title: Gait speed as a predictor of outcomes in post-acute transitional care for older people.
abstract: OBJECTIVE
  Gait speed has been advocated as a marker of vulnerability, but its discriminatory utility and predictive ability in frail older people in a post-acute community-based rehabilitation program has not been extensively investigated. The aims of this research were to examine whether there was a meaningful improvement in gait speed in post-acute care patients, and to determine whether gait speed predicted outcomes at 6-month follow up.
  
  
  METHODS
  In a prospective cohort study, 351 older persons admitted to a transition care program were comprehensively assessed using the interRAI Home Care instrument. This included a timed 4-m walk at admission and discharge. A telephone interview 6 months after admission determined functional independence, living status and readmissions to hospital.
  
  
  RESULTS
  Mean (SD) gait speed was 0.34 m/s (0.21 m/s) at admission and 0.54 m/s (0.33 m/s) at discharge. The improvement in gait speed over the program was significant (P<0.001), and represents a clinically meaningful change. At 6 months postadmission to transition care, a majority of patients (86.9%) were living in the community and 40.5% had at least one readmission to hospital. Higher gait speed at admission was associated with increased likelihood of living in the community (OR 1.34, P=0.015) and being functionally independent (OR 1.19 P=0.017) at follow up, as well as a reduced risk of hospital readmissions (OR 1.18, P=0.006).
  
  
  CONCLUSIONS
  Gait speed is an inexpensive, feasible and objective measure of physical performance in frail older people. It could be a useful tool in community-based transition care settings to predict outcomes.
authors.affiliation: Center for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Nancye M
authors.initials: NM
authors.lastname: Peel
authors.forename: Sukumar
authors.initials: S
authors.lastname: Navanathan
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Hubbard
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D051346:Mobility Limitation; D011446:Prospective Studies; D016138:Walking / Q000502:physiology*
keywords: gait speed; older people; post-acute care; rehabilitation