Introducción
La velocidad de marcha se relaciona con la funcionalidad en actividades cotidianas. El Examen de Medicina Preventiva del Adulto Mayor es un hito relevante en la prevención de adultos mayores chilenos de la comunidad. Sin embargo, no incorpora a la velocidad dentro de su batería de pruebas.

Objetivo
Evaluar una propuesta complementaria al Examen de Medicina Preventiva del Adulto Mayor según Espacios de Clasificación Funcional para valores umbrales, referenciales y de categorización de velocidad de marcha confortable y máxima aplicada a personas mayores autovalentes.

Métodos
Participaron en este estudio observacional, exploratorio y transversal 72 adultos mayores autovalentes. Se solicitó a cada participante caminar naturalmente y luego a máxima velocidad durante 3 minutos. A través de un gráfico de dispersión entre velocidad de mar-cha confortable (eje “x”) y máxima (eje “y”), se construyeron Espacios de Clasificación Funcional según valores documentados para i) umbrales de funcionalidad básica, ii) referenciales para el espectro instrumental y iii) categorización funcional para actividades “dentro del hogar” (< 0,4 m/s), “limitadas en la comunidad” (0,40 a0,80 m/s), “eficiente en la comunidad” (0,81 a1,3 m/s) y “cruce seguro de calles” (> 1,3 m/s). Se determinó la frecuencia relativa (%) de adultos mayores que cumplen con cada cuadrante establecido.

Resultados
El umbral fue sobrepasado por el 100% de los participantes (actividades cotidianas básicas). Cerca del 80% de los participantes presenta un Espacio de Clasificación Funcional bajo el límite de referencia (actividades cotidianas instrumentales y avanzadas). El 81% de las mujeres y el 69% de los hombres, se encuentran dentro del Espacio de Clasificación Funcional “eficiente en la comuni-dad”. El 31% de los hombres y el 14% de las mujeres alcanzan el valor mínimo para el “cruce efectivo de calles” (actividades coti-dianas avanzadas).

Conclusiones
La exploración de Espacios de Clasificación Funcional según de velocidad de marcha confortable y máxima aplicada a un grupo de adultos mayores clasificados como autovalentes, resulta en individuos con riesgo para desarrollar actividades instrumentales y avanzadas.

Author: Paul Medina-González[1]

Affiliation:
[1] Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile

E-mail: pmedina@ucm.cl

Author address:
[1] Av. San Miguel N° 3605
Talca
Chile

Citation: Medina-González P. Functional Classification Spaces according to walking speed in self-sufficient Chilean older adults: A complement to the Periodic Physical Examination. Medwave 2022;22(5):e002551 doi: 10.5867/medwave.2022.04.002551

Submission date: 29/12/2021

Acceptance date: 28/4/2022

Publication date: 27/5/2022

Origin: Not commissioned

Type of review: Externally peer-reviewed by four reviewers, double-blind

Comments (0)

We are pleased to have your comment on one of our articles. Your comment will be published as soon as it is posted. However, Medwave reserves the right to remove it later if the editors consider your comment to be: offensive in some sense, irrelevant, trivial, contains grammatical mistakes, contains political harangues, appears to be advertising, contains data from a particular person or suggests the need for changes in practice in terms of diagnostic, preventive or therapeutic interventions, if that evidence has not previously been published in a peer-reviewed journal.

No comments on this article.

---

To comment please log in

Medwave provides HTML and PDF download counts as well as other harvested interaction metrics.

There may be a 48-hour delay for most recent metrics to be posted.

1. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing; 2019. | Link |
2. World Health Organization. Active Ageing. A Policy Framework. | Link |
3. Weinert BT, Timiras PS. Invited review: Theories of aging. J Appl Physiol (1985). 2003;95: 1706–16. | CrossRef |
4. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381: 752–62. | CrossRef |
5. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56: M146-56. | CrossRef |
6. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J. 1965;14:61-5. | Link |
7. Ministerio de Salud del Gobierno de Chile, Programa de Salud del Adulto Mayor. División de Prevención y Control de Enfermedades. Subsecretaría de Salud Pública. Manual de Aplicación del Examen de Medicina Preventiva del Adulto Mayor (EMPAM). | Link |
8. Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. J  Am Geriatr Soc. 1990;38: 855–61. | CrossRef |
9. Garcia- Pinillos F, Cozar- Barba M, Munoz- Jimenez M, Soto- Hermoso V, Latorre- Roman P. Gait speed in older people: an easy test for detecting cognitive impairment, functional independence, and health state. Psychogeriatrics. 2016;16: 165–71. | CrossRef |
10. Kubicki A. Functional assessment in older adults: should we use timed up and go or gait speed test? Neurosci Lett. 2014;577: 89–94. | CrossRef |
11. Middleton A, Fulk GD, Beets MW, Herter TM, Fritz SL. Self- Selected Walking Speed is Predictive of Daily Ambulatory Activity in Older Adults. J  Aging Phys Act. 2016;24: 214–22. | CrossRef |
12. Middleton A, Fritz SL, Lusardi M. Walking speed: the functional vital sign. J Aging Phys Act. 2015;23: 314–22. | CrossRef |
13. Zielińska D, Bellwon J, Rynkiewicz A, Elkady MA. Prognostic value of the six- minute walk test in heart failure patients undergoing cardiac surgery: a literature review. Rehabil Res Pract. 2013;2013. | CrossRef |
14. Teixeira- Leite H, Manhães AC. Association between functional alterations of senescence and senility and disorders of gait and balance. Clinics (Sao Paulo). 2012;67: 719–29. | CrossRef |
15. Mendes J, Borges N, Santos A, Padrão P, Moreira P, Afonso C, et al. Nutritional status and gait speed in a nationwide population- based sample of older adults. Sci Rep. 2018;8. https://doi.org/ 10.1038/s41598-018-22584-3. | CrossRef |
16. Bohannon RW. Comfortable and maximum walking speed of adults aged 20- 79 years: reference values and determinants. Age Ageing. 1997;26: 15–9. | CrossRef |
17. Nakao H, Yoshikawa T, Hara T, Wang L, Suzuki T, Fujimoto S. Thresholds of physical activities necessary for living a self- supporting life in elderly women. Osaka City Med J. 2007;53(2):53-61. | Link |
18. Hong S, Kim S, Yoo J, Kim BS, Choi HR, Choi SE, et al. Slower gait speed predicts decline in Instrumental Activities of Daily Living in community- dwelling elderly: 3- year prospective finding from Living Profiles of Older People Survey in Korea. Journal of Clinical Gerontology and Geriatrics. 2016;7: 141–145. | CrossRef |
19. Silva J. Evaluación funcional adulto mayor EFAM- Chile. Medwave. 2005;5. | CrossRef |
20. Ministerio de Salud del Gobierno de Chile. Departamento de estadísticas e información en Salud. | Link |
21. Barrett RS, Mills PM, Begg RK. A􀀀 systematic review of the effect of ageing and falls history on minimum foot clearance characteristics during level walking. Gait Posture. 2010;32: 429–35. | CrossRef |
22. Mancilla E, Valenzuela J, Escobar M. Rendimiento en las pruebas "Timed Up and Go" y "Estación Unipodal" en adultos mayores chilenos entre 60 y 89 años. Rev Med Chil. 2015;143(1):39-46. | CrossRef |
23. Bohannon RW. Reference values for the timed up and go test: a descriptive meta- analysis. J􀀀Geriatr Phys Ther. 2006;29(2):64-8. | CrossRef |
