Walking Toward Better Health

By Dr. Peter Abaci

Walking can be affected by all kinds of pain problems and injuries, including back pain, hip or knee arthritis, sciatica, and plantar fasciitis just to name a few. Despite the challenges, our ability to stay ambulatory and to walk at a good pace offers many valuable health benefits. If you have chronic pain, an important part of your rehabilitation work should focus on how much and how fast you can walk. 

Walking speed, often referred to as gait speed, seems to be an important tool for measuring overall health and mortality risk. Research in this field provides some interesting findings including:

  • A decline in gait speed is associated with an increase in mortality rate
  • But an increase in gait speed correlates with reduced mortality
  • A decline in gait speed correlates with a decline in attention
  • Gait speed correlates nicely with how well a person can function with daily activities
  • Measuring gait speed repeatedly over time is a way of monitoring progress to treatment like physical therapy and occupational therapy.

Consider a study published in JAMA in 2011 by Studenski, Perera, and Guralnik which found strong evidence that gait speed correlated with survival rates in the elderly. Age itself is not always an accurate predictor of life expectancy and health risks. One hypothetical way of looking at this information is that one person who is 80 years old but walks twice as fast as another person who is 75 years old may be more likely to actually outlive the younger 75 year old.

Gait speed can be measured different ways, and in our practice, we often go by how fast a patient can walk on a treadmill with appropriate mechanics as a rough guide. A simple and proven method is the ten meter walking test (TMWT). All that is needed is a tape measure, stop watch, and some room to walk. When conducting this test, the patient walks 20 meters and the speed during the middle 10 meters is recorded, and the gait speed is calculated by dividing 10 meters by the time spent traveling. A gait speed in the range of 1.2 to 1.4 meters/sec is considered normal.

It can be helpful to convert the data into miles per hour to gain a more practical perspective. For example, we use a gait speed in the range of 2.7 to 3.0 miles/hour as a critical number because that is the pace generally required crossing a street before the light changes. A gait speed of only .4 miles/hour reflects someone who is largely housebound, while being able to walk at 2.0 miles/hour means a person can generally walk about town. For patients enrolled in our comprehensive rehabilitation program, we measure their gait speed each week as an important tool of gauging progress.

Some of the new activity monitors that have recently become popular, like the Fitbit, may help access useful information about walking activity that can be used to track outcomes and progress.

If pain is making it difficult to walk, consider consulting with your doctors about the problem to come up with a plan that can ultimately put more pep in your step.

References: 
http://physical-therapy.advanceweb.com/Archives/Article-Archives/Using-G...
http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=901. 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080184/
http://www.ncbi.nlm.nih.gov/pubmed/24052577

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