Estudios originales
Medwave 2019;19(3):e7611 doi: 10.5867/medwave.2019.03.7611
Fiabilidad de dos pruebas de velocidad de marcha de diferentes fases cronometradas e iguales fases no cronometradas en personas mayores que viven en la comunidad
Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons
Lincoyán Fernández-Huerta, Karen Córdova-León
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Palabras clave: older adults, gait speed, walking, reproducibility

Resumen

Antecedentes
La velocidad de la marcha es una medida rápida, económica y precisa para evaluar la capacidad funcional de las personas mayores, tanto saludables como con diferentes comorbilidades. Estudios previos han evaluado la velocidad de la marcha medida a lo largo de cursos de diferentes distancias, pero las fases no cronometradas no se miden de manera uniforme y se desconoce si esto afecta los resultados de la prueba.

Objetivo
El objetivo de este estudio fue evaluar la confiabilidad de la prueba de velocidad de marcha de diferentes fases cronometradas e iguales fases no cronometradas.

Métodos
Estudio de confiabilidad descriptivo, con diseño observacional analítico y de corte transversal. Se incluyeron 136 personas mayores. Se realizaron pruebas de 4 y 10 metros, con 2 metros para la fase de aceleración/desaceleración de ambas. El promedio de dos intentos se obtuvo como la medida final de cada prueba. Los resultados se obtuvieron mediante el coeficiente de correlación intraclase (CCI) con un modelo de efectos fijos y el método Bland y Altman (con un intervalo de confianza del 95%). Se complementaron con los valores de error estándar de la media y del cambio mínimo detectable (CMD95).

Resultados
Los resultados indican un excelente nivel de acuerdo entre los intentos de las pruebas de 4 y 10 metros (CCI = 0,959 y 0,976, respectivamente), así como entre el promedio de las dos pruebas (CCI = 0,867). Destaca un nivel de acuerdo ligeramente mejor entre los dos intentos de la prueba de 10 metros. Por lo tanto, el número de intentos no es capaz de afectar los resultados de la velocidad de la marcha; sin embargo, se requieren análisis adicionales para concluir lo mismo con respecto a la distancia de la prueba. La diferencia del análisis Bland Altman para el promedio de las pruebas de 4 y 10 metros fue 1,5945 m/s (intervalo de confianza 95%: 0,9759 a 2,2130 m/s), siendo demasiado grande y más alto que el valor CMD95.

Conclusiones
El CCI fue excelente en todos los casos, pero se requiere un análisis adicional para concluir lo mismo con respecto a la distancia de la prueba. Existe un acuerdo insuficiente entre las dos pruebas para permitir que se utilicen indistintamente en poblaciones con las características de este estudio.


 

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Background
Gait speed is a fast, low cost and accurate measurement for evaluating older persons’ functional ability, both health and with comorbidities. Previous studies have evaluated gait speed measured over courses of varying distances, but the non-timed phases are not measured uniformly. It is unknown if this affects the results of the test.

Objective
This study aims to evaluate the reliability of the running speed test of two different timed phases compared to the same nontimed phases.

Methods
We conducted a descriptive reliability study, with an observational and cross-sectional analytical design. One hundred thirty-six older persons were included. Two gait speed tests were taken, one of 4 and 10 meters, and 2 meters for the acceleration/deceleration phase for both tests. The average of two attempts was obtained as a final measure of each test. The intraclass correlation coefficient was used to express the results (ICC) with a fixed effects model and the Bland and Altman method (confidence interval of 95%), complemented with the standard error of the mean and minimal detectable change with 95% confidence values (MDC95).

Results
The results indicate an excellent level of agreement between the attempts of the tests of 4- and 10-m (ICC = 0.959 and 0.976, respectively), as well as between the average of the two tests (ICC = 0.867). The agreement was slightly better between the two attempts in the 10-meter test. The number of attempts does not affect the results of gait speed. Further analysis is required to conclude the same regarding the distance of the test (4 and 10 meters). The difference in the results of the Bland Altman analysis for the average of the 4 and 10-meter tests was 1.5945 m/s (95% confidence interval: 0.9759 to 2.2130 m/s), which is too wide and higher than the MDC95 value.

Conclusions
The ICC value was excellent in all cases, and the number of attempts does not affect the results of gait speed. However, further analysis is required to conclude the same regarding the distance of the test. There is an insufficient agreement between the two tests to allow them to be used interchangeably in populations with the characteristics of this study.

