To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.
WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65–93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS − SSWS) and ratio (WSRratio = MWS/SSWS).
SSWS (P < 0.001), MWS (P < 0.001), and WSRdiff (P < 0.01) were associated with fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64).
SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWS to calculate an individual’s WSR does not provide additional insight into fall status in this population.
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Upon completion of this article, the reader should be able to: (1) Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure; (2) Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults; and (3) Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions.
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From the Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas (AM); Department of Physical Therapy, Clarkson University, Potsdam, New York (GDF); Department of Exercise Science, Division of Rehabilitation Sciences, University of South Carolina, Columbia, South Carolina (TMH, SLF); Department of Exercise Science, Division of Health Aspects of Physical Activity, University of South Carolina, Columbia, South Carolina (MWB); and Palmetto Health, Research Physical Therapy Specialists, Columbia, South Carolina (JD).
All correspondence and requests for reprints should be addressed to: Addie Middleton, PhD, DPT, Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555.
The authors have no commercial interest relevant to the subject of the manuscript, nor any other conflicts of interest to report. This work was partially funded by NIH Grant #T32GM081740. The study described in the manuscript was completed as part of Addie Middleton’s dissertation project, and the results are included as part of the larger dissertation document submitted to the University of South Carolina. Abstracts for completed dissertations are made available through ProQuest Dissertations & Theses. Additionally, data from this manuscript has been submitted for presentation at the American Physical Therapy Association’s Combined Sections Meeting in Anaheim, CA, February 17–20, 2016. A subset of the results were also presented orally as part of a “Three Minute Dissertation Presentation” at the University of South Carolina’s Graduate Student Day on April 10, 2015 in Columbia, SC.
Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.
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