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Center of pressure characteristics from quiet standing measures to predict the risk of falling in older adults: a protocol for a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Falling is the most common accident of daily living and the second most prevalent cause of accidental death in the world. The complex nature of risk factors associated with falling makes those at risk amongst the elderly population difficult to identify. Commonly used clinical tests have limitations when it comes to reliably detecting the risk of falling, but existing laboratory tests, such as force platform measurements, represent one method of overcoming this lack of a test. Despite their widespread use, however, Center of Pressure (COP) signal analysis techniques vary and there is currently no consensus on which features should be used diagnostically. Our objective is to identify, through a systematic review and meta-analysis, the COP characteristics of older adults (??60?years old) during quiet bipedal stance which will allow fallers to be distinguished from non-fallers. METHODS:The systematic review will include both prospective and retrospective articles. Five databases will be searched: PubMed, Cochrane CENTRAL, EMBASE, and ScienceDirect. In addition, a search of gray literature will be performed using Google Scholar and ClinicalTrials.gov. Searches will be circumscribed to include only older adults (aged over 60?years) who underwent a bipedal quiet standing measure of their balance and for whom the number of falls was reported. Two authors will independently assess the risk of bias for each included article using a 26-item checklist. Funnel plots will be drawn to attest of possible publication biases for each COP parameters. The results will be synthesized descriptively and a meta-analysis will be undertaken. When trial methodological heterogeneity is too great for pooling of the data into a meta-analysis, evidence strength will be evaluated using best evidence analysis. DISCUSSION:Despite the numerous advantages of posturography, the diversity of studies exploring balance in older fallers has led to uncertainty regarding the method's ability to reliably identify fall-prone older adults. It is expected that the findings from this systematic review will help clinicians use bipedal quiet standing measures as a diagnostic test and allow researchers to explore COP characteristics to create better models for fall prevention care. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42018098671.

SUBMITTER: Quijoux F

PROVIDER: S-EPMC6731576 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Center of pressure characteristics from quiet standing measures to predict the risk of falling in older adults: a protocol for a systematic review and meta-analysis.

Quijoux Flavien F Vienne-Jumeau Aliénor A Bertin-Hugault François F Lefèvre Marie M Zawieja Philippe P Vidal Pierre-Paul PP Ricard Damien D

Systematic reviews 20190907 1

<h4>Background</h4>Falling is the most common accident of daily living and the second most prevalent cause of accidental death in the world. The complex nature of risk factors associated with falling makes those at risk amongst the elderly population difficult to identify. Commonly used clinical tests have limitations when it comes to reliably detecting the risk of falling, but existing laboratory tests, such as force platform measurements, represent one method of overcoming this lack of a test. ...[more]

PMID: 31493792

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Project description:The control of posture, as in quiet upright standing, is distributed among postural reflexes and higher (cortical) centers. According to the theory of "intermittent control," the control of posture involves a rapid succession of brief periods of postural stability, during which the body dwells relatively motionless in a particular posture, and postural instability, during which the body rapidly transits to a new stable point. This theory assumes a combination of stiffness control, keeping the body in the same position, and top-down ballistic control, moving the body to a new reference position. We tested the prediction that exerting ballistic control consumes more attention, relative to stiffness control, using variations in reaction time as our index of attention load. Slower reactions to external stimulus events were expected if these events happen to coincide with ballistic control regimes compared to stiffness regimes, as unveiled from local features of the posturogram. Thirty-two participants stood on a force plate, and were instructed to press a hand-held button as soon as they heard a stimulus tone. About 40 stimuli were presented at random instances during a 3-min trial. Postural control regimes were characterized using sway-density analysis for each stimulus-response interval, by computing local dwell times from the corresponding center-of-pressure samples. We correlated stimulus-response durations with the corresponding local dwell times, and also with local velocity and local eccentricity (distance from the origin). As predicted, an overall negative correlation was observed, meaning that shorter dwell times are associated with longer stimulus-response intervals, as well as a positive correlation with local center-of-pressure velocity. The correlation between reaction times and local eccentricity was not significant. Thus, by mapping stimulus-response intervals to local center-of-pressure features we demonstrated attentional fluctuations in the control of quiet upright standing, thereby validating a core assumption underlying the notion of intermittent postural control.

Dataset Information

Center of pressure characteristics from quiet standing measures to predict the risk of falling in older adults: a protocol for a systematic review and meta-analysis.

Publications

Center of pressure characteristics from quiet standing measures to predict the risk of falling in older adults: a protocol for a systematic review and meta-analysis.

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