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Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals
Manual measurement of 4-meter gait speed by a stopwatch is the gold standard test for functional assessment in older adults. However, the accuracy of this technique may be biased by several factors, including intra- and inter-operator variability. Instrumental techniques of measurement using acceler...
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creator | Maggio, Marcello Ceda, Gian Paolo Ticinesi, Andrea De Vita, Francesca Gelmini, Giovanni Costantino, Cosimo Meschi, Tiziana Kressig, Reto W Cesari, Matteo Fabi, Massimo Lauretani, Fulvio |
description | Manual measurement of 4-meter gait speed by a stopwatch is the gold standard test for functional assessment in older adults. However, the accuracy of this technique may be biased by several factors, including intra- and inter-operator variability. Instrumental techniques of measurement using accelerometers may have a higher accuracy. Studies addressing the concordance between these two techniques are missing. The aim of the present community-based observational study was to compare manual and instrumental measurements of 4-meter gait speed in older individuals and to assess their relationship with other indicators of physical performance. One-hundred seventy-two (69 men, 103 women) non-disabled community-dwellers aged [greater than or equal to]65 years were enrolled. They underwent a comprehensive geriatric assessment including physical function by Short Physical Performance Battery (SPPB), hand grip strength, and 6-minute walking test (6MWT). Timed usual walking speed on a 4-meter course was assessed by using both a stopwatch (4-meter manual measurement, 4-MM) and a tri-axial accelerometer (4-meter automatic measurement, 4-MA). Correlations between these performance measures were evaluated separately in men and women by partial correlation coefficients. In both genders, 4-MA was associated with 4-MM (men r = 0.62, p |
doi_str_mv | 10.1371/journal.pone.0153583 |
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However, the accuracy of this technique may be biased by several factors, including intra- and inter-operator variability. Instrumental techniques of measurement using accelerometers may have a higher accuracy. Studies addressing the concordance between these two techniques are missing. The aim of the present community-based observational study was to compare manual and instrumental measurements of 4-meter gait speed in older individuals and to assess their relationship with other indicators of physical performance. One-hundred seventy-two (69 men, 103 women) non-disabled community-dwellers aged [greater than or equal to]65 years were enrolled. They underwent a comprehensive geriatric assessment including physical function by Short Physical Performance Battery (SPPB), hand grip strength, and 6-minute walking test (6MWT). Timed usual walking speed on a 4-meter course was assessed by using both a stopwatch (4-meter manual measurement, 4-MM) and a tri-axial accelerometer (4-meter automatic measurement, 4-MA). Correlations between these performance measures were evaluated separately in men and women by partial correlation coefficients. In both genders, 4-MA was associated with 4-MM (men r = 0.62, p<0.001; women r = 0.73, p<0.001), handgrip strength (men r = 0.40, p = 0.005; women r = 0.29, p = 0.001) and 6MWT (men r = 0.50, p = 0.0004; women r = 0.22, p = 0.048). 4-MM was associated with handgrip strength and 6MWT in both men and women. Considering gait speed <0.6 m/s as diagnostic of dismobility syndrome, the two methods of assessment disagreed, with a different categorization of subjects, in 19% of men and 23% of women. The use of accelerometer resulted in 29 (13 M, 16 F) additional diagnoses of dismobility, compared with the 4-MM. In an older population, the concordance of gait speeds manually or instrumentally assessed is not optimal. The results suggest that manual measures might lead to misclassification of a substantial number of subjects. However, longitudinal studies using standardized and validated procedures aimed at the comparison of different techniques are needed before recommending the use of accelerometers in comprehensive geriatric assessment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0153583</identifier><language>eng</language><publisher>Public Library of