24. Viccaro LJ, Perera S, Studenski SA. Is􀀀timed up and go better than gait speed in predicting health, function, and falls in older adults?J􀀀Am Geriatr Soc. 2011;59: 887–92. | CrossRef |
25. Steffen TM, Hacker TA, Mollinger L. Age- and gender- related test performance in community- dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82: 128–37. | CrossRef |
26. Shinkai S, Watanabe S, Kumagai S, Fujiwara Y, Amano H, Yoshida H, et􀀀 al. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age and Ageing. 2000;29: 441–446. | CrossRef |
27. Middleton A, Fulk GD, Herter TM, Beets MW, Donley J, Fritz SL. Self- Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community- Dwelling Older Adults. American Journal of Physical Medicine & Rehabilitation. 2016;95: 475–482. | CrossRef |
28. González PM, Cofré RM, Cabello ME. Functional reserve in functionally independent elderly persons: a calculation of gait speed and physiological cost. Rev bras geriatr gerontol. 2016;19: 577–589. | CrossRef |
29. Medina G P, Mancilla S E, Muñoz C R, Escobar C M. Distancia recorrida y costo fisiológico según el nivel socioeconómico y género durante la prueba de caminata en seis minutos en adultos mayores autovalentes de la ciudad de Talca. Rev méd Chile. 2015;143: 484–492. | CrossRef |
30. Bohannon RW, Bubela D, Magasi S, McCreath H, Wang Y- C, Reuben D, et􀀀al. Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six- Minute Walk Test. BMC Res Notes. 2014;7: 269. | CrossRef |
31. Salbach NM, O’Brien K, Brooks D, Irvin E, Martino R, Takhar P, et􀀀al. Speed and distance requirements for community ambulation: a systematic review. Arch Phys Med Rehabil. 2014;95: 117-128. | CrossRef |
32. Saibene F, Minetti AE. Biomechanical and physiological aspects of legged locomotion in humans. Eur J Appl Physiol. 2003;88: 297–316. | CrossRef |
33. González PM. Anthropometric, functional and foot trajectory determinants of stride length in self- reliant community- dwelling elderly persons in Talca, Chile. Rev bras geriatr gerontol. 2016;19: 495–505. | CrossRef |
34. Duncan MJ, Mota J, Carvalho J, Nevill AM. An􀀀Evaluation of Prediction Equations for the 6 Minute Walk Test in Healthy European Adults Aged 50- 85 Years. PLoS One. 2015;10. | CrossRef |
35. Wang CY, Chen TR, Lin YH, Liu MH, Chen YC. Gait speed measure: the effect of different measuring distances and the inclusion and exclusion of acceleration and deceleration. Percept Mot Skills. 2012;114: 469–78. | CrossRef |
36. Ng SSM, Ng PCM, Lee CYW, Ng ESW, Tong MHW, Fong SSM, et􀀀al. Assessing the walking speed of older adults: the influence of walkway length. Am􀀀 J Phys Med Rehabil. 2013;92: 776–80. | CrossRef |
37. Ministerio de Salud del Gobierno de Chile. Estrategia Nacional de Salud para el cumplimiento de los Objetivos Sanitarios de la Década 2011- 2020 Metas. Inscripción N° 211.726, Registro de Propiedad Intelectual. ISBN: 978- 956- 348- 005- 4; | Link |
38. Lindemann U, Najafi B, Zijlstra W, Hauer K, Muche R, Becker C, et􀀀al. Distance to achieve steady state walking speed in frail elderly persons. Gait Posture. 2008;27: 91–6. | CrossRef |
39. Clark DJ. Automaticity of walking: functional significance, mechanisms, measurement and rehabilitation strategies. Front Hum Neurosci. 2015;9. | CrossRef |
40. Toker Z. Walking beyond the Socioeconomic Status in an Objectively and Perceptually Walkable Pedestrian Environment. Urban Studies Research. 2015;2015: 1–15. | CrossRef |
41. Mancilla Solorza E, Carreño Torres R, Palma Suarez C, Leiva Rebolledo E, Contreras Montero C, Quezada Roldán L, et􀀀al. Método para establecer la reserva funcional de la velocidad de marcha en una muestra de adultas mayores autosuficientes chilenas: la relevancia del estímulo. Fisioterapia. 2021. | CrossRef |