Authors: Lincoyán Fernández-Huerta[1], Karen Córdova-León[1]

Filiación:
[1] Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad de Las Américas, Concepción, Chile

E-mail: lincoyan.f@gmail.com

Citación: Fernández-Huerta L, Córdova-León K. Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons. Medwave 2019;19(3):e7611 doi: 10.5867/medwave.2019.03.7611

Fecha de envío: 2/1/2019

Fecha de aceptación: 8/4/2019

Fecha de publicación: 15/4/2019

Origen: no solicitado

Tipo de revisión: con revisión por tres pares revisores externos, a doble ciego

Ficha PubMed

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  1. Busch T de A, Duarte YA, Pires Nunes D, Lebrão ML, Satya Naslavsky M, dos Santos Rodrigues A, et al. Factors associated with lower gait speed among the elderly living in a developing country: a cross-sectional population-based study. BMC Geriatr. 2015 Apr 1;15:35. | CrossRef | PubMed |
  2. Varela Pinedo L, Ortiz Saavedra PJ, Chávez Jimeno H. [Gait speed as an indicator of fragility in community-dwelling elders in Lima, Peru]. Rev Esp Geriatr Gerontol. 2010 Jan-Feb;45(1):22-5. | CrossRef | PubMed |
  3. Fritz S, Lusardi M. White paper: "walking speed: the sixth vital sign". J Geriatr Phys Ther. 2009;32(2):46-9. | CrossRef | PubMed |
  4. Hardy SE, Perera S, Roumani YF, Chandler JM, Studenski SA. Improvement in usual gait speed predicts better survival in older adults. J Am Geriatr Soc. 2007 Nov;55(11):1727-34. | CrossRef | PubMed |
  5. Kline Mangione K, Craik RL, Lopopolo R, Tomlinson JD, Brenneman SK. Predictors of gait speed in patients after hip fracture. Physiother Can. 2008 Winter;60(1):10-8. | CrossRef | PubMed |
  6. Montero-Odasso M, Schapira M, Duque G, Soriano ER, Kaplan R, Camera LA. Gait disorders are associated with non-cardiovascular falls in elderly people: a preliminary study. BMC Geriatr. 2005 Dec 1;5:15. | CrossRef | PubMed |
  7. Abellan van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009 Dec;13(10):881-9. | CrossRef | PubMed |
  8. Sustakoski A, Perera S, VanSwearingen JM, Studenski SA, Brach JS. The impact of testing protocol on recorded gait speed. Gait Posture. 2015 Jan;41(1):329-31. | CrossRef | PubMed |
  9. Steffen TM, Mollinger LA. Age- and gender-related test performance in community-dwelling adults. J Neurol Phys Ther. 2005 Dec;29(4):181-8. | CrossRef | PubMed |
  10. Dalgas U, Severinsen K, Overgaard K. Relations between 6 minute walking distance and 10 meter walking speed in patients with multiple sclerosis and stroke. Arch Phys Med Rehabil. 2012 Jul;93(7):1167-72. | CrossRef | PubMed |
  11. Karpman C, Lebrasseur NK, Depew ZS, Novotny PJ, Benzo RP. Measuring gait speed in the out-patient clinic: methodology and feasibility. Respir Care. 2014 Apr;59(4):531-7. | CrossRef | PubMed |
  12. Caetano MJD, Lord SR, Brodie MA, Schoene D, Pelicioni PHS, Sturnieks DL, et al. Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people. Gait Posture. 2018 Jan;59:188-192. | CrossRef | PubMed |
  13. Aranda-García S, Busquets A, Planas A, Prat-Subirana JA, Angulo-Barroso RM. Strength, Static Balance, Physical Activity, and Age Predict Maximal Gait Speed in Healthy Older Adults From a Rural Community: A Cross-Sectional Study. J Aging Phys Act. 2015 Oct;23(4):580-7. | CrossRef | PubMed |
  14. Studenski S. Bradypedia: is gait speed ready for clinical use? J Nutr Health Aging. 2009 Dec;13(10):878-80. | CrossRef | PubMed |
  15. Kon SS, Patel MS, Canavan JL, Clark AL, Jones SE, Nolan CM, et al. Reliability and validity of 4-metre gait speed in COPD. Eur Respir J. 2013 Aug;42(2):333-40. | CrossRef | PubMed |
  16. Wilson CM, Kostsuca SR, Boura JA. Utilization of a 5-Meter Walk Test in Evaluating Self-selected Gait Speed during Preoperative Screening of Patients Scheduled for Cardiac Surgery. Cardiopulm Phys Ther J. 2013 Sep;24(3):36-43. | CrossRef | PubMed |
  17. Lusardi MM, Pellecchia GL, Schulman M. Functional performance in community living older adults. journal of geriatric physical therapy. Ovid Technologies (Wolters Kluwer Health); 2003 Dec;26(3):14-22. | CrossRef |
