Determinants of reduced walking speed in people with musculoskeletal pain.
OBJECTIVE
Maintenance of good walking speed is essential to independent living. People with musculoskeletal disease often have reduced walking speed. We investigated determinants of slower walking, other than musculoskeletal disease, that might provide valuable additional targets for therapy.


METHODS
We analyzed data from the Somerset and Avon Survey of Health, a community based survey of people aged over 35 years. A total of 2703 participants who reported hip or knee pain at baseline (1994/1995) were studied, and reassessed in 2002-2003; 1696 were available for followup, and walking speed was tested in 1074. Walking speed (m/s) was used as outcome measure. Baseline characteristics, including comorbidities and socioeconomic factors, were tested for their ability to predict reduced walking speed using multiple linear regression analysis.


RESULTS
Age, female sex, and immobility at baseline were predictive of slower walking speed. Other independent risk factors included the presence of cataract, low socioeconomic status, intermittent claudication, and other cardiovascular conditions. Having a cataract was associated with a decrease of 0.10 m/s (95% CI 0.03, 0.16). Those in social class V had a walking speed 0.22 m/s (95% CI 0.126, 0.31) slower than those in social class I.


CONCLUSIONS
Comorbidities, age, female sex, and lower socioeconomic position determine walking speed in people with joint pain. Issues such as poor vision and social-economic disadvantage may add to the effect of musculoskeletal disease, suggesting the need for a holistic approach to management of these patients.
Ayis
Salma
S
Department of Social Medicine, University of Bristol, Bristol, UK. S.Ayis@bristol.ac.uk
Ebrahim
Shah
S
Williams
Susan
S
Jüni
Peter
P
Dieppe
Paul
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000150:complications*; D002386:Cataract / Q000150:complications; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006621:Hip Joint; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications*; D010147:Pain Measurement; D011446:Prospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D016138:Walking