Gait speed assessed by a 4-m walk test is not representative of daily-life gait speed in community-dwelling adults

Jeanine M. Van Ancum, Kimberley S. van Schooten, Nini H. Jonkman, Bas Huijben, Rob C. van Lummel, Carel G.M. Meskers, Andrea B. Maier, Mirjam Pijnappels

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60 Citations (Scopus)


Objectives: Standardized tests of gait speed are regarded as being of clinical value, but they are typically performed under optimal conditions, and may not reflect daily-life gait behavior. The aim of this study was to compare 4-m gait speed to the distribution of daily-life gait speed. Study design: The cross-sectional Grey Power cohort included 254 community-dwelling participants aged 18 years or more. Main outcome measures: Pearson's correlations were used to compare gait speed assessed using a timed 4-m walk test at preferred pace, and daily-life gait speed obtained from tri-axial lower-back accelerometer data over seven consecutive days. Results: Participants (median age 66.7 years [IQR 59.4–72.5], 65.7% female) had a mean 4-m gait speed of 1.43 m/s (SD 0.21), and a mean 50th percentile of daily-life gait speed of 0.90 m/s (SD 0.23). Ninety-six percent had a bimodal distribution of daily-life gait speed, with a mean 1st peak of 0.61 m/s (SD 0.15) and 2nd peak of 1.26 m/s (SD 0.23). The percentile of the daily-life distribution that corresponded best with the individual 4-m gait speed had a median value of 91.2 (IQR 75.4–98.6). The 4-m gait speed was very weakly correlated to the 1st and 2nd peak (r = 0.005, p = 0.936 and r=0.181, p = 0.004), and the daily-life gait speed percentiles (range: 1st percentile r = 0.076, p = 0.230 to 99th percentile r = 0.399, p < 0.001; 50th percentile r = 0.132, p = 0.036). Conclusions: The 4-m gait speed is only weakly related to daily-life gait speed. Clinicians and researchers should consider that 4-m gait speed and daily-life gait speed represent two different constructs.

Original languageEnglish
Pages (from-to)28-34
Number of pages7
Early online date7 Dec 2018
Publication statusPublished - 1 Mar 2019


  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Gait Analysis
  • Humans
  • Independent Living
  • Male
  • Middle Aged
  • Walk Test
  • Walking/physiology
  • Young Adult

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