Reliability of the 400-M Usual-Pace Walk Test as an Assessment of Mobility Limitation in Older Adults

Authors

  • Yves M. Rolland MD,

    1. From the *Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaService de Médecine Interne et de Gérontologie Clinique (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France.
    Search for more papers by this author
  • Matteo Cesari MD,

    1. From the *Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaService de Médecine Interne et de Gérontologie Clinique (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France.
    Search for more papers by this author
  • Michael E. Miller PhD,

    1. From the *Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaService de Médecine Interne et de Gérontologie Clinique (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France.
    Search for more papers by this author
  • Brenda W. Penninx PhD,

    1. From the *Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaService de Médecine Interne et de Gérontologie Clinique (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France.
    Search for more papers by this author
  • Hal H. Atkinson MD,

    1. From the *Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaService de Médecine Interne et de Gérontologie Clinique (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France.
    Search for more papers by this author
  • Marco Pahor MD

    1. From the *Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaService de Médecine Interne et de Gérontologie Clinique (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France.
    Search for more papers by this author

  • This study was supported by Claude Pepper Older Americans Independence Center National Institutes of Health—National Institute on Aging Grant P30AG021332-01.

Address correspondence to Yves Rolland, MD, 12 grande rue Saint Jacques, 31450 Montesquieu, Lauragais, France. E-mail: yves.rolland@9online.fr

Abstract

Objectives: To assess the test-retest reliability of the 400-m usual-pace walk test (400-MWT), and to determine whether the 4-m walk test predicts inability to walk 400 m.

Design: Observational.

Setting: Community, 20-m tract course.

Participants: Sixty study participants (aged≥65) were enrolled from the community and met the following eligibility criteria: self-reported difficulty in two or more of four functional domains (mobility and exercise tolerance, upper extremity function, basic self-care, higher functional tasks of independent living) and a score of 18 or higher on the Mini-Mental State Examination.

Methods: The 400-MWT and 4-m walk test were each repeated within 7 days.

Results: The mean age±standard deviation of the study population was 84.3±6.3; 88.3% were women. Nineteen participants (31.7%) failed both 400-MWTs, and 41 successfully completed both tests (kappa=1). Mean walking speed for the 4-m test was 0.87±0.18 m/s for those who completed the 400-MWT and 0.53±0.17 m/s for those who failed (P<.001). The Spearman correlation coefficient between 4-m and 400-m walking speeds was 0.93. The estimated area under the receiver operating characteristic curve between 4-m walking speed and the ability to perform the 400-MWT was 0.91. The 4-m gait speed averaged less than 0.6 m/s in 80% of subjects who failed the 400-MWT.

Conclusion: The test-retest reliability for inability to complete the 400-MWT is high. Four-m walking speed is highly predictive of ability to perform the 400-MWT. These findings may prove useful to future clinical trials and observational studies that involve assessment of mobility limitations in older adults.

Ancillary