Spoiler Alert: We Think So!

By: Brie Darcy, PT, DPT

There has been a lot of buzz in the medical community recently about walking speed. It’s even earned itself a nickname as “the 6th vital sign,” including claims that it may provide as much medical value as more traditional vital signs like blood pressure and heart rate.1 But is it really as important as they say? Research suggests a resounding YES!

So, why is walking speed such a hot topic? Walking ability—with speed as a significant, measurable factor—often declines as we age. In fact, studies show this decline may accelerate around age 62.2 While a very common phenomenon, a 2014 article entitled “Walking Speed: The Functional Vital Sign” found that a slowed walking speed is correlated to and may even be predictive of many health factors. These health factors include general health status, level of disability, falls, hospitalization risk, quality of life, and even mortality.3 

Conversely, studies show that an improved gait speed can result in positive health outcomes. In a large pooled analysis of nine studies, data from nearly 35,000 community-dwelling older adults showed survival increased significantly in increments of 0.10 m/s.4 Additionally, a study of elderly male veterans showed that every 0.10 m/s increase in walking speed resulted in improved health status, improved physical function, fewer basic disabilities, fewer hospitalization days, and one-year cost reductions of $1188.5 

Why One Easy Measurement Means So Much

Typically developed in infancy, the act of walking is a very complex skill resulting from a coordinated effort of several systems including our neuromuscular, musculoskeletal, and cardiopulmonary systems. Walking starts in the brain with a signal that travels to the spinal cord. Nerve cells in the spinal cord activate muscles throughout our body that achieve postural control and the advancement of our limbs.6 Additional systems work together to ensure your steps are the appropriate length and direction, and to achieve a pace that will get you to your desired destination. Don’t forget that strength, balance, proprioception, vision, and aerobic capacity play a role as well!6 

Amazingly, when all of these systems work together in a synchronized fashion, we create the coordinated pattern known as walking. The decline in walking ability and speed as we age, while at times due to a large event such as a stroke or orthopedic injury, more often results from small declines in the functioning of any of these systems.7 

Valuable information about this multi-faceted process can be obtained quickly and easily by measuring walking speed. Unlike many medical assessments, measuring gait speed is quick (taking less than 5 minutes), reliable, easily performed in a variety of settings, and useful in monitoring progress over time. As a result, it has become a highly recommended clinical tool used to identify those at risk for adverse outcomes or in need of intervention.

Okay, You’ve Got My Attention! But How Do I Improve My Walking Speed?

If you are reading this, chances are you (or someone you know) may have been affected by a stroke or other neurological injury. An unfortunate but common consequence of neurological injuries is impaired walking ability and speed. If this sounds familiar, don’t lose hope! Medical research has shown several effective methods can be used to improve walking speed.

1. Impairment-Based Interventions. This method involves breaking down and treating the individual and unique components of gait that may be causing your impairment.7 For example, some individuals may walk with a slower gait speed due to weakness of the leg muscles, limited endurance, or impaired balance. Treating these impairments individually may help to improve your overall walking ability and speed. A research study looking at the most commonly used training techniques found that progressive resistance training at high intensities was the most effective exercise to improve gait speed.8 Similarly, a group of individuals who performed resistance training exercises three times per week for 12 weeks significantly improved their gait speed over a group performing just flexibility exercises.9 

2. Task-Oriented Practice. This refers to practicing the actual task you are trying to improve. If a basketball player wants to improve his or her jump shot … they practice their jump shot. The same logic can apply to walking. If you want to improve your walking, your treatments should involve walking!7 This might include walking drills such as practicing changing speed, changing directions, or stepping over objects. Studies show that this approach may even be superior for improving gait speed, as compared to focusing on the individual gait components.10

  • Music lovers, take note! Studies that included a rhythmic component (such as walking or even dancing while keeping time to music or a rhythm) have shown very promising results for improving gait speed due to the notion that this task performance may train higher brain functions.8

Here at Moterum Technologies …

Our innovative iStride™ Gait System, used to treat hemiparetic gait impairments arising from neurologic injuries, is equipped with sensors that can quickly, easily, and accurately track your gait speed (among other important markers of gait) every time you use it. In our recent clinical trial, participants improved their gait speed by an average of 16.14 meters per minute in just 12 visits!

Curious To Know Your Walking Speed?

It’s easy to measure! First, measure a distance. You can use just about anything, from marks on the ground to chairs in your living room! The most important aspect is to know the distance you’re covering (6 or 10 meters are commonly used). Now grab a stopwatch (most smartphones and tablets have a free timer app), and walk at your comfortable pace. For even more accuracy, start walking several steps before your first mark and give yourself a few steps after the measured distance to stop, so you are walking at your normal walking speed across the entire distance. Just remember to start the timer when you pass the first mark and stop it when you pass the second.

Divide the number of meters you walked by the number of seconds it took, and that’s your walking speed in meters per second! If you are concerned about your walking speed, make an appointment with your doctor or physical therapist. And don’t forget: If you feel your walking difficulties are related to a stroke or other neurologic injury, we are here to help!

References

1. Fritz S, Lusardi M. White paper: “Walking speed: the sixth vital sign”. J Geriatr Phys Ther. 2009;32(2):46-49.

2. Himann JE, Cunningham DA, Rechnitzer PA, Paterson DH. Age-related changes in speed of walking. Med Sci Sports Exerc. 1988;20(2):161-166.

3. Middleton A, Fritz SL, Lusardi M. Walking speed: the functional vital sign. J Aging Phys Act. 2015;23(2):314-322.

4. Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50-58.

5. Purser JL, Weinberger M, Cohen HJ, et al. Walking speed predicts health status and hospital costs for frail elderly male veterans. J Rehabil Res Dev. 2005;42(4):535-546.

6. Takakusaki K. Functional Neuroanatomy for Posture and Gait Control. J Mov Disord. 2017;10(1):1-17.

7. Brach JS, Vanswearingen JM. Interventions to Improve Walking in Older Adults. Curr Transl Geriatr Exp Gerontol Rep. 2013;2(4).

8. Van Abbema R, De Greef M, Craje C, Krijnen W, Hobbelen H, Van Der Schans C. What type, or combination of exercise can improve preferred gait speed in older adults? A meta-analysis. BMC Geriatr. 2015;15:72.

9. Judge JO, Underwood M, Gennosa T. Exercise to improve gait velocity in older persons. Arch Phys Med Rehabil. 1993;74(4):400-406.

10. VanSwearingen JM, Perera S, Brach JS, Wert D, Studenski SA. Impact of exercise to improve gait efficiency on activity and participation in older adults with mobility limitations: a randomized controlled trial. Phys Ther. 2011;91(12):1740-1751.