  18. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997 Jan;26(1):15-9. | CrossRef | PubMed |
  19. Peters DM, Fritz SL, Krotish DE. Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther. 2013 Jan-Mar;36(1):24-30. | CrossRef | PubMed |
  20. Middleton A, Fritz SL. Assessment of gait, balance, and mobility in older adults: considerations for clinicians. current translational geriatrics and experimental gerontology reports. Springer Nature; 2013 Aug 28;2(4):205-14. | CrossRef |
  21. Unver B, Baris RH, Yuksel E, Cekmece S, Kalkan S, Karatosun V. Reliability of 4-meter and 10-meter walk tests after lower extremity surgery. Disabil Rehabil. 2017 Dec;39(25):2572-2576. | CrossRef | PubMed |
  22. Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture. 2004 Aug;20(1):20-5. | CrossRef | PubMed |
  23. Wyrwich KW, Tierney WM, Wolinsky FD. Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol. 1999 Sep;52(9):861-73. | CrossRef | PubMed |
  24. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307-10. | CrossRef | PubMed |
  25. Pavasini R, Guralnik J, Brown JC, di Bari M, Cesari M, Landi F, et al. Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis. BMC Med. 2016 Dec 22;14(1):215. | CrossRef | PubMed |
  26. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994 Mar;49(2):M85-94. | CrossRef | PubMed |
  27. Adell E, Wehmhörner S, Rydwik E. The test-retest reliability of 10 meters maximal walking speed in older people living in a residential care unit. J Geriatr Phys Ther. 2013 Apr-Jun;36(2):74-7. | CrossRef | PubMed |
  28. Graham JE, Ostir GV, Kuo YF, Fisher SR, Ottenbacher KJ. Relationship between test methodology and mean velocity in timed walk tests: a review. Arch Phys Med Rehabil. 2008 May;89(5):865-72. | CrossRef | PubMed |
  29. Inzitari M, Calle A, Esteve A, Casas Á, Torrents N, Martínez N. [Do you measure gait speed in your daily clinical practice? A review]. Rev Esp Geriatr Gerontol. 2017 Jan-Feb;52(1):35-43. | CrossRef | PubMed |
  30. Andersson M, Moberg L, Svantesson U, Sundbom A, Johansson H, Emtner M. Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test. Prim Care Respir J. 2011 Dec;20(4):434-40. | CrossRef | PubMed |
  31. Bongers KT, Schoon Y, Graauwmans MJ, Hoogsteen-Ossewaarde ME, Olde Rikkert MG. Safety, Feasibility, and Reliability of the Maximal Step Length, Gait Speed, and Chair Test Measured by Seniors Themselves: The Senior Step Study. J Aging Phys Act. 2015 Jul;23(3):438-43. | CrossRef | PubMed |
  32. Kim HJ, Park I, Lee HJ, Lee O. The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults. J Exerc Nutrition Biochem. 2016 Sep;20(3):46-50. | CrossRef | PubMed |
  33. Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8. | CrossRef | PubMed |
  34. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31. | CrossRef | PubMed |
  35. Phan-Ba R, Calay P, Grodent P, Delrue G, Lommers E, Delvaux V, et al. A corrected version of the Timed-25 Foot Walk Test with a dynamic start to capture the maximum ambulation speed in multiple sclerosis patients. NeuroRehabilitation. 2012;30(4):261-6. | CrossRef | PubMed |
  36. Bohannon RW. Population representative gait speed and its determinants. J Geriatr Phys Ther. 2008;31(2):49-52. | CrossRef | PubMed |
  37. Bohannon RW, Williams Andrews A. Normal walking speed: a descriptive meta-analysis. Physiotherapy. 2011 Sep;97(3):182-9. | CrossRef | PubMed |
  38. Bridenbaugh SA, Kressig RW. Laboratory review: the role of gait analysis in seniors' mobility and fall prevention. Gerontology. 2011;57(3):256-64. | CrossRef | PubMed |
  39. Lyons JG, Heeren T, Stuver SO, Fredman L. Assessing the agreement between 3-meter and 6-meter walk tests in 136 community-dwelling older adults. J Aging Health. 2015 Jun;27(4):594-605. | CrossRef | PubMed |
  40. 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 Apr;114(2):469-78. | CrossRef | PubMed |
Busch T de A, Duarte YA, Pires Nunes D, Lebrão ML, Satya Naslavsky M, dos Santos Rodrigues A, et al. Factors associated with lower gait speed among the elderly living in a developing country: a cross-sectional population-based study. BMC Geriatr. 2015 Apr 1;15:35. | CrossRef | PubMed |

