Abstract 262: Speed and Distance Requirements for Community Ambulation: A Systematic Review

Abstract

Introduction: People with chronic conditions, such as stroke, commonly experience walking limitations and require rehabilitation services to optimize ability. Speed and distance requirements for walking around common community sites would help patients and health care professionals gauge readiness for community ambulation and set realistic goals relevant to activities patients wish to perform. Objective: To synthesize the research literature on speed and distance requirements for adults walking outside the home. Methods: A systematic review was conducted to identify full text peer-reviewed articles written in English, French or Spanish reporting distance and/or speed requirements for walking outside the home. Eight electronic databases (PubMed, MEDLINE, EMBASE, CINAHL, Scopus, PEDro, ProQuest® digital dissertations and The Cochrane Library ) were searched until August 2011. The principal investigator’s library and reference lists of included studies were also reviewed. Two authors independently reviewed titles and abstracts. One reviewer determined inclusion and extracted data. A second reviewer independently verified data accuracy. Stakeholders and decision-makers from the physical therapy community were consulted throughout the course of the review to guide the team with respect to the review question, interpretation of results and message creation. Results: Six English-language studies (5 in the United States and 1 in Singapore) were included. In the American studies, community sites were measured in 26 cities/towns. Across all studies, 27 unique community sites were investigated. Sites most frequently examined include: banks, supermarkets, department stores, drugstores, post offices and physican’s offices. Superstores and club warehouses required the greatest average walking distance of 606.6 metres (m) and 676.8 m, respectively. In four studies that examined common sites using the same protocol, the average walking distance was highest for supermarkets, department stores and drugstores (Range 129-380 m) and lowest for banks, physican’s offices and post offices (Range 38-98 m). Walking distance requirements appeared to substantially increase with population size for some sites (supermarkets, department stores, drugstores and post offices) but not others (banks, physican’s offices). The median speed required to cross the street was lowest in rural areas (0.74 metres/second (m/s)) and highest in cities (1.06 m/s). Conclusions: In conclusion, our findings suggest that retail sites have the highest walking distance requirements and that site distances increase with population size. Walking speed requirements for crosswalks also appear to increase with population size. Clients and health professionals may use findings to help establish practical rehabilitation goals and to determine readiness for community ambulation.