Gait speed as a measure in geriatric assessment in clinical settings: a systematic review.

BACKGROUND Gait speed is a quick, inexpensive, reliable measure of functional capacity with well-documented predictive value for major health-related outcomes. Numerous epidemiological studies have documented gait speed in healthy, community-dwelling older people. The purpose of this study is to undertake a systematic review and meta-analysis of gait speed in a specific group with mobility limitations-geriatric patients in clinical settings. METHODS Relevant databases were searched systematically for original research articles published in February 2011 measuring gait speed in persons aged 70 or older in hospital inpatient or outpatients settings. Meta-analysis determined gait speed data for each setting adjusting for covariates. RESULTS The review included 48 studies providing data from 7,000 participants. Across the hospital settings, the gait speed estimate for usual pace was 0.58 m/s (95% confidence interval [CI]: 0.49-0.67) and for maximal pace was 0.89 m/s (95% CI: 0.75-1.02). These estimates were based on most recent year of publication (2011) and median percentage of female participants (63%). Gait speed at usual pace in acute care settings was 0.46 m/s (95% CI: 0.34-0.57), which was significantly slower than the gait speed of 0.74 m/s (95% CI: 0.65-0.83) recorded in outpatient settings. CONCLUSIONS Gait speed is an important measure in comprehensive geriatric assessment. The consolidation of data from multiple studies reported in this meta-analysis highlights the mobility limitations experienced by older people in clinical settings and the need for ongoing rehabilitation to attain levels sufficient for reintegration in the community.