Do older adults present altered pelvic and trunk movement pattern during gait? A systematic review with meta-analysis and GRADE recommendations

Abstract

BackgroundCognitive, sensory, and biomechanical factors may affect gait of older adults. Among biomechanical factors, reduced pelvis and trunk range of motion (ROM) were associated with slower gait speed, shorter step length, and increased susceptibility to fall in older adults. ObjectiveTo systematically review the studies that compared trunk and pelvic movement during gait among adults and older adults. MethodsElectronic search was conducted on MEDLINE, EMBASE, and Cinahl from inception until May 2020. Studies that compared trunk and/or pelvis kinematics during gait between adults and older adults were included. The following data were extracted from studies: gait speed, walking surface, and pelvis trunk ROM during gait in the three planes of motion. Meta-analyses were calculated for slow, comfortable, and fast gait speeds using random effects models. GRADE determined the strength of evidence. ResultsTwelve studies were included in this review. There was moderate-quality evidence that older adults have reduced pelvic rotation ROM at comfortable speed (SMD = −0.90 [−1.35, −0.45]) and high-quality evidence that older adults also have reduced pelvic rotation ROM at fast walking speed (SMD = −1.55 [−3.43, −0.33]). In addition, there was low-quality evidence that older adults have reduced trunk rotation at fast walking speed (SMD = −0.63 [−1.23, −0.03]). There were no differences for pelvic and trunk movement in the sagittal and frontal planes. ConclusionThere is low to high quality of evidence that older adults walk with less pelvic rotation ROM in comfortable and fast walking speeds, and less trunk rotation ROM during fast walking speed.