Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis

British Journal of Sports Medicine - Tập 51 Số 7 - Trang 586-593 - 2017
Yoshiro Okubo1,2,3, Daniel Schoene4, Stephen R. Lord1,2,5
1Falls and Balance Research Group
2Neuroscience Research Australia, University of New South Wales
3The Japan Society for the Promotion of Science
4Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg
5School of Public Health and Community Medicine, University of New South Wales

Tóm tắt

ObjectiveTo examine the effects of stepping interventions on fall risk factors and fall incidence in older people.Data sourceElectronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015.Study selectionRandomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors.ResultsMeta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, p<0.0001, I2=0%) and the proportion of fallers (risk ratio=0.51, 95% CI 0.38 to 0.68, p<0.0001, I2=0%). Subgroup analyses stratified by reactive and volitional stepping interventions revealed a similar efficacy for rate of falls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36–416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (p<0.05), but not measures of strength.ConclusionsThe findings indicate that both reactive and volitional stepping interventions reduce falls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required.Systematic reviews registration numberCRD42015017357.

Từ khóa


Tài liệu tham khảo

10.1093/aje/kwi023

10.2188/jea.10.1sup_90

10.1159/000212543

10.1136/ip.2005.011015

10.1002/14651858.CD007146.pub3

10.1111/j.1532-5415.2008.02014.x

10.1071/NB10056

10.1016/S0003-9993(96)90085-4

10.1016/0006-8993(93)90188-S

10.1093/gerona/58.1.M46

10.2522/ptj.20140090

10.1136/bmj.b2700

10.1186/1471-2318-12-74

10.1371/journal.pone.0057734

10.1007/BF03324655

10.1093/gerona/63.1.76

10.1007/BF03324743

10.1111/ggi.12011

10.1111/psyg.12017

10.1016/j.apmr.2011.10.027

10.1016/j.gaitpost.2006.09.010

10.1093/gerona/glu087

10.1007/s10439-011-0477-0

10.1111/jgs.12453

10.1186/1471-2318-13-49

10.2522/ptj.20090070

10.1097/01.PHM.0000130025.54168.91

10.1016/j.jesf.2012.04.002

10.1249/JES.0000000000000023

10.1016/j.jelekin.2007.06.004

10.1093/gerona/57.8.M496

10.1016/j.jbiomech.2004.03.029

10.1093/gerona/56.10.M627

10.1371/journal.pone.0040297

Ferrucci, 1997, Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study, J Gerontol A Biol Sci Med Sci, 52, M275, 10.1093/gerona/52A.5.M275

10.1016/S0140-6736(12)61263-X

10.1111/j.1532-5415.2005.53455.x

Thông tin
Thông tin xuất bản

British Journal of Sports Medicine

Tập 51 Số 7

586-593

Thông tin tác giả