Gait speed as a functional vital sign in musculoskeletal physiotherapy: Normative values, clinical thresholds, and digital measurement.

Abstract

Walking (or gait) speed is recognised as a robust indicator of health status, functional capacity, and physiological reserve across the lifespan; however, its objective measurement remains underused in routine musculoskeletal physiotherapy practice. This commentary argues that gait speed is underutilised in musculoskeletal physiotherapy despite its strong prognostic and functional relevance, and proposes its cautious adoption as a functional vital sign to support more objective, standardised, and interpretable rehabilitation decision making. Evidence from an orthopaedic population undergoing total hip and knee arthroplasty illustrates the persistent gap between surgical success and functional recovery, as reflected in sustained deficits in walking speed relative to healthy benchmarks. Methodological issues in gait speed assessment are considered, and the potential future role of wearable sensors and digital health technologies in capturing real-world locomotor performance is highlighted. Overall, the evidence suggests that gait speed can provide an objective, lowcost, and scalable measure that integrates multiple domains of musculoskeletal function. Therefore, the routine integration of gait speed into physiotherapy assessment may help to quantify functional impairment, support personalised rehabilitation, reduce practice variation, and align musculoskeletal care with contemporary adaptive and digitally enabled healthcare models.