Doctor of Philosophy (PhD) in Physical Therapy
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College of Health Care Sciences - Physical Therapy Department
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Nova Southeastern University
Michelle Germaine Criss. 2020. Does the range of walking speeds produced by community-dwelling older adults relate to or predict function, disability, and community mobility?. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences - Physical Therapy Department. (192)
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.
Community-dwelling older adults, Disability, Life-space, Total walking speed reserve, Walking speed