Science</publisher><subject>Analysis ; Elderly ; Gait ; Physiological aspects ; Walking</subject><ispartof>PLoS ONE, 2016, Vol.11 (4)</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776,780,4476,27901</link.rule.ids></links><search><creatorcontrib>Maggio, Marcello</creatorcontrib><creatorcontrib>Ceda, Gian Paolo</creatorcontrib><creatorcontrib>Ticinesi, Andrea</creatorcontrib><creatorcontrib>De Vita, Francesca</creatorcontrib><creatorcontrib>Gelmini, Giovanni</creatorcontrib><creatorcontrib>Costantino, Cosimo</creatorcontrib><creatorcontrib>Meschi, Tiziana</creatorcontrib><creatorcontrib>Kressig, Reto W</creatorcontrib><creatorcontrib>Cesari, Matteo</creatorcontrib><creatorcontrib>Fabi, Massimo</creatorcontrib><creatorcontrib>Lauretani, Fulvio</creatorcontrib><title>Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals</title><title>PLoS ONE</title><description>Manual measurement of 4-meter gait speed by a stopwatch is the gold standard test for functional assessment in older adults. However, the accuracy of this technique may be biased by several factors, including intra- and inter-operator variability. Instrumental techniques of measurement using accelerometers may have a higher accuracy. Studies addressing the concordance between these two techniques are missing. The aim of the present community-based observational study was to compare manual and instrumental measurements of 4-meter gait speed in older individuals and to assess their relationship with other indicators of physical performance. One-hundred seventy-two (69 men, 103 women) non-disabled community-dwellers aged [greater than or equal to]65 years were enrolled. They underwent a comprehensive geriatric assessment including physical function by Short Physical Performance Battery (SPPB), hand grip strength, and 6-minute walking test (6MWT). Timed usual walking speed on a 4-meter course was assessed by using both a stopwatch (4-meter manual measurement, 4-MM) and a tri-axial accelerometer (4-meter automatic measurement, 4-MA). Correlations between these performance measures were evaluated separately in men and women by partial correlation coefficients. In both genders, 4-MA was associated with 4-MM (men r = 0.62, p<0.001; women r = 0.73, p<0.001), handgrip strength (men r = 0.40, p = 0.005; women r = 0.29, p = 0.001) and 6MWT (men r = 0.50, p = 0.0004; women r = 0.22, p = 0.048). 4-MM was associated with handgrip strength and 6MWT in both men and women. Considering gait speed <0.6 m/s as diagnostic of dismobility syndrome, the two methods of assessment disagreed, with a different categorization of subjects, in 19% of men and 23% of women. The use of accelerometer resulted in 29 (13 M, 16 F) additional diagnoses of dismobility, compared with the 4-MM. In an older population, the concordance of gait speeds manually or instrumentally assessed is not optimal. The results suggest that manual measures might lead to misclassification of a substantial number of subjects. However, longitudinal studies using standardized and validated procedures aimed at the comparison of different techniques are needed before recommending the use of accelerometers in comprehensive geriatric assessment.</description><subject>Analysis</subject><subject>Elderly</subject><subject>Gait</subject><subject>Physiological aspects</subject><subject>Walking</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2016</creationdate><recordtype>report</recordtype><recordid>eNqVikFrwjAYQMPYYOr8Bx5y3aE1adquHoc41oMKVhB2KR_LZ4mLX6RJxJ8_Dzvocaf3eDzGJlKkUr3J6cHFnsCmJ0eYClmoolIPbCBnKkvKTKjHG39mQ-8PQhSqKssB-6rJhz4ekQJYDqT5ylFyFxdnsBGCccTdnufJEgP2fAf2x1DHmxOi5ob42uprrkmbs9ERrH9hT_srcPzHEXv9WGznn0kHFltD344CXkIH0fu2bjbte16oPK9kJtV_3l9YMU-2</recordid><startdate>20160414</startdate><enddate>20160414</enddate><creator>Maggio, Marcello</creator><creator>Ceda, Gian Paolo</creator><creator>Ticinesi, Andrea</creator><creator>De Vita, Francesca</creator><creator>Gelmini, Giovanni</creator><creator>Costantino, Cosimo</creator><creator>Meschi, Tiziana</creator><creator>Kressig, Reto W</creator><creator>Cesari, Matteo</creator><creator>Fabi, Massimo</creator><creator>Lauretani, Fulvio</creator><general>Public Library of Science</general><scope>ISR</scope></search><sort><creationdate>20160414</creationdate><title>Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals</title><author>Maggio, Marcello ; Ceda, Gian Paolo ; Ticinesi, Andrea ; De