Time a 40-foot walk while reciting letters, and compare with published fall-risk cut-offs.
The Walking While Talking Test checks how well someone walks while their mind is busy, the kind of divided attention that is part of everyday life. It was developed at Albert Einstein College of Medicine in the Bronx, takes about 10 minutes with practice, and needs a stopwatch and tape.
Stand close enough to help, keep the area clear and stop if the person feels dizzy, unsteady or has pain. Use a gait belt if your setting calls for one.
This is a measurement, not a diagnosis. The Walking While Talking Test shows how walking changes when the mind is busy. It can’t tell you why, or what treatment is needed. Results should be reviewed with a physical therapist or another licensed health care provider who examines the person.
Reference values, not pass/fail rules. The numbers below come from specific published study groups. Use them as a guide alongside your own examination.
Sources. Shirley Ryan AbilityLab, Rehabilitation Measures Database: Walking While Talking Test (cost: free). Verghese J, Buschke H, Viola L, et al. Validity of divided attention tasks in predicting falls in older individuals: a preliminary study. J Am Geriatr Soc. 2002;50(9):1572-1576. Verghese J, Holtzer R, et al. Mobility stress test approach to predicting frailty, disability, and mortality in high-functioning older adults. J Am Geriatr Soc. 2012;60(10):1901-1905. Brandler TC, Oh-Park M, et al. Walking while talking: investigation of alternate forms. Gait Posture. 2012;35(1):164-166. Instructions on this page are written in our own words. Holsman Physical Therapy is not affiliated with these organizations, and they do not endorse this website.
Next step: Bring this printout to your next visit, or attach it to your referral. Holsman physical therapists treat balance, strength and walking problems at 17 clinics in North Jersey, the Bronx and Brooklyn, plus in-home visits. Request an appointment or call 1-855-465-7626. No referral needed to start with most plans; we verify your insurance free.
The Walking While Talking Test (WWT) times a short walk, 20 feet out, a turn and 20 feet back, while the person says the alphabet out loud (simple version) or every other letter (complex version). It tests how well someone can divide attention between walking and thinking.
No. In the “stops walking when talking” test, the tester starts a conversation during a longer walk and notes whether the person stops walking. The WWT is timed.
In community-living older adults without dementia, 20 seconds or longer on the simple version and 33 seconds or longer on the complex version predicted falls over the next 12 months (Verghese et al., 2002). Both cut-offs were very specific but missed many people who fell.
Vary the starting letter of the complex version between trials (for example A, B, M or N), as Brandler and colleagues (2012) did.
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