How much evidence did you find about normal or comfortable gait speed?

There are numerous articles published where researchers measured normal gait speed.

Using search terms for normative, gait and speed in addition to their synonyms, we found 1444 articles published in the past decade worthy of review.

However, we applied rather stringent inclusion/exclusion criteria to ensure that the methods employed across studies were comparable regarding key elements.

For example, we only included studies with untimed acceleration and deceleration phases since beginning timing from a static starting position may yield relatively slower gait speed values (Pasma et al 2014, Phan-Ba et al 2012).

After applying all our inclusion/exclusion criteria, we ended up with gait speed data from 38 articles published in the past decade that we could add to a database we established back in 2011.

The combined database used in our meta-analysis consisted of comfortable gait speeds obtained from 51,248 apparently healthy adults and stratified by sex and age (ie, 18–29, 30–39… 80+ years).

When you pooled the data, did normal gait speed vary with age and/or sex?

In concurrence with previous studies, gait speed decreased as age increased.

We found a steady decline in the mean gait speed for women with increasing age.

The mean gait speed for men remained stable from 18 to 29 years to 40 to 49 years and thereafter decreased with increasing age.

Overall, the mean gait speed ranged from a low of 97 cm/s for women aged 80+ years to a high of 140 cm/s for men aged 40–49 years.

Another interesting finding related to age was that older participants had wider confidence intervals for their gait speeds, indicating less homogeneity in the older age groups than in the younger age groups.

Even though all investigators required their participants to be independently ambulatory in the community, participants with comorbidities that may affect gait speed (eg, diabetes mellitus; Nilsson et al 2017) could have been included in some studies in this meta-analysis but not in others.

Since older adults are more likely to have comorbidities that may affect gait, this variance in exclusion criteria may have contributed to less homogeneity in the older age groups.

What about geographical region? Did that have an influence?

After stratifying the participants even further by the continents where the studies were conducted (Australia, Asia, Europe, North America and South America), we found that gait speeds between groups could not be analysed with an analysis of variance because assumptions of homoscedasticity were violated.

In other words, gait speed variances were greater in some sex/age groups than others, thus raising the risk of skewed statistical test results.

An observation of the results showed overlaps in gait speed confidence interval values for just about every sex/age group between continents.

We recommend that clinicians and researchers compare their patients, clients and participants to the table of comfortable gait speed for all participants, broken down by sex and age.

Breaking down gait speed normative values even further by geographic region is not useful with this data set.

>> Bill Andrews is a physiotherapist who serves as Professor in the Department of Physical Therapy Education at Elon University in North Carolina in the United States. His clinical, academic and research interest areas are clinical measurement and stroke rehabilitation.

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