Limitations in Gait Speed Persist at Discharge from Subacute Rehabilitation

抄録

[Purpose] Walking speed is related to important outcomes such as mortality and is fundamental to independent and safe ambulation in the community. The objectives of this study were to determine if the discharge gait speed of patients completing subacute rehabilitation was slow relative to normative and street crossing reference values, and whether such speed was associated with age, gender, or diagnosis. [Subjects and Methods] Consecutive patients admitted to a subacute rehabilitation facility were screened based on inclusion and exclusion criteria. Participants were 109 patients (56 women) 60 to 98 (mean=78.2) years old who were divided into 10 diagnostic categories. Gait speed was measured over a distance of 5.2 meters as patients walked at their most comfortable speed beyond a designated finish line. Timing with a digital stopwatch began after an acceleration distance of 1 meter and ceased as patients crossed the finish line. [Results] The patients’ comfortable gait speed (mean=0.58; SD=0.19; range=0.09–1.10 m/s) was significantly less than 1.0m/s (normal reference value) (1.11±0.15 m/s) but significantly greater than that required for crossing the street (0.49 m/s). Nevertheless, 27.5% of patients did not achieve a walking speed of 0.49 m/s. Speed was inversely related to age and was lower among women, but it was not affected by diagnostic category. [Conclusion] Gait speed remains limited when patients are discharged home from subacute rehabilitation and was slowest among older women patients. Further therapy may be warranted for such patients after discharge.