Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences - Physical Therapy Department

First Advisor

Jennifer Canbek

Second Advisor

Joann Gallichio

Third Advisor

Kevin Chui

Publication Date / Copyright Date

2020

Publisher

Nova Southeastern University

Abstract

Background: Self-selected (SSWS) and maximum walking speeds (MWS) are frequently studied and related to multiple body systems, function, falls, and mortality. Walking at a slow speed voluntarily or measuring a range of walking speeds (WS), however, has rarely been investigated. Purpose: The aims ofthis project were to explore a proposed measure of WS adaptability called total walking speed range(TWSR), to assess the reliability and validity of slow walking speed (slowWS) as a component of TWSR, to assess if TWSR could predict function, disability or community mobility, and finally, to compare thepredictive ability of TWSR to single walking speeds. Methods: This was a cross-sectional, observational study using a convenience sample of independent community-dwelling older adults. Subjects were assessed in a single session with a battery of tests measuring common correlates of walking speed, several walking speeds, and outcome measures for function, disability (Late Life Function and DisabilityInstrument), and community mobility (Life-Space Assessment). Results: SlowWS demonstrated excellent test-retest and interrater reliability. SlowWS was only significantly correlated with TWSR, but TWSR was correlated with all study variables including the outcomes. TWSR significantly predicted function (adj. R2 = .364, p < .0005), life-space (adj. R2 = .185, p = .019), disability limitation (adj. R2 = .107, p < .0005) and disability frequency (adj. R2 = .041, p < .0005). In comparisons, SSWS predicted more variance in function, disability limitation and frequency than TWSR or MWS, but TWSR predicted life-space better. When covariates were included in models, neither TWSR, SSWS, nor MWS contributed independently to prediction of the outcomes. The hierarchical models for TWSR/SSWS/MWS performed similarly and final explained variances were within 1% of each other, except for the prediction of life-space. The model with covariates + TWSR predicted more life-space variance than covariates + SSWS (adj. R2 = .173, p < .0005 vs .145, p = .001). Conclusion: Walking at a slow speed can be reliably measured, consistent with findings for other WS. TWSR, but not slowWS, correlated with measures of body structure/function, activities, and participation and also predicted function, disability, and community mobility. However, the predictive ability of TWSR was not superior to SSWS or MWS. TWSR requires further research as a measure of walking speedadaptability, especially in relation to life-space.

Disciplines

Physical Therapy

Keywords

Community-dwelling older adults, Disability, Life-space, Total walking speed reserve, Walking speed

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