Systematic reviewNormal walking speed: a descriptive meta-analysis
Introduction
Walking is second only to private cars as the most common means by which individuals get from place to place in the USA and Europe [1]. The speed at which individuals walk is relevant to their functioning in the community [2], [3]. Moreover, gait speed is an important predictor of outcomes such as: length of stay and discharge disposition for patients admitted for acute rehabilitation after stroke [4], mortality of older adults [5], incident ischaemic stroke among postmenopausal women [6], and incident dementia among older adults [7]. It should not be surprising, therefore, that gait speed is commonly measured by physical therapists and other clinicians [8], [9].
Judgements about how an individual's task performance compares with that of a relevant population requires the availability of normative reference values (norms) for that population [10]. Several studies have presented data purported to be normative for comfortable walking speed [12], [13], [14], [15], [16], [17]. Other studies, not normative by intent, present walking speed data for apparently healthy individuals. These studies, regardless of purpose, involve samples that vary greatly in number and composition. They also incorporate instructions, courses and timing procedures that vary considerably [18].
If the data from these seemingly diverse studies could be legitimately consolidated, a better sense of normal might be obtained than is provided by individual studies. Meta-analysis is a means by which relevant data from multiple sources can be consolidated if homogeneous. Such analysis has been used previously to estimate norms for other physical performance tests, such as the single-limb stance test [19], five repetition sit-to-stand test [20], and 6-minute walk test [21]. The purpose of this meta-analysis was to use the data from multiple relevant but diverse studies to estimate norms for normal gait speed that could be used in clinical practice.
Section snippets
Methods
Identification of potentially relevant literature began with the electronic search of four databases: PubMed, the Cumulative Index of Nursing and Allied Health (CINAHL), Scopus and Science Citation Index. The terms and Boolean mode used were (gait speed OR walking speed) AND (normal OR comfortable OR usual OR preferred OR self-selected). Databases were searched up to the end of 2008. Searches were limited to human subjects, adults aged ≥19 years and published in the English language. The two
Results
The yield of potentially relevant articles for the four databases was: PubMed, 621; CINAHL, 509; Scopus, 1622; and Science Citation Index, 674. Based on the focus of this study, adherence to inclusion and exclusion criteria, and ability to obtain clarification from authors, 41 articles were ultimately judged to be relevant sources of data for normal gait speed (Table 1) [12], [13], [14], [15], [16], [17], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40],
Discussion
Given the relevance of gait speed to community ambulation [2], [3] and its value as a predictor of important outcomes [4], [5], [6], [7], [8], [9], it should not be surprising that gait speed has been recommended as a ‘vital sign’ [62], [63]. As such, an individual's gait speed can be interpreted relative to a criterion reference or a normative reference [10], [11], the focus of this meta-analysis. By consolidating data from numerous diverse studies, this meta-analysis provides strata-specific
Conclusions
This meta-analysis consolidates measurements of normal gait speed from over 23 000 subjects tested in 41 different studies. Normative reference values are provided for gender- and age-specific strata. The norms provided can be used to determine how an individual's speed compares with the average for healthy individuals of the same gender and age.
Ethical approval: Not applicable.
Conflict of interest: None declared.
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