Review article
Relationship Between Test Methodology and Mean Velocity in Timed Walk Tests: A Review

Presented to the American Congress of Rehabilitation Medicine, October 5, 2007, Washington, DC.
https://doi.org/10.1016/j.apmr.2007.11.029Get rights and content

Abstract

Graham JE, Ostir GV, Kuo Y-F, Fisher SR, Ottenbacher KJ. Relationship between test methodology and mean velocity in timed walk tests: a review.

Objective

To assess the degree to which test methodology affects outcomes in clinical evaluations of walking speed.

Data Sources

Medline database and reference lists from relevant articles.

Study Selection

We conducted electronic searches by using various combinations of terms related to clinical evaluations of walking speed. Resultant abstracts were then reviewed, and the methods and results section of promising full-text articles were searched for detailed descriptions of walk-test methodologies and results. Ultimately, articles were limited to the most common participant groups, older adults (aged) and individuals with neurologic conditions (neuro). The final sample included 46 studies.

Data Extraction

Three aspects of test methodology (pace, starting protocol, distance timed) were extracted for use as independent variables. Group mean age was extracted for use as a covariate. Group mean velocity was extracted for use as the dependent variable. Data were extracted by a single investigator.

Data Synthesis

Usual and/or comfortable pace was reported nearly twice as often as fast pace in both groups. Static-start protocols were more frequently used in aged studies, whereas dynamic (ie, rolling) starts were more common in neuro studies. Distances of 6 and 10m were most common in aged and neuro studies, respectively. Multivariate analyses (analysis of covariance) showed that only pace was significantly related to the mean velocity in both groups (aged: pace, P<.01; starting protocol, P=.21; distance, P=.05; neuro: pace, P=.01; starting protocol, P=.63; distance, P=.49). However, methodology-related differences in the distribution (95% confidence intervals) of performance scores across certain clinical standards were noted within all 3 methodology variables.

Conclusions

Clinical assessments of walking velocity are not conducted uniformly. Common methodologic factors may influence the clinical interpretation of walk performances. Universal walk-test methodology is warranted to improve intergroup comparisons and the development of useful clinical criteria and consensus norms.

Section snippets

Data Sources and Selection Criteria

Data for the current study were obtained from a review of the health care literature for studies using an established distance-based measure of walking speed. Electronic searches of the MEDLINE database were conducted followed by concerted searches within the bibliographies of obtained full-text (including review) articles. Because walking speed is not one of the National Library of Medicine's medical subjects heading terms, article abstracts and titles were searched for general descriptions of

Results

The sample included 46 studies. See figure 1 for a list of the studies included in the analyses and a detailed schematic of the study selection process.

Some studies evaluated walking speed with more than 1 methodology (eg, both usual- and fast-pace trials) so we obtained the mean velocity data from 56 participant groups (22 aged, 34 neuro) representing a total sample size of 18,428 (16,683 aged, 1745 neuro). The numbers of groups within each methodologic variable are shown in table 1. The aged

Discussion

The purpose of this study was to assess the impact of walk-test methodology on walking performance within the published literature. We found that pace is the single most important methodologic factor influencing walk performance. Neither starting protocol nor distance timed showed statistically significant affects on mean walking velocities. Also, whereas age was significantly associated with the mean velocity in bivariate analysis, it did not remain significant as a covariate in the weighted

Conclusions

Walk-test data are not measured uniformly nor is walk-test methodology reported completely. Consequently, it is difficult to compare walking performance across studies with dissimilar or unspecified test procedures.30 Although pace was the only methodologic factor that yielded consistent and statistically significant differences in walking velocity, the results suggest that all 3 methodologic factors evaluated may influence the clinical interpretation (meaningfulness) of a group's and/or

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    Supported by the National Institutes of Health (grant nos. K02-AG019736, T32-HD007539, K01-HD046682) and the National Institute on Disability and Rehabilitation Research (grant no. H133P040003).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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