Reliability of the 400-m usual pace walk test as an assessment of mobility limitation in older adults
Open accessAbstract
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.
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A gait speed lower than 0.6 ms-1 predicted the probability (>80%) of not performing a 400-meter test.
“Indeed, a gait speed lower then 0.6 ms-1 predicted the probability (>80%) of not performing a 400-meter test (49).”
The LDCW has previously been shown to have prognostic value for prevalent subclinical cardiovascular disease and for all-cause and cardiovascular mortality, cardiovascular events, and functional limitation over 4-6 years.
“Previously, we demonstrated the prognostic value of the LDCW for identifying prevalent subclinical cardiovascular disease (26) and all-cause and cardiovascular mortality, cardiovascular events and functional limitation over 4-6 years (27).”
From Mobility Limitation in Self-Described Well-Functioning Older Adults: Importance of Endurance Walk Testing (2008) · cites this paper as [27]
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“Inability to complete this test in 15 min is accepted as an early clinical manifestation of the disability cascade [23, 24].”
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- Authors
- Rolland, Y. M., Cesari, M., Miller, M. E., Penninx, B. W., Atkinson, H. H., & Pahor, M.
- Affiliations
- Wake Forest University Health Sciences (US)
- Hôpital de La Grave (FR)
- Corresponding author
- Rolland, Yves M.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2004-05-24
- Volume
- 52
- Issue
- 6
- Pages
- 972-976
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1570598499
- Cited by
- 194
- References
- 17
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 9 · 2023: 15 · 2022: 4 · 2021: 14 · 2020: 11 · 2019: 15 · 2018: 11 · 2017: 10 · 2016: 9 · 2015: 12 · 2014: 10 · 2013: 5 · 2012: 11
- FWCI
- 11.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P30AG021332)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- test-retest reliability, walking speed, mobility limitations, older adults, gait analysis, functional capacity
- MeSH terms
- Aged, Aged, 80 and over, Disability Evaluation, Female, Humans, Male, Predictive Value of Tests, Reproducibility of Results, Geriatric Assessment, Walking, Exercise Tolerance
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