Gait Speed: The Sixth Vital Sign

By Lisa Kohler, BS, PT, Director of Clinical Education

 

Gait speed as the sixth vital sign

Research has stated that gait speed could be considered the sixth vital sign.  We all know to measure our patients’ overall health status and tolerance to activity by blood pressure, heart rate, respiration, and temperature.  Pain is considered the fifth vital sign that professionals use to determine health.  Gait speed has been shown to predict mortality/morbidity, discharge location from acute care, and ability to cross the street safely, to name a few. This measure can be easily used in all therapy settings.  

What is normal gait speed?

Normal gait speed ranges from 1.2-1.4 meters/second, which is the speed to safely cross an intersection.  It is also a predictor of ability to climb several flights of steps.  It is a quick and simple test to execute.  The gold standard is a space of 20 meters (65.6 feet) and a stopwatch.  If you don’t have a space that large or the patient cannot tolerate that distance, the research has shown as little as 4 meters (13.1 feet).  Personally, I like the gait speed app because it allows you to choose 10 feet as an option!  If you are like me, the metric system is not my comfort zone.  

Gait speed with related therapeutic applications:

Meters/second Therapeutic applications
< 0.15 Discharge to extended care facility
0.24 – 0.25 Discharge to acute or sub-acute rehab
< 0.4 Slower recovery of physical health
0.4 Home with caregiver, no steps
0.6 – 0.61 Home with steps
0.67 Able to complete self-care
< 0.8 Twice the mortality rate or hospital re-admission in one year after MI
> 0.89 IADLs
0.95 Home independently
< 1.0 Fall risk
1.2 Cross intersection
1.33 Climb several flights of steps

 

Therapeutically, it also assists in goal development.  It is very sensitive to change and the minimal clinically important difference to the patient is a range from 0.1-0.28 m/s.  It justifies insurance payment, because it supports skilled need.  Gait speed can be improved 3 types of exercise interventions:  resistance, coordination, and a multimodal approach of cardiovascular, flexibility and balance.  Specific to strength, to increase usual/self-selected gait speed, you need to strengthen the non-dominant hip abductors.  To increase maximal gait speed, you need to strengthen the non-dominant knee extensors.

If you would like more information on gait speed, the OPTA, at https://ce.ohiopt.org/index.cfm?pg=semwebCatalog&panel=showSWOD&seminarid=7972, offers an hour webinar titled The Sixth Vital:  Gait Speed.  It provides more detail on specific areas of practice, as well as more detail on all of the information presented above.

 

 

REFERENCES:

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