An Investigation of the Predictors of Comfortable and Fast Gait Speed in Community-Dwelling Older Adults

Abstract

Background/Purpose: To identify the unique predictors of comfortable and fast gait speed in community-dwelling older adults using measures of physical performance (eg, lower extremity strength and balance), self-reported balance confidence, and global cognitive function. Methods: Demographic information was collected from 60 healthy, community-dwelling older adults older than 60 years. Participants completed the following assessments: Mini-Mental State Examination; Activities-Specific Balance Confidence Scale; 30-second Chair Stand (30-SCS); Functional Reach (FR); and gait speed (comfortable and fast) using the GAITRite system. Hierarchical linear regression was used to examine the relationship of both fast and comfortable gait speeds with functional performance (CST and FR), cognition (Mini-Mental State Examination), Activities-Specific Balance Confidence Scale, and demographic information (age, gender, and body mass index). Results and Discussion: Functional performance measures (30-SCS and FR) explained 55.4% and 64.7%, respectively, of the variance in comfortable and fast gait speed. Unique predictors for comfortable gait speed included 30-SCS, FR, and body mass index. Unique predictors of fast gait speed included 30-SCS, FR, gender, body mass index, and Activities-Specific Balance Confidence Scale score. These predictors explained 68.5% and 80.4% of the total variance in comfortable and fast gait speed, respectively. Global cognition was not a unique predictor of gait speed when performance measures were statistically controlled. However, the current study measured global cognitive status rather than the specific cognitive constructs, such as processing speed or executive function. Further research is needed to determine the role of cognition in the composition of gait speed. Conclusions: Gait speed is an important indicator for many outcomes such as fall risk, mortality, and functional status. Understanding that key variables of strength and balance comprise a large portion of gait speed allows clinicians to better direct their care and optimize rehabilitation outcomes. This study specifically used functional measures of strength and balance that can be easily implemented in the clinical setting.

Age-Related Differences in the Predictability of Fast Gait Speed with Absolute and Rapid Squat Strength

“…By focusing on muscle performance and lean mass of the entire lower extremity, rather than isolated muscles, we would contend that our approach better reflects measures that may typically be used in a clinical setting. We should concede, however, that while the absolute and rapid strength measurements utilized herein explained roughly 25% of the variance in fast gait speed, other previous studies have demonstrated stronger prediction [9,27,47]. For example, Clark et al [9] reported that the combination of age, muscle and fat mass variables, and the rate of electromyographic rise accounted for 72.4% and 43.7% of the variance in fast gait speed for men and women, respectively.…”

“…We sought to study the isometric squat rather than isolated joint movements because we felt that analysis of a lower-extremity, multi-joint movement involving the activation of dozens of muscles would better characterize fast gait performance. Squatting movements are also commonly utilized in resistance training interventions [37] and physical therapy and rehabilitation clinics [27]. By focusing on muscle performance and lean mass of the entire lower extremity, rather than isolated muscles, we would contend that our approach better reflects measures that may typically be used in a clinical setting.…”

“…For example, Clark et al [9] reported that the combination of age, muscle and fat mass variables, and the rate of electromyographic rise accounted for 72.4% and 43.7% of the variance in fast gait speed for men and women, respectively. More recently, Mantel et al [27] was able to explain more than 80% of the variance in fast gait speed utilizing a comprehensive assessment battery focused on both strength and balance. Given the totality of evidence, it seems likely that fast gait speed is best predicted by multiple outcome measures.…”

What Makes Us Walk: Predictors and the Interplay of Physical and Cognitive Factors on Gait Speed in Community Dwelling Older Adults

“…Current literature recognizes a number of influencing variables on gait speed including balance [14][15][16][17], lower extremity muscle strength [14,15,18,19], cognition [20][21][22], and demographic characteristics (e.g. age) [17].…”

Mobility but Not Balance Limitations Are Associated With Cognitive Decline among Older Hispanics

“…While each clinical parameter may assess a specific aspect of lower-body functioning, achieving a high performance on any one task requires adequate performance on the other measures. For example, being able to quickly walk 8 ft requires a person to have sufficient lower body strength to move themselves forward and be able to maintain their balance during each phase of the gait cycle ( Mantel et al, 2019 ; Shubert et al, 2006 ).…”