United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing; 2019. | Link |

World Health Organization. Active Ageing. A Policy Framework. | Link |

Weinert BT, Timiras PS. Invited review: Theories of aging. J Appl Physiol (1985). 2003;95: 1706–16. | CrossRef |

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381: 752–62. | CrossRef |

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56: M146-56. | CrossRef |

Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J. 1965;14:61-5. | Link |

Ministerio de Salud del Gobierno de Chile, Programa de Salud del Adulto Mayor. División de Prevención y Control de Enfermedades. Subsecretaría de Salud Pública. Manual de Aplicación del Examen de Medicina Preventiva del Adulto Mayor (EMPAM). | Link |

Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. J  Am Geriatr Soc. 1990;38: 855–61. | CrossRef |

Garcia- Pinillos F, Cozar- Barba M, Munoz- Jimenez M, Soto- Hermoso V, Latorre- Roman P. Gait speed in older people: an easy test for detecting cognitive impairment, functional independence, and health state. Psychogeriatrics. 2016;16: 165–71. | CrossRef |

Kubicki A. Functional assessment in older adults: should we use timed up and go or gait speed test? Neurosci Lett. 2014;577: 89–94. | CrossRef |

Middleton A, Fulk GD, Beets MW, Herter TM, Fritz SL. Self- Selected Walking Speed is Predictive of Daily Ambulatory Activity in Older Adults. J  Aging Phys Act. 2016;24: 214–22. | CrossRef |

Middleton A, Fritz SL, Lusardi M. Walking speed: the functional vital sign. J Aging Phys Act. 2015;23: 314–22. | CrossRef |

Zielińska D, Bellwon J, Rynkiewicz A, Elkady MA. Prognostic value of the six- minute walk test in heart failure patients undergoing cardiac surgery: a literature review. Rehabil Res Pract. 2013;2013. | CrossRef |

Teixeira- Leite H, Manhães AC. Association between functional alterations of senescence and senility and disorders of gait and balance. Clinics (Sao Paulo). 2012;67: 719–29. | CrossRef |

Mendes J, Borges N, Santos A, Padrão P, Moreira P, Afonso C, et al. Nutritional status and gait speed in a nationwide population- based sample of older adults. Sci Rep. 2018;8. https://doi.org/ 10.1038/s41598-018-22584-3. | CrossRef |

Bohannon RW. Comfortable and maximum walking speed of adults aged 20- 79 years: reference values and determinants. Age Ageing. 1997;26: 15–9. | CrossRef |

Nakao H, Yoshikawa T, Hara T, Wang L, Suzuki T, Fujimoto S. Thresholds of physical activities necessary for living a self- supporting life in elderly women. Osaka City Med J. 2007;53(2):53-61. | Link |

Hong S, Kim S, Yoo J, Kim BS, Choi HR, Choi SE, et al. Slower gait speed predicts decline in Instrumental Activities of Daily Living in community- dwelling elderly: 3- year prospective finding from Living Profiles of Older People Survey in Korea. Journal of Clinical Gerontology and Geriatrics. 2016;7: 141–145. | CrossRef |

Silva J. Evaluación funcional adulto mayor EFAM- Chile. Medwave. 2005;5. | CrossRef |

Ministerio de Salud del Gobierno de Chile. Departamento de estadísticas e información en Salud. | Link |

Barrett RS, Mills PM, Begg RK. A􀀀 systematic review of the effect of ageing and falls history on minimum foot clearance characteristics during level walking. Gait Posture. 2010;32: 429–35. | CrossRef |

Mancilla E, Valenzuela J, Escobar M. Rendimiento en las pruebas "Timed Up and Go" y "Estación Unipodal" en adultos mayores chilenos entre 60 y 89 años. Rev Med Chil. 2015;143(1):39-46. | CrossRef |

Bohannon RW. Reference values for the timed up and go test: a descriptive meta- analysis. J􀀀Geriatr Phys Ther. 2006;29(2):64-8. | CrossRef |

Viccaro LJ, Perera S, Studenski SA. Is􀀀timed up and go better than gait speed in predicting health, function, and falls in older adults?J􀀀Am Geriatr Soc. 2011;59: 887–92. | CrossRef |

