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July 2016 CME Article No. 7: Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults
Additional Information
Objective:
To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.

Design:
WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65Y93 years) at a local outpatient PT clinic and local retirement communities and senior centers.WSR was calculated as a difference (WSRdiff = MWS j SSWS) and ratio (WSRratio = MWS/SSWS).

Results:
SSWS (P G 0.001), MWS (P G 0.001), and WSRdiff (P G 0.01) were associated with fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64).

Conclusions:
SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWSto calculate an individual's WSR does not provide additional insight into fall status in this population.

Learning Objectives:
  1. Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure
  2. Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults
  3. Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions
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