall risk and of the DGI , TUG , and FGA in identifying prospect i ve falls . Results The FGA correlated with the ABC ( r=.053 , P<.001 ) , BBS ( r=.84 , P<.001 ) , and TUG ( r=−.84 , P<.001 ) . An  FGA  score of ≤22/30 provides both discriminative and predictive validity . The FGA ( scores ≤22/30 ) provided 100 % Sn , 72 % Sp , LR+ of 3.6 , and LR− of 0 to predict prospect i ve falls . Limitations The study was limited by the length of time of follow-up and the small sample size that did not allow for evaluation of criterion scores by decade . Conclusions The FGA with a cutoff score of 22/30 is effective in classifying fall risk in older adults and predicting unexplained falls in community-dwelling older adults Examining gait characteristics in older adults who are transitioning to frailty enhances our underst and ing of movement control in this fall-prone population and helps to better target preventive interventions . This work presents data on temporal and spatial gait parameters  of a group of older adults who have been operationally defined as " transitionally frail " .  Gait speed , cadence , stride length , stance , swing , double-support , and horizontal heel velocity at heel contact were measured in 50 transitionally frail older adults while walking at a self-selected pace . These data suggest that the temporal and spatial gait features of these older adults differ substantially from published results from other older adults Background Slow gait is common in dementia , but it remains unknown whether the slowing happens many years prior to dementia onset . We therefore examined the relationship between slow baseline gait speed ( GS ) , change in GS , and the hazard of incident dementia  in a community dwelling of elderly people . Methods A total of 3,663 participants dementia-free at baseline ( mean age , 73.5 years ) were followed up for 9 years from a prospect i ve cohort ( Three-City study , France ) for incident dementia ( all-cause , Alzheimer 's disease , vascular dementia , and other causes ) .  GS  over 6 m was assessed 4 times over the follow-up using two photoelectric cells . We used a multistate model to estimate the hazard ratio ( HR ) of dementia for baseline GS and tested a washout period of 4 to 7 years . The role of GS change between 65 and 85 years was examined using linear mixed models and joint models for survival and longitudinal data . Results A total of 296 participants developed dementia  during the follow-up . In age/sex-adjusted models , 1-SD ( 0.204 m/s ) lower GS was associated with an increased hazard of dementia ( HR = 1.59 , 95 % confidence interval [ CI ] = 1.39 , 1.81 , p < .001 ) , with associations evident when gait assessment s were taken from 4 years ( HR = 1.46 ; CI = 1.26 , 1.68 ) and 7 years ( HR=1.30 ; CI = 1.00 , 1.70 ) prior to dementia onset . Independently of baseline GS , those with a steeper decline had a higher hazard of dementia ( HR per 1 SD [ 0.007 m/s/year ] decrease = 3.39 [ 1.37 - 8.43 ] , p = .009 ) . Conclusions Gait is slower up to 7 years prior to clinical onset of dementia . Decline in GS is also more accelerated , suggesting strong links between cognitive and motor function in older adults OBJECTIVES To determine the independent prognostic effect of seven potential frailty criteria , including five from the Fried phenotype , on several adverse outcomes . DESIGN Prospect i ve cohort study . SETTING Greater New Haven , Connecticut . PARTICIPANTS Seven hundred fifty-four initially nondisabled , community-living persons aged 70 and older . MEASUREMENTS An assessment of seven potential frailty criteria ( slow gait speed , low physical activity , weight loss , exhaustion , weakness , cognitive impairment , and depressive symptoms ) was completed at baseline and every 18 months for 72 months . Participants were followed with monthly telephone interviews for up to 96 months to determine the occurrence of chronic disability , long-term nursing home ( NH ) stays , injurious falls , and death . RESULTS In analyses adjusted for age , sex , race , education , number of chronic conditions , and the presence of the other potential frailty criteria , three of the five Fried criteria ( slow gait speed , low physical activity , and weight loss ) were independently associated with chronic disability , long-term NH stays , and death . Slow gait speed was the strongest predictor of chronic disability ( hazard ratio (HR)=2.97 , 95 % confidence interval (CI)=2.32 - 3.80 ) and long-term NH stay ( HR=3.86 , 95 % CI=2.23 - 6.67 ) and was the only significant predictor of injurious falls ( HR=2.19 , 95 % CI=1.33 - 3.60 ) . Cognitive impairment was also associated with chronic disability ( HR=1.82 , 95 % CI=1.40 - 2.38 ) , long-term NH stay ( HR=2.64 , 95 % CI=1.75 - 3.99 ) , and death ( HR=1.54 , 95 % CI=1.13 - 2.10 ) , and the magnitude of these associations was comparable with that of weight loss . CONCLUSION The results of this study provide strong evidence to support the use of slow gait speed , low physical activity , weight loss , and cognitive impairment as key indicators of frailty while raising concerns about the value of self-reported exhaustion and muscle