Gait Speed Test And Falls Risk Screening: What Is The 4 Meter Gait Speed Test?

In this article, we outline the importance of the gait speed test as a falls risk screening assessment. We explain what the test measures in detail, as well as how to set up and complete it. Indicating mobility and walking ability, gait speed is a simple yet powerful predictor of falls risk, functional decline, and early mortality.

Falls are one of the most common and serious health risks for older adults and those with chronic conditions. More than 37 million falls annually are severe enough to require medical attention, according to data from the World Health Organization. One in four adults aged 65 and older in the US experience a fall each year, costing the healthcare system approximately $50 billion annually, according to the CDC.

Key takeaways: The 4 Meter Gait Speed test

This test measures the time it takes for a patient to walk 4 meters, offering insights into mobility, balance, and overall functional health.
A walking speed below 0.8 m/s for individuals aged 65+ indicates high falls risk and increased mortality, necessitating targeted interventions.
The gait speed test metric alone is not enough to classify a patient’s risk of falls. NICE guidelines recommend multifactorial assessment (both subjective and objective) to guide intervention for patients at risk of falling in hospitals.
The combination of measuring grip strength, gait speed, lower limb strength, and balance provides a comprehensive approach to objective falls risk assessment.
Able Assess is the first platform to combine these four key indicators of falls risk in one solution.

What is a Gait Speed Test?

Gait speed measures the time it takes for a patient to walk a set distance, usually 4 meters, offering insights into mobility, balance, and overall functional status. It is a simple yet powerful predictor of falls risk, functional decline, and early mortality.

This assessment is crucial for evaluating an individual’s risk of falls or other adverse health events. Gait speed can also help identify older adults at high risk of early mortality, particularly those with speeds slower than 0.8 m/s, enabling targeted evaluations of modifiable health risks (Studenski et al., 2011).

Research indicates a strong relationship between walking speed and frailty, serving to highlight the need for preventive strategies (Navarrete-Villanueva et al., 2021). Furthermore, changes in gait speed over time can reveal patterns indicative of increased mortality risk, allowing for better monitoring of health trajectories (White et al., 2013).

The 4 meter gait speed test exhibits excellent test-retest and interobserver reliability, making it a preferred tool in interventional trials for frail populations (Kon et al., 2013). Whilst there are several tests for assessing gait and balance impairment, the use of gait speed has been recommended for risk stratification especially for predicting falls risk, due to its predictive ability and simplicity (Montero-Odesso et al., 2022).

How Does the 4 Meter Gait Speed Test Work?

The following is a step-by-step guide to how the 4 meter gait speed test works using Able Assess, our falls risk screening platform. It times how many seconds a patient takes to walk 4 meters, with below average scores indicating a risk of falls.

Our digital solution measures the gait speed test reliably and accurately. The control of the test can be carried out by an individual, or by an assessor on their behalf:

Choose the ‘Gait Speed Test’ option in the Able Assess app and collect the items you will need for the test: the GripAble sensor, its accompanying waist bag, and the turquoise tape provided.
Find a clear walkway and roll out the 4 meter long tape. Squeeze the GripAble sensor until a blue light turns on.
Place the GripAble sensor into the pocket of the belt bag provided and fasten the bag around your waist, buckling it at the front with the GripAble positioned on your lower back
To start the test, while standing, press ‘Ready’ on the screen to begin the assessment and when you hear the beep, start walking. Walk to the end of the tape at a comfortable pace.
Click the ‘Test Complete’ button after reaching the end of the tape. The GripAble device saves your data.

The results are compared to normative data for the patient’s age and biological sex. A walking speed below 0.8 m/s for individuals aged 65+ indicates high falls risk and increased mortality, necessitating targeted interventions.

More Falls Risk Screening Measurements in Able Assess

Able Assess also captures three other integral measurements to help assess the risk of falls. Other key measurements available in the app that screen for the risk of falls include:

Grip strength

Grip strength is measured using a hand dynamometer. It is a vital biomarker for senior care. Measuring full-body strength and physiological reserve, it is a very important assessment in falls risk screening. It is a core measure of functional health, reflecting muscle strength, bone density and balance, but also a key indicator of biological resilience for many chronic conditions.

Assessment: Single maximum grip strength test (SMGT): Measuring grip strength involves administering a SMGT, which assesses peak grip strength by recording the maximum force exerted in a single grip.

Dynamic balance

Measurements of balance and functional mobility are extensively used in falls risk assessments to predict mobility impairments, frailty, and falls risk.

Assessment: Timed up and go (TUG) test: Assessing mobility as the patient stands up from a chair, walks to a line three meters away, turns, walks back and sits down again. An older adult taking more than 12 seconds to complete the TUG is at risk of falling, as per the CDC’s STEADI initiative.

Lower limb strength

Lower body strength is critical for mobility, balance, and independence in daily activities. It is widely used in rehabilitation and preventative care settings to enable early identification of at-risk individuals, promoting interventions that enhance functional independence and reduce falls risk.

Assessment: 30 second chair-to-stand (CTS) test: Counting the number of times a patient can reach a full standing position from a seated chair in half a minute. Below average scores indicate a risk of falls, as per the CDC’s STEADI initiative.

For more details, read out comprehensive guide: Able Assess as a Falls Risk Assessment Solution.

This video shows sample results from a patient at risk of falling. In this case, it is indicated by a below average score in the chair-to-stand test:

Able Assess: The Only Platform With Four Key Falls Risk Assessments

One test alone should not be used in isolation to identify patients at high risk of falls. The NICE guidelines recommend multifactorial assessment and intervention for patients at risk of falling in hospitals. Read our key takeaways for clinical practice in the NICE guidelines: falls prevention 2025 updates.

The Able Assess Falls Risk Screening platform is the first and only solution worldwide that is able to capture all four integral measurements accurately. However, the combination of measuring grip strength, lower limb strength, gait speed, and balance provides a comprehensive approach to falls risk assessment.

Able Assess delivers accurate, reliable and sensitive data for better decision-making. It measures the gait speed test, a measure of mobility and walking ability that is extensively used in falls risk assessments to predict mobility impairments, frailty, and falls risk. In addition, it measures the TUG test, 30 second chair-to-stand test (CTS), and the single maximum grip strength test (SMGT).

Able Care has designed the first falls risk screening tool that empowers every clinical and non-clinical staff member to deliver a standardized, objective, low-cost, data driven assessment in under five minutes. It combines the best-in-class GripAble sensor with a user-friendly app, clinician-facing web portal and robust data model.