从静立测量的中心压力特征预测老年人跌倒风险：系统评价和荟萃分析的方案。
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.
机构信息
CNRS, UMR 8257 Cognition and Action Group, Paris, France.
Orpéa Group, Puteaux, France.
出版信息
Syst Rev. 2019 Sep 7;8(1):232. doi: 10.1186/s13643-019-1147-9.
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.
背景
跌倒（falling）是日常生活中最常见的意外事故，也是世界上第二大常见的意外死亡原因。与跌倒相关的风险因素复杂多样，这使得老年人中的高危人群难以识别。常用的临床测试在可靠检测跌倒风险方面存在局限性，但现有的实验室测试（如力台测量）代表了克服这一测试不足的一种方法。然而，尽管它们被广泛使用，但中心压力（Center of Pressure，COP）信号分析技术存在差异，目前尚无共识确定应使用哪些特征进行诊断。我们的目标是通过系统回顾和荟萃分析，确定老年人（≥60 岁）在安静双足站立时的 COP 特征，以便将跌倒者与非跌倒者区分开来。
方法
系统回顾将包括前瞻性和回顾性文章。将在五个数据库中进行搜索：PubMed、Cochrane CENTRAL、EMBASE 和 ScienceDirect。此外，还将使用 Google Scholar 和 ClinicalTrials.gov 进行灰色文献搜索。搜索将限定为仅包括接受过双足安静站立平衡测量且报告跌倒次数的老年人（年龄超过 60 岁）。两名作者将使用 26 项清单独立评估纳入文章的偏倚风险。将绘制漏斗图以证明每个 COP 参数可能存在发表偏倚。结果将进行描述性综合，并进行荟萃分析。当试验方法学异质性太大而无法将数据汇总进行荟萃分析时，将使用最佳证据分析评估证据强度。
讨论
尽管姿势描记术有许多优点，但探索老年跌倒者平衡的研究多样性导致了对该方法可靠识别易跌倒老年人能力的不确定性。预计这项系统综述的结果将帮助临床医生将双足安静站立测量作为诊断测试，并使研究人员能够探索 COP 特征，以创建更好的跌倒预防护理模型。
系统综述注册
PROSPERO CRD42018098671。
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