Varela Pinedo L, Ortiz Saavedra PJ, Chávez Jimeno H. [Gait speed as an indicator of fragility in community-dwelling elders in Lima, Peru]. Rev Esp Geriatr Gerontol. 2010 Jan-Feb;45(1):22-5. | CrossRef | PubMed |

Fritz S, Lusardi M. White paper: "walking speed: the sixth vital sign". J Geriatr Phys Ther. 2009;32(2):46-9. | CrossRef | PubMed |

Hardy SE, Perera S, Roumani YF, Chandler JM, Studenski SA. Improvement in usual gait speed predicts better survival in older adults. J Am Geriatr Soc. 2007 Nov;55(11):1727-34. | CrossRef | PubMed |

Kline Mangione K, Craik RL, Lopopolo R, Tomlinson JD, Brenneman SK. Predictors of gait speed in patients after hip fracture. Physiother Can. 2008 Winter;60(1):10-8. | CrossRef | PubMed |

Montero-Odasso M, Schapira M, Duque G, Soriano ER, Kaplan R, Camera LA. Gait disorders are associated with non-cardiovascular falls in elderly people: a preliminary study. BMC Geriatr. 2005 Dec 1;5:15. | CrossRef | PubMed |

Abellan van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009 Dec;13(10):881-9. | CrossRef | PubMed |

Sustakoski A, Perera S, VanSwearingen JM, Studenski SA, Brach JS. The impact of testing protocol on recorded gait speed. Gait Posture. 2015 Jan;41(1):329-31. | CrossRef | PubMed |

Steffen TM, Mollinger LA. Age- and gender-related test performance in community-dwelling adults. J Neurol Phys Ther. 2005 Dec;29(4):181-8. | CrossRef | PubMed |

Dalgas U, Severinsen K, Overgaard K. Relations between 6 minute walking distance and 10 meter walking speed in patients with multiple sclerosis and stroke. Arch Phys Med Rehabil. 2012 Jul;93(7):1167-72. | CrossRef | PubMed |

Karpman C, Lebrasseur NK, Depew ZS, Novotny PJ, Benzo RP. Measuring gait speed in the out-patient clinic: methodology and feasibility. Respir Care. 2014 Apr;59(4):531-7. | CrossRef | PubMed |

Caetano MJD, Lord SR, Brodie MA, Schoene D, Pelicioni PHS, Sturnieks DL, et al. Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people. Gait Posture. 2018 Jan;59:188-192. | CrossRef | PubMed |

Aranda-García S, Busquets A, Planas A, Prat-Subirana JA, Angulo-Barroso RM. Strength, Static Balance, Physical Activity, and Age Predict Maximal Gait Speed in Healthy Older Adults From a Rural Community: A Cross-Sectional Study. J Aging Phys Act. 2015 Oct;23(4):580-7. | CrossRef | PubMed |

Studenski S. Bradypedia: is gait speed ready for clinical use? J Nutr Health Aging. 2009 Dec;13(10):878-80. | CrossRef | PubMed |

Kon SS, Patel MS, Canavan JL, Clark AL, Jones SE, Nolan CM, et al. Reliability and validity of 4-metre gait speed in COPD. Eur Respir J. 2013 Aug;42(2):333-40. | CrossRef | PubMed |

Wilson CM, Kostsuca SR, Boura JA. Utilization of a 5-Meter Walk Test in Evaluating Self-selected Gait Speed during Preoperative Screening of Patients Scheduled for Cardiac Surgery. Cardiopulm Phys Ther J. 2013 Sep;24(3):36-43. | CrossRef | PubMed |

