Gait speed is limited but improves over the course of acute care physical therapy

Heather J. Braden, Sean Hilgenberg, Richard W. Bohannon, Man Soo Ko, Scott Hasson

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Gait is a common focus of physical therapists' management of patients in acute care settings. Walking speed, the distance a patient covers per unit time, has been advocated as a "sixth vital sign." However, the feasibility of measuring walking speed and the degree to which walking speed is limited or improves over the course of therapy in the acute care setting are unclear. Purpose: The purpose of this study of patients undergoing physical therapy during acute care hospitalization, therefore, was to determine whether walking speed can be measured in acute care and whether walking speed is limited and changes over the course of therapy. Methods: This was an observational cross-sectional study. Participants were 46 hospital inpatients, mean age 75.0 years (SD = 7.8), referred to physical therapy and able to walk at least 20 ft. Information regarding diagnosis, comorbidities, physical assistance, device use, body height, and weight was obtained. Speed was determined during initial and fi nal physical therapy visits while patients walked at their self-selected speed over a marked course in a hospital corridor. Results: Therapists reported that walking speed was clinically feasible, requiring inexpensive, available resources, 4 minutes' additional time, and simple calculations for documentation. Initial walking speed was a mean of 0.33 m/s (SD = 0.21; 95% confi dence interval [CI]: 0.27-0.39), whereas fi nal speed was 0.37 m/s (SD = 0.20; 95% CI: 0.31-0.43). The Wilcoxon test showed the increase in walking speed (0.04 m/s) to be signifi cant (P =.005) over a mean therapy period of 2.0 days (SD = 1.4) and total hospitalization period of 5.5 days (SD = 3.6). The effect size and standardized response mean were 0.19 and 0.36, respectively. Minimal detectable change was 0.18 m/s. Conclusion: Walking speed is a feasible measure for patients admitted to an acute care hospital. It shows that patients walk slowly relative to community requirements but that their speed improves even over a short course of therapy.

Original languageEnglish (US)
Pages (from-to)140-144
Number of pages5
JournalJournal of Geriatric Physical Therapy
Volume35
Issue number3
DOIs
StatePublished - Jul 1 2012

Fingerprint

Therapeutics
Hospitalization
Walking Speed
Body Height
Vital Signs
Physical Therapists
Gait
Documentation
Comorbidity
Inpatients
Cross-Sectional Studies
Body Weight
Equipment and Supplies

Keywords

  • Acute care
  • Geriatric assessment
  • Mobility
  • Walking speed

ASJC Scopus subject areas

  • Rehabilitation
  • Geriatrics and Gerontology

Cite this

Gait speed is limited but improves over the course of acute care physical therapy. / Braden, Heather J.; Hilgenberg, Sean; Bohannon, Richard W.; Ko, Man Soo; Hasson, Scott.

In: Journal of Geriatric Physical Therapy, Vol. 35, No. 3, 01.07.2012, p. 140-144.

Research output: Contribution to journalArticle

Braden, Heather J. ; Hilgenberg, Sean ; Bohannon, Richard W. ; Ko, Man Soo ; Hasson, Scott. / Gait speed is limited but improves over the course of acute care physical therapy. In: Journal of Geriatric Physical Therapy. 2012 ; Vol. 35, No. 3. pp. 140-144.
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abstract = "Background: Gait is a common focus of physical therapists' management of patients in acute care settings. Walking speed, the distance a patient covers per unit time, has been advocated as a {"}sixth vital sign.{"} However, the feasibility of measuring walking speed and the degree to which walking speed is limited or improves over the course of therapy in the acute care setting are unclear. Purpose: The purpose of this study of patients undergoing physical therapy during acute care hospitalization, therefore, was to determine whether walking speed can be measured in acute care and whether walking speed is limited and changes over the course of therapy. Methods: This was an observational cross-sectional study. Participants were 46 hospital inpatients, mean age 75.0 years (SD = 7.8), referred to physical therapy and able to walk at least 20 ft. Information regarding diagnosis, comorbidities, physical assistance, device use, body height, and weight was obtained. Speed was determined during initial and fi nal physical therapy visits while patients walked at their self-selected speed over a marked course in a hospital corridor. Results: Therapists reported that walking speed was clinically feasible, requiring inexpensive, available resources, 4 minutes' additional time, and simple calculations for documentation. Initial walking speed was a mean of 0.33 m/s (SD = 0.21; 95{\%} confi dence interval [CI]: 0.27-0.39), whereas fi nal speed was 0.37 m/s (SD = 0.20; 95{\%} CI: 0.31-0.43). The Wilcoxon test showed the increase in walking speed (0.04 m/s) to be signifi cant (P =.005) over a mean therapy period of 2.0 days (SD = 1.4) and total hospitalization period of 5.5 days (SD = 3.6). The effect size and standardized response mean were 0.19 and 0.36, respectively. Minimal detectable change was 0.18 m/s. Conclusion: Walking speed is a feasible measure for patients admitted to an acute care hospital. It shows that patients walk slowly relative to community requirements but that their speed improves even over a short course of therapy.",
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