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Table 5 Summary table of Gait Speed as a falls assessment tool

From: Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility

Review

Review characteristics

Risk of bias

Summary of key findings

Interpretation

Ambrose [19]

Narrative

High

No data to extract

Unclear

Abellan Van Kan [22]

Systematic review without meta-analysis

(n = 4, 9477 participants)

Community-dwelling older adults

High

All demonstrated gait speed was an independent predictor of falls or falls related fracture. Gait speed reported as at usual pace.

Favourable

Pamoukdjian [34]

Systematic review without meta-analysis

(n = 9, 6357 participants)

Community-dwelling

High

Recommend evaluating gait speed over a distance of 4 m with a threshold of 1 m/s in a single measure as a screening tool for frailty in older patients with cancer (aged 65 years and older); those with gait speed < 1 m/s over a 4-m distance should then be assessed with a CGA.

Favourable

Lee [29]

Systematic review without meta-analysis

(n = 2)

Mixed settings

High

Community dwelling older people (n = 1):

- 6-m walk test 50% sensitivity, 68% specificity, 37% positive predictive value

Outpatient stroke clinics (n = 1):

- 10-MWT sensitivity 80%, specificity 58%, positive predictive value 64%, negative predictive value 76%, AUC (95%CI) 0.74 (0.64–0.81)

Favourable for stroke patients

Scott [35]

Systematic review without meta-analysis

(n = 1)

Mixed settings

High

Long term care setting:

IRR = 0.88 and not reported as an independent predictor for falls.

Not favourable

Dolatabadi [26]

Systematic review without meta-analysis

(n = 6)

Older adults with diagnosis of dementia

Unclear

Gait speeds were often found to differentiate between faller and non-faller in a dementia population. No specific synthesis of data to extract from the review.

Favourable

Chantanachai [38]

Meta-analysis

(n = 18)

Older people with cognitive impairment living in the community

Low

Gait speed −0.07 (−0.28,-0.06) (4 studies, (p = 0.46)

Of the eight studies that assessed gait speed, six found slow gait speed under standard conditions to predict falls

Not favourable

Ganz [28]

Meta-analysis

(n = 15)

Community-dwelling older adults

Low

Taking more than 13 seconds to walk 10 m predicts recurrent falls with about the same LR as perceived mobility problems (LR, 2.0; 95% CI, 1.5–2.7)

Favourable

Marin-Jimenez [30]

Systematic review without meta-analysis

(n = 25, 2 systematic reviews)

Healthy community-based population older than 18 years.

Sub population > 65 years old

Low

Strong evidence for slower gait predicting falls in adults over 60 years (seven studies+ seven studies from systematic reviews)

Three studies did not find an association between gait speed test and falls.

6 m walk test reported

Favourable

Menant [41]

Meta-analysis

(n = 30)

Mixed settings

Low

Pooled MD (95% CI) for gait speed between fallers and non-fallers (0.069 (0.045–0.094). Findings indicate single and dual task tests of gait speed are equivalent in the prediction of falls. Slower gait speeds under both single and dual-Task conditions significantly discriminate between fallers and non-fallers.

The majority of included studie reported self selected gait speed with two studies reporting unclear specifications.

Favourable

  1. Abbreviation: AUC Area under the curve, CI Confidence interval, CGA Comprehensive geriatric assessment, IRR Incidence rate ratio, n number of included studies, MD Mean difference, SROC Summary receiver operating characteristic, 10-MWT 10 m walking test