Lusardi MM, Pellecchia GL, Schulman M. Functional performance in community living older adults. journal of geriatric physical therapy. Ovid Technologies (Wolters Kluwer Health); 2003 Dec;26(3):14-22. | CrossRef |

Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997 Jan;26(1):15-9. | CrossRef | PubMed |

Peters DM, Fritz SL, Krotish DE. Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther. 2013 Jan-Mar;36(1):24-30. | CrossRef | PubMed |

Middleton A, Fritz SL. Assessment of gait, balance, and mobility in older adults: considerations for clinicians. current translational geriatrics and experimental gerontology reports. Springer Nature; 2013 Aug 28;2(4):205-14. | CrossRef |

Unver B, Baris RH, Yuksel E, Cekmece S, Kalkan S, Karatosun V. Reliability of 4-meter and 10-meter walk tests after lower extremity surgery. Disabil Rehabil. 2017 Dec;39(25):2572-2576. | CrossRef | PubMed |

Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture. 2004 Aug;20(1):20-5. | CrossRef | PubMed |

Wyrwich KW, Tierney WM, Wolinsky FD. Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol. 1999 Sep;52(9):861-73. | CrossRef | PubMed |

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307-10. | CrossRef | PubMed |

Pavasini R, Guralnik J, Brown JC, di Bari M, Cesari M, Landi F, et al. Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis. BMC Med. 2016 Dec 22;14(1):215. | CrossRef | PubMed |

Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994 Mar;49(2):M85-94. | CrossRef | PubMed |

Adell E, Wehmhörner S, Rydwik E. The test-retest reliability of 10 meters maximal walking speed in older people living in a residential care unit. J Geriatr Phys Ther. 2013 Apr-Jun;36(2):74-7. | CrossRef | PubMed |

Graham JE, Ostir GV, Kuo YF, Fisher SR, Ottenbacher KJ. Relationship between test methodology and mean velocity in timed walk tests: a review. Arch Phys Med Rehabil. 2008 May;89(5):865-72. | CrossRef | PubMed |

Inzitari M, Calle A, Esteve A, Casas Á, Torrents N, Martínez N. [Do you measure gait speed in your daily clinical practice? A review]. Rev Esp Geriatr Gerontol. 2017 Jan-Feb;52(1):35-43. | CrossRef | PubMed |

Andersson M, Moberg L, Svantesson U, Sundbom A, Johansson H, Emtner M. Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test. Prim Care Respir J. 2011 Dec;20(4):434-40. | CrossRef | PubMed |

Bongers KT, Schoon Y, Graauwmans MJ, Hoogsteen-Ossewaarde ME, Olde Rikkert MG. Safety, Feasibility, and Reliability of the Maximal Step Length, Gait Speed, and Chair Test Measured by Seniors Themselves: The Senior Step Study. J Aging Phys Act. 2015 Jul;23(3):438-43. | CrossRef | PubMed |

Kim HJ, Park I, Lee HJ, Lee O. The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults. J Exerc Nutrition Biochem. 2016 Sep;20(3):46-50. | CrossRef | PubMed |

Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8. | CrossRef | PubMed |

Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31. | CrossRef | PubMed |

Phan-Ba R, Calay P, Grodent P, Delrue G, Lommers E, Delvaux V, et al. A corrected version of the Timed-25 Foot Walk Test with a dynamic start to capture the maximum ambulation speed in multiple sclerosis patients. NeuroRehabilitation. 2012;30(4):261-6. | CrossRef | PubMed |

Bohannon RW. Population representative gait speed and its determinants. J Geriatr Phys Ther. 2008;31(2):49-52. | CrossRef | PubMed |

Bohannon RW, Williams Andrews A. Normal walking speed: a descriptive meta-analysis. Physiotherapy. 2011 Sep;97(3):182-9. | CrossRef | PubMed |

Bridenbaugh SA, Kressig RW. Laboratory review: the role of gait analysis in seniors' mobility and fall prevention. Gerontology. 2011;57(3):256-64. | CrossRef | PubMed |

Lyons JG, Heeren T, Stuver SO, Fredman L. Assessing the agreement between 3-meter and 6-meter walk tests in 136 community-dwelling older adults. J Aging Health. 2015 Jun;27(4):594-605. | CrossRef | PubMed |

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 Apr;114(2):469-78. | CrossRef | PubMed |