Systematic review of candidate prognostic factors for falling in older adults identified from motion analysis of challenging walking tasks

European Review of Aging and Physical Activity

Review Article

Rosemary Dubbeldam¹  Yu Yuan Lee¹  Juliana Pennone²  Luis Mochizuki²  Charlotte Le Mouel³ 

[1] Department of Movement Science, Institute of Sport and Exercise Science, University of Münster, Münster, Germany;School of Arts, Sciences, and Humanities, University of São Paulo and School of Medicine, University of São Paulo, Sao Paulo, Brazil;Université Paris Cité, Université Paris Saclay, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, Paris, France;

关键词: Fall risk prediction;    Ageing;    Walking;    Stairs;    Obstacles;    Perturbations;    Motion analysis;   

DOI  :  10.1186/s11556-023-00312-9

 received in 2022-06-16, accepted in 2023-01-27,  发布年份 2023

来源: Springer

【 摘 要 】

The objective of this systematic review is to identify motion analysis parameters measured during challenging walking tasks which can predict fall risk in the older population. Numerous studies have attempted to predict fall risk from the motion analysis of standing balance or steady walking. However, most falls do not occur during steady gait but occur due to challenging centre of mass displacements or environmental hazards resulting in slipping, tripping or falls on stairs. We conducted a systematic review of motion analysis parameters during stair climbing, perturbed walking and obstacle crossing, predictive of fall risk in healthy older adults. We searched the databases of Pubmed, Scopus and IEEEexplore.A total of 78 articles were included, of which 62 simply compared a group of younger to a group of older adults. Importantly, the differences found between younger and older adults did not match those found between older adults at higher and lower risk of falls. Two prospective and six retrospective fall history studies were included. The other eight studies compared two groups of older adults with higher or lower risk based on mental or physical performance, functional decline, unsteadiness complaints or task performance. A wide range of parameters were reported, including outcomes related to success, timing, foot and step, centre of mass, force plates, dynamic stability, joints and segments. Due to the large variety in parameter assessment methods, a meta-analysis was not possible. Despite the range of parameters assessed, only a few candidate prognostic factors could be identified: older adults with a retrospective fall history demonstrated a significant larger step length variability, larger step time variability, and prolonged anticipatory postural adjustments in obstacle crossing compared to older adults without a fall history. Older adults who fell during a tripping perturbation had a larger angular momentum than those who did not fall. Lastly, in an obstacle course, reduced gait flexibility (i.e., change in stepping pattern relative to unobstructed walking) was a prognostic factor for falling in daily life. We provided recommendations for future fall risk assessment in terms of study design.In conclusion, studies comparing older to younger adults cannot be used to explore relationships between fall risk and motion analysis parameters. Even when comparing two older adult populations, it is necessary to measure fall history to identify fall risk prognostic factors.

【 授权许可】

CC BY   
© The Author(s) 2023

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