Abstract
Introduction: Gait speed is simple physical function measure associated with key outcomes in the elderly. Gait speed measurements may improve clinical care in patients with COPD. However, there is a knowledge gap about the reliability and variability of gait speed testing protocols in COPD. We evaluated established techniques of measuring gait speed in patients with COPD, and assessed feasibility of implementing gait speed as a routine vital sign in outpatient clinic.
Methods: Subjects with stable COPD performed usual 4 meter gait speed (4MGS) (“walk at a comfortable/natural pace”), maximal 4MGS (“walk as fast as you can safely”), usual 10 meter gait speed (10MGS) and maximal 10MGS measurements. Walks were measured using stopwatch and automated timing system. For feasibility/implementation phase, patients from entire spectrum of respiratory diseases completed acceptability surveys and clinical assistants administered gait speed measurements using automated timing system. Time to train, administer test, and acceptability by staff was evaluated.
Results: Seventy subjects enrolled, 60% male and age (mean±SD) was 69±10. All methods showed excellent test-retest reliability (ICC 0.95-0.97). The difference between the two timing systems did not exceed suggested minimal clinically importance difference of 0.1 m/s for the usual pace instructions, but did exceed 0.1m/s for maximal pace walks. The difference between 4MGS and 10MGS was 0.13±0.10 m/s.
Feasibility: Most subjects reported that gait speed measurement prior to clinic appointment was very acceptable (66%) or acceptable (33%). Time added to clinic visit measuring 4MGS was 95 ± 20 seconds, and clinical assistants reported gait speed measurements as very acceptable (60%), acceptable (30%), and somewhat acceptable (10%).
Conclusion: Gait speed is a reliable measure in COPD, regardless of instructed pace, distance or timing mechanism, however adhering to one protocol is suggested. 4MGS was easily implemented into clinical practice with high acceptability by patients and clinic staff.
- gait
- pulmonary disease
- chronic obstructive
- methods
- feasibility studies
- ambulatory care facilities
- patient acceptance of health care
Footnotes
- Corresponding author: Roberto P. Benzo M.D. M.Sc. Mindful Breathing Laboratory Mayo Clinic, Division of Pulmonary and Critical Care Medicine, 200 1st St SW Rochester, MN 55905; email: benzo.roberto{at}mayo.edu phone: 507-774-0561; fax: 507-266-4372
Conflict of Interest Statement: C.K., N.K.L., Z.S.D., P.J.N, and R.P.B. have no potential conflicts of interest to report.
Funding sources: This work was supported by the National Institutes of Health [Grant NIH NHLBI1R01CA163293-01 (PI: R. Benzo)].
- Copyright © 2013 by Daedalus Enterprises Inc.