The relationship between gait speed, functional reserve and frailty in community dwelling older adults

  • Soares W
  • Lima C
  • Ferrioli E
  • et al.
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Abstract

Background: Gait speed may be a marker of functional reserve as a result of age-related and diseases burden, ultimately expressing the overall state of health in older adults. However, it is not clear if the relation of walking in a usual pace and walking in a fast pace could be used as an expression of functional reserve. Purpose: To explore the association between functional gait reserve and frailty and disability in community dwelling older adults. Methods: Cross-sectional population-based study with a sample of 761, men and women, aged 65 years and or older (FIBRA Network Study). The participants were classified as non-frail, pre-frail and frail according with frailty phenotype (non-intentional weight loss, slow walking speed, decreased hand grip strength, low physical activity level, self-perceived exhaustion). Disability was ascertained by Lawton scale (IADL) and those with one or more activities restricted were disabled. Gait speed, usual and fast, were obtained by dividing the distance travelled to walk 4.6m by the time to cover that distance using a stopwatch (Cronobio, model SW2018). It was used a distance of 2m for acceleration and 2m for deceleration. The mean value of three trials for usual and fast gait speed assessment was ascertained. We considered a cut-off of 1 m/s to classify the participants into three groups: (1) those who walked above 1 m/s when were asked to walk in their usual pace, and continued to walk above this threshold when were asked to walk as fast as possible were classified as the 'Good gait functional reserve group' (GG); (2) those who did not walk above 1 m/s when were asked to walk in their usual pace, but improved their speed walking above 1 m/s when were asked to walk as fast as possible were classified as the 'Average gait functional reserve group' (AG); (3) those who could not walk above 1 m/s when were asked to walk in their usual pace, and continued to walk bellow this threshold when were asked to walk as fast as possible, classified as the 'Poor gait functional reserve group' (PG). Analysis: Descriptive statistic was used to characterize participants in the three groups and Chi-square test was used to identify the association between frailty and disability and the GG, AG and PG groups. Results: Participants mean age was 71.9 (5.9 SD). 42.3% were classified as non-frail, 48% as pre-frail and 9.7% as frail. Among GG only 1.4% were frail, 39.3% were pre-frail and 59.2% were non-frail; among the AG 10.7% were frail, 62.2% were pre-frail and 27% were non-frail; and among the PG 40.4% were frail, 53.5% pre-frail and 6.1 non-frail (p < 0.001). Participants with an IADL restriction above the median were 27.7%, 49.1%, 70.6% in the GG, AG and PG respectively (p < 0.001). Conclusion(s): Functional gait reserve is associated with frailty and disability in community dwelling older adults. Implications: The relation of walking in a usual pace and walking in a fast pace may be used as a screening tool in clinical practice.

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Soares, W. J. d. S., Lima, C., Ferrioli, E., Dias, R. C., & Perracini, M. R. (2015). The relationship between gait speed, functional reserve and frailty in community dwelling older adults. Physiotherapy, 101, e1416. https://doi.org/10.1016/j.physio.2015.03.1370

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