Modest Improvements in Gait Speed Predict 36% Better Survival for Seniors

Their results were published in the Journal of the American Geriatric Society and later reviewed in Geriatric Emergencies. Researchers performed physical assessments on all participants at baseline. Seniors who showed no improvement in habitual gait speed after one year experienced an eight-year mortality rate of 49.3%.

Participants who showed a gain in gait speed during a quarterly assessment but lost the gains by the one-year assessment experienced a mortality rate of 41.2% over the next eight years. Seniors who showed only a 0.1 meter-per-second improvement in gait speed after one year experienced a much improved mortality rate of 31.6% over the next eight years. Hardy et al. state that their findings support the recommendations that primary care practitioners should assess gait speed as part of annual geriatric exams.

Hardy et al. also suggest that these findings may underscore the importance of prescribing interventions such as exercise physiology to manage declining habitual gait speed. 

Therapeutic exercise can improve habitual gait speed in older adults.2 At Advanced Physiotherapy, a comprehensive exercise physiology approach can include:

• Gait and balance training • Lower extremity strengthening and range of motion
• Assessment for mobility devices
• Upper extremity training so patients are better able to stabilise themselves
• Fall training to minimise injury when falls occur • Nutritional consultation to help ensure elderly patients get the most out of training
• Proprioceptive training
• Access to the Advanced Physiotherapy low-cost, patient-only gym

 

Hardy et al. recruited patients from two primary care practices serving Medicare populations – making these results particularly relevant to primary care. We encourage primary care practitioners to make referrals directly from their offices. Patients using walking aids were included. Patients who were cognitively intact and patients who were mildly impaired but with a caregiver were included. Improvement in gait speed proved to be a strong predictor of mortality regardless of whether a patient had been hospitalised during the year.

References

1. Stiffler K, Mattu A, Grossman S, Rosen P. Functional assessment of the elderly. Geriatric Emergencies: A Discussion-based Review. 2016 Jun 20.

2. Van Abbema R, De Greef M, Crajé C, et al. What type, or combination of exercise can improve preferred gait speed in older adults? A meta-analysis. BMC Geriatrics. 2015 Jul 1;15(1):1.

3. Boxall A, Barclay L, Sayers A, et al. Managing chronic obstructive pulmonary disease in the community. A randomized controlled trial of home-based pulmonary rehabilitation for elderly housebound patients. J Cardiopulm Rehabil. 2005; 25: 378-385.

4. Fransen M, McConnell S, Harmer A, et al. Exercise for osteoarthritis of the knee. Br J Sports Med. 2015; 49 (24): 1554-1557.

5. Olsson L, Swedberg K, Clark A, et al. Six minute corridor walk test as an outcome measure for the assessment of treatment in randomized, blinded intervention trials of chronic heart failure: A systematic review. Eur Heart J. 2005; 26: 778-793.