Vita, Francesca ; Gelmini, Giovanni ; Costantino, Cosimo ; Meschi, Tiziana ; Kressig, Reto W ; Cesari, Matteo ; Fabi, Massimo ; Lauretani, Fulvio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-gale_incontextgauss_ISR_A4534481213</frbrgroupid><rsrctype>reports</rsrctype><prefilter>reports</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Analysis</topic><topic>Elderly</topic><topic>Gait</topic><topic>Physiological aspects</topic><topic>Walking</topic><toplevel>online_resources</toplevel><creatorcontrib>Maggio, Marcello</creatorcontrib><creatorcontrib>Ceda, Gian Paolo</creatorcontrib><creatorcontrib>Ticinesi, Andrea</creatorcontrib><creatorcontrib>De Vita, Francesca</creatorcontrib><creatorcontrib>Gelmini, Giovanni</creatorcontrib><creatorcontrib>Costantino, Cosimo</creatorcontrib><creatorcontrib>Meschi, Tiziana</creatorcontrib><creatorcontrib>Kressig, Reto W</creatorcontrib><creatorcontrib>Cesari, Matteo</creatorcontrib><creatorcontrib>Fabi, Massimo</creatorcontrib><creatorcontrib>Lauretani, Fulvio</creatorcontrib><collection>Gale In Context: Science</collection></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maggio, Marcello</au><au>Ceda, Gian Paolo</au><au>Ticinesi, Andrea</au><au>De Vita, Francesca</au><au>Gelmini, Giovanni</au><au>Costantino, Cosimo</au><au>Meschi, Tiziana</au><au>Kressig, Reto W</au><au>Cesari, Matteo</au><au>Fabi, Massimo</au><au>Lauretani, Fulvio</au><format>book</format><genre>unknown</genre><ristype>RPRT</ristype><atitle>Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals</atitle><jtitle>PLoS ONE</jtitle><date>2016-04-14</date><risdate>2016</risdate><volume>11</volume><issue>4</issue><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Manual measurement of 4-meter gait speed by a stopwatch is the gold standard test for functional assessment in older adults. However, the accuracy of this technique may be biased by several factors, including intra- and inter-operator variability. Instrumental techniques of measurement using accelerometers may have a higher accuracy. Studies addressing the concordance between these two techniques are missing. The aim of the present community-based observational study was to compare manual and instrumental measurements of 4-meter gait speed in older individuals and to assess their relationship with other indicators of physical performance. One-hundred seventy-two (69 men, 103 women) non-disabled community-dwellers aged [greater than or equal to]65 years were enrolled. They underwent a comprehensive geriatric assessment including physical function by Short Physical Performance Battery (SPPB), hand grip strength, and 6-minute walking test (6MWT). Timed usual walking speed on a 4-meter course was assessed by using both a stopwatch (4-meter manual measurement, 4-MM) and a tri-axial accelerometer (4-meter automatic measurement, 4-MA). Correlations between these performance measures were evaluated separately in men and women by partial correlation coefficients. In both genders, 4-MA was associated with 4-MM (men r = 0.62, p<0.001; women r = 0.73, p<0.001), handgrip strength (men r = 0.40, p = 0.005; women r = 0.29, p = 0.001) and 6MWT (men r = 0.50, p = 0.0004; women r = 0.22, p = 0.048). 4-MM was associated with handgrip strength and 6MWT in both men and women. Considering gait speed <0.6 m/s as diagnostic of dismobility syndrome, the two methods of assessment disagreed, with a different categorization of subjects, in 19% of men and 23% of women. The use of accelerometer resulted in 29 (13 M, 16 F) additional diagnoses of dismobility, compared with the 4-MM. In an older population, the concordance of gait speeds manually or instrumentally assessed is not optimal. The results suggest that manual measures might lead to misclassification of a substantial number of subjects. However, longitudinal studies using standardized and validated procedures aimed at the comparison of different techniques are needed before recommending the use of accelerometers in comprehensive geriatric assessment.</abstract><pub>Public Library of Science</pub><doi>10.1371/journal.pone.0153583</doi></addata></record> |
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source | Publicly Available Content (ProQuest); PubMed Central |
subjects | Analysis Elderly Gait Physiological aspects Walking |
title | Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals |
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