Stepping impairment and falls in older adults: A systematic review and meta-analysis of volitional and reactive step tests

Okubo Y, Schöne D, Caetano MJ, Pliner EM, Osuka Y, Toson B, Lord SR (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

Ageing Research Reviews Elsevier

Book Volume: 66

Article Number: 101238

DOI: 10.1016/j.arr.2020.101238

Abstract

Objective: To systematically examine stepping performance as a risk factor for falls. More specifically, we examined (i) if step tests can distinguish fallers from non-fallers and (ii) the type of step test (e.g. volitional vs reactive stepping) that is required to distinguish fallers from non-fallers. Data source: PubMed, EMBASE, CINAHL, Cochrane Database of Systematic Reviews and reference lists of included articles. Study selection: Cross-sectional and cohort studies that assessed the association between at least one step test and falls in older people (age ≥ 60 and/or mean age of 65). Results: A meta-analysis of 61 studies (n = 9536) showed stepping performance was significantly worse in fallers compared to non-fallers (Cohen'sd 0.56, 95 % CI 0.48 to 0.64, p < 0.001, I2 66 %). This was the case for both volitional and reactive step tests. Twenty-three studies (n = 3615) were included in a diagnostic meta-analysis that showed that step tests have moderate sensitivity (0.70, 95 % CI 0.62 to 0.77), specificity (0.68, 95 % CI 0.58 to 0.77) and area under the receiver operating characteristics curve (AUC) (0.75, 95 % CI 0.59 to 0.86) in discriminating fallers from non-fallers. Conclusions: This large systematic review demonstrated that both volitional and reactive stepping impairments are significant fall risk factors among older adults. Step tests can identify fallers from non-fallers with moderate accuracy.

Authors with CRIS profile

Daniel Schöne Lehrstuhl für Medizinische Physik und Mikrogewebetechnik (IMP)

Involved external institutions

Neuroscience Research Australia NeuRA AU Australia (AU) Tokyo Metropolitan Institute of Gerontology JP Japan (JP)

How to cite

APA:

Okubo, Y., Schöne, D., Caetano, M.J., Pliner, E.M., Osuka, Y., Toson, B., & Lord, S.R. (2021). Stepping impairment and falls in older adults: A systematic review and meta-analysis of volitional and reactive step tests. Ageing Research Reviews, 66. https://doi.org/10.1016/j.arr.2020.101238

MLA:

Okubo, Yoshiro, et al. "Stepping impairment and falls in older adults: A systematic review and meta-analysis of volitional and reactive step tests." Ageing Research Reviews 66 (2021).

BibTeX: Download