title: Gait speed is limited but improves over the course of acute care physical therapy.
abstract: BACKGROUND
  Gait is a common focus of physical therapists' management of patients in acute care settings. Walking speed, the distance a patient covers per unit time, has been advocated as a "sixth vital sign." However, the feasibility of measuring walking speed and the degree to which walking speed is limited or improves over the course of therapy in the acute care setting are unclear.
  
  
  OBJECTIVE
  The purpose of this study of patients undergoing physical therapy during acute care hospitalization, therefore, was to determine whether walking speed can be measured in acute care and whether walking speed is limited and changes over the course of therapy.
  
  
  METHODS
  This was an observational cross-sectional study. Participants were 46 hospital inpatients, mean age 75.0 years (SD = 7.8), referred to physical therapy and able to walk at least 20 ft. Information regarding diagnosis, comorbidities, physical assistance, device use, body height, and weight was obtained. Speed was determined during initial and final physical therapy visits while patients walked at their self-selected speed over a marked course in a hospital corridor.
  
  
  RESULTS
  Therapists reported that walking speed was clinically feasible, requiring inexpensive, available resources, 4 minutes' additional time, and simple calculations for documentation. Initial walking speed was a mean of 0.33 m/s (SD = 0.21; 95% confidence interval [CI]: 0.27-0.39), whereas final speed was 0.37 m/s (SD = 0.20; 95% CI: 0.31-0.43). The Wilcoxon test showed the increase in walking speed (0.04 m/s) to be significant (P = .005) over a mean therapy period of 2.0 days (SD = 1.4) and total hospitalization period of 5.5 days (SD = 3.6). The effect size and standardized response mean were 0.19 and 0.36, respectively. Minimal detectable change was 0.18 m/s.
  
  
  CONCLUSIONS
  Walking speed is a feasible measure for patients admitted to an acute care hospital. It shows that patients walk slowly relative to community requirements but that their speed improves even over a short course of therapy.
authors.affiliation: Physical Therapy Program, Department of Nursing and Rehabilitation Sciences, Angelo State University, San Angelo, Texas, USA. hbraden@angelo.edu
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Braden
authors.forename: Sean
authors.initials: S
authors.lastname: Hilgenberg
authors.forename: Richard W
authors.initials: RW
authors.lastname: Bohannon
authors.forename: Man-Soo
authors.initials: MS
authors.lastname: Ko
authors.forename: Scott
authors.initials: S
authors.lastname: Hasson
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D016138:Walking