What is the Optimal Tool to Measure Gait Speed in a Clinical Setting?

Physical changes due to age, cognitive decline, reduced agility to cope with the risk of falling, and environmental factors are becoming a significant threat to healthy aging.¹) In older adults, reduced gait speed is strongly associated with the risk of falls and limited physical functional capacity.^2,3) Gait speed measurement is the most important and simple test to assess changes in the physical function of older adults.^4-6) Gait speed is used not only to evaluate physical function but also to assess the general health status and diagnose sarcopenia in older adults.⁷) Generally, manual stopwatch measurement is the most frequently used method to evaluate gait speed because it is easy, simple, fast, convenient, and economical and can be performed without the need for experts.^8,9) However, with the emerging importance of gait speed measurement, automatic sensors are increasingly used for more accurate measurement.¹⁰)

We read the article by Jung et al.¹¹) with great interest. Our laboratory measures gait speed using automatic sensors and manual stopwatch. We agree with the results of the study performed by Jung et al.¹¹) in their cross-comparisons of gait speed measured using four different versions of automatic sensors and a conventional stopwatch. Until now, gait speed has mainly been measured manually using a stopwatch in clinical settings; however, gait speed assessment requires more accurate and consistent measurement for assessing the physical function in older adults. Therefore, cross-comparison of gait speed assessed by various automatic walking measurement equipment and stopwatch is an exciting and meaningful topic. In particular, we thank Jung et al.¹¹) for their impressive research on a more advanced version of the automatic sensor.

We previously compared the results of gait speed measured using automatic sensors by beam-breaking to those measured by manual stopwatch according to the starting protocols (standing start or moving start).¹²) We suggested the need for careful attention to avoid misevaluation when gait speed was measured manually using a stopwatch with a moving start. The use of automatic measuring equipment is recommended when a moving start is used as the starting protocol. Therefore, not only the timing method (manual stopwatch vs. automatic timer) but also the starting protocol (standing vs. moving start) require consideration in the study of gait speed measurement.

One disadvantage of measurement by the beam-breaking system described by the authors is an enlarged fanning effect in participants with wide-based gait or veering tendency.¹¹) To compensate for this problem, assessment of trunk movement with the sensor facing the participant’s trunk rather than the side of the ankle has been proposed. However, this method requires some consideration. First, in the moving start method, the automatic measurement equipment is located in front of the end of walking, which may interfere with regular straight walking. Moreover, measurement of gait speed using longitudinal one-dimensional light detection and ranging technology requires a linear distance of about 10 m within the measurable range, imposing a space limitation in the clinical setting. The clinical utility of this equipment will be enhanced with troubleshooting of these issues in further studies.