Abstract
Falling is the second most prevalent cause of accidental death in the world. Currently available clinical tests to assess balance in older people are insufficiently sensitive to screen for fall risk in this population. Laboratory tests that record the center of pressure (COP) trajectory could overcome this problem but despite their widespread use, the choice of COP trajectory features for use as a biomarker of fall risk lacks consensus. This systematic review and meta-analysis aimed at identifying the best COP characteristics to predict risk of falling in older adults. More than 4000 articles were screened; 44 (7176 older adults) were included in this study. Several COP parameters emerged as good indices to discriminate fallers from non-fallers. From sensitivity analysis, Sway area per unit time, anteroposterior mean velocity, and radial mean velocity were the best traditional features. In this study, identification of older people with a high fall risk was demonstrated using quiet-standing recordings. Such screening would also be useful for routine follow-up of balance changes in older fallers in clinical practice.
Highlights
Falls in older people are a major issue, representing one of the main causes of injury deaths in this age-group (“WHO global report on falls prevention in older age,” 2008)
Intrinsic precipitating causes include a past history of falls (Gerdhem et al, 2005), dementia (Scherder et al, 2007), degeneration and lesions of the visual, vestibular and proprioceptive systems (Goble et al, 2009), gait and balance disorders (Seidler et al, 2010), sarcopenia (Landi et al, 2012), and other musculoskeletal modifications (Álvarez Barbosa et al, 2016; Kinney, 2004), all of which can lead to instabilities in different contexts (Bock and Schneider, 2002; Horak, 2006; Li et al, 2018)
18 studies reported the number of falls and the center of pressure (COP) features computed for each group of participants
Summary
Falls in older people are a major issue, representing one of the main causes of injury deaths in this age-group (“WHO global report on falls prevention in older age,” 2008). Reduced independence increases anxiety, social isolation, psychomotor problems related to the fall, and the subsequent development of any otherwise preventable chronic diseases that result from the traumatic consequences that limit physical activity (Lee et al., 2007; Pereira et al, 2008). Intrinsic precipitating causes include a past history of falls (Gerdhem et al, 2005), dementia (Scherder et al, 2007), degeneration and lesions of the visual, vestibular and proprioceptive systems (Goble et al, 2009), gait and balance disorders (Seidler et al, 2010), sarcopenia (Landi et al, 2012), and other musculoskeletal modifications (Álvarez Barbosa et al, 2016; Kinney, 2004), all of which can lead to instabilities in different contexts (Bock and Schneider, 2002; Horak, 2006; Li et al, 2018)
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