weakness Background and Purpose : Distinguishing between a clinical ly significant change and change due to measurement error can be difficult . The purpose of this study was to determine test-retest reliability and minimal detectable change for the Berg Balance Scale ( BBS ) , forward and backward functional reach , the  Romberg Test and the Sharpened Romberg Test ( SRT ) with eyes open and closed , the Activities-specific Balance Confidence ( ABC ) Scale , the  Six-Minute Walk Test ( 6MWT ) , comfortable and fast gait speed , the  Timed “ Up & Go ” Test ( TUG ) , the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) , and the Unified Parkinson Disease Rating Scale ( UPDRS ) in people with parkinsonism . Subjects : Thirty-seven community-dwelling adults with parkinsonism ( mean age=71 years ) participated . The Hoehn and Yahr Scale median score of 2 was on the lower end of the scale ; however , the scores ranged from 1 to 4 . Methods : Subjects were tested twice by the same raters , with 1 week between tests . Test-retest reliability was calculated using intraclass correlation coefficients ( ICCs ) . Minimal detectable change was calculated using a 95 % confidence interval ( MDC95 ) . Results : The ICCs for test-retest reliability were above .90 for the BBS , ABC Scale , SRT with eyes closed , 6MWT , and comfortable and fast gait speeds . The MDC95 values for those functional tests were : BBS=5/56 , ABC Scale=13 % , SRT with eyes closed=19 seconds , 6MWT=82 m , comfortable gait speed=0.18 m/s , and fast gait speed=0.25 m/s . The ICCs for test-retest reliability of SF-36 scores were above .80 , with the exception of the social functioning subscale . The MDC95 values for the SF-36 ranged between 19 % and 45 % . The MDC95 values for the UPDRS Activities of Daily Living section , Motor Examination section , and total scores were 4/52 , 11/108 , and 13/176 , respectively . Discussion and Conclusion : Minimal detectable change values are useful to therapists in rehabilitation and wellness programs in determining whether change during or after intervention is clinical ly significant . High test-retest reliability of scores for the BBS , ABC Scale , SRT with eyes closed , 6MWT , and gait speed make them trustworthy functional assessment s in people with parkinsonism . The SF-36 and UPDRS provide quality -of-life and disease severity rating values in the ongoing assessment of people with parkinsonism AIM To assess the association of measured gait speed with hemodialysis ( HD ) patients ' hospitalization , in conjunction with , and apart from , recent fall history . METHODS  Gait speed was measured by a st and ard protocol and  falls during the past 12 mo were ascertained for a prevalent multi-center HD cohort ( n = 668 ) aged 20 - 92 . Hospitalization during the past 12 mo was identified in the patient 's clinic records , and the first hospitalization after gait speed assessment ( or the competing event of death ) was identified in the 2013 United States Renal Data System St and ard Analysis Files . RESULTS Slow gait speed , defined as < 0.8 m/s , characterized 34.7 % of the patients , and 27.1 % had experienced a recent fall . Patients with slow gait speed but without a history of recent falls were 1.79 times more likely to have been hospitalized during the past 12 mo ( OR = 1.79 , 95%CI : 1.11 - 2.88 , P = 0.02 ) , and patients with slow gait speed and a history of recent falls were over two times more likely to have been hospitalized ( OR = 2.10 , 95%CI : 1.19 - 3.73 , P = 0.01 ) , compared with patients having faster gait speed and no recent fall history . Prospect i ve examination of gait speed/fall history status in relation to first hospitalization ( or death ) incurred by the end of follow-up December 31 , 2011 also showed that slow gait speed was associated with these events in conjunction with a history of falls ( HR = 1.54 , 95%CI : 1.04 - 2.30 , P = 0.03 ) . CONCLUSION The International Task Force on Nutrition and Aging reported that gait speed is a powerful predictor for older adults of adverse outcomes such as hospitalization . In our data , gait speed -- apart from , as well as in conjunction with , recent fall history -- was associated with HD patients ' hospitalization for multiple causes . Gait speed may be a sensitive health indicator among HD patients across the age spectrum
Gait speed at usual pace in acute care setting s was 0.46 m/s ( 95 % CI : 0.34 - 0.57 ) , which was significantly slower than the gait speed of 0.74 m/s ( 95 % CI : 0.65 - 0.83 ) recorded in outpatient setting s. CONCLUSIONS Gait speed is an important measure in comprehensive geriatric assessment .
The consolidation of data from multiple studies reported in this meta- analysis highlights the mobility limitations experienced by older people in clinical setting s and the need for ongoing rehabilitation to attain levels sufficient for reintegration in the community
BACKGROUND  Gait speed  is a quick , inexpensive , reliable measure of functional capacity with well-documented predictive value for major health-related outcomes .
Numerous epidemiological studies have documented gait speed in healthy , community-dwelling older people .