Steffen TM, Hacker TA, Mollinger L. Age- and gender- related test performance in community- dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82: 128–37. | CrossRef |

Shinkai S, Watanabe S, Kumagai S, Fujiwara Y, Amano H, Yoshida H, et􀀀 al. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age and Ageing. 2000;29: 441–446. | CrossRef |

Middleton A, Fulk GD, Herter TM, Beets MW, Donley J, Fritz SL. Self- Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community- Dwelling Older Adults. American Journal of Physical Medicine & Rehabilitation. 2016;95: 475–482. | CrossRef |

González PM, Cofré RM, Cabello ME. Functional reserve in functionally independent elderly persons: a calculation of gait speed and physiological cost. Rev bras geriatr gerontol. 2016;19: 577–589. | CrossRef |

Medina G P, Mancilla S E, Muñoz C R, Escobar C M. Distancia recorrida y costo fisiológico según el nivel socioeconómico y género durante la prueba de caminata en seis minutos en adultos mayores autovalentes de la ciudad de Talca. Rev méd Chile. 2015;143: 484–492. | CrossRef |

Bohannon RW, Bubela D, Magasi S, McCreath H, Wang Y- C, Reuben D, et􀀀al. Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six- Minute Walk Test. BMC Res Notes. 2014;7: 269. | CrossRef |

Salbach NM, O’Brien K, Brooks D, Irvin E, Martino R, Takhar P, et􀀀al. Speed and distance requirements for community ambulation: a systematic review. Arch Phys Med Rehabil. 2014;95: 117-128. | CrossRef |

Saibene F, Minetti AE. Biomechanical and physiological aspects of legged locomotion in humans. Eur J Appl Physiol. 2003;88: 297–316. | CrossRef |

González PM. Anthropometric, functional and foot trajectory determinants of stride length in self- reliant community- dwelling elderly persons in Talca, Chile. Rev bras geriatr gerontol. 2016;19: 495–505. | CrossRef |

Duncan MJ, Mota J, Carvalho J, Nevill AM. An􀀀Evaluation of Prediction Equations for the 6 Minute Walk Test in Healthy European Adults Aged 50- 85 Years. PLoS One. 2015;10. | CrossRef |

Wang CY, Chen TR, Lin YH, Liu MH, Chen YC. Gait speed measure: the effect of different measuring distances and the inclusion and exclusion of acceleration and deceleration. Percept Mot Skills. 2012;114: 469–78. | CrossRef |

Ng SSM, Ng PCM, Lee CYW, Ng ESW, Tong MHW, Fong SSM, et􀀀al. Assessing the walking speed of older adults: the influence of walkway length. Am􀀀 J Phys Med Rehabil. 2013;92: 776–80. | CrossRef |

Ministerio de Salud del Gobierno de Chile. Estrategia Nacional de Salud para el cumplimiento de los Objetivos Sanitarios de la Década 2011- 2020 Metas. Inscripción N° 211.726, Registro de Propiedad Intelectual. ISBN: 978- 956- 348- 005- 4; | Link |

Lindemann U, Najafi B, Zijlstra W, Hauer K, Muche R, Becker C, et􀀀al. Distance to achieve steady state walking speed in frail elderly persons. Gait Posture. 2008;27: 91–6. | CrossRef |

Clark DJ. Automaticity of walking: functional significance, mechanisms, measurement and rehabilitation strategies. Front Hum Neurosci. 2015;9. | CrossRef |

Toker Z. Walking beyond the Socioeconomic Status in an Objectively and Perceptually Walkable Pedestrian Environment. Urban Studies Research. 2015;2015: 1–15. | CrossRef |

Mancilla Solorza E, Carreño Torres R, Palma Suarez C, Leiva Rebolledo E, Contreras Montero C, Quezada Roldán L, et􀀀al. Método para establecer la reserva funcional de la velocidad de marcha en una muestra de adultas mayores autosuficientes chilenas: la relevancia del estímulo. Fisioterapia. 2